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. 2011 Oct;19(10):1593-600.
doi: 10.1007/s00520-010-0987-6. Epub 2010 Aug 28.

The diagnostic value of CRP, IL-8, PCT, and sTREM-1 in the detection of bacterial infections in pediatric oncology patients with febrile neutropenia

Karin G E Miedema  1 , Eveline S J M de Bont, Rob F M Oude Elferink, Michel J van Vliet, Claudi S M Oude Nijhuis, Willem A Kamps, Wim J E Tissing
Affiliations

The diagnostic value of CRP, IL-8, PCT, and sTREM-1 in the detection of bacterial infections in pediatric oncology patients with febrile neutropenia

Karin G E Miedema et al. Support Care Cancer. 2011 Oct.

Abstract

Purpose: In this study, we evaluated C-reactive protein (CRP), interleukin (IL)-8, procalcitonin (PCT), and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) as predictors for bacterial infection in febrile neutropenia, plus their usefulness in febrile neutropenia during chemotherapy-induced gastrointestinal mucositis.

Methods: Plasma was obtained from pediatric oncology patients at presentation with febrile neutropenia (n = 43) and 24-48 h later (n = 17). The patients were classified as having or not having a bacterial infection. Plasma was also obtained of patients in the absence and in the presence of mucositis (n = 26).

Results: At presentation with febrile neutropenia, median IL-8 and PCT levels were significantly increased in patients with a bacterial infection, in contrast to CRP and sTREM-1. IL-8 was the most sensitive marker for the early detection of bacterial infection, in combination with clinical parameters or PCT the sensitivity reached 100%. After 24-48 h, only PCT was significantly elevated during bacterial infection. IL-8 levels were significantly increased during mucositis. Mucositis did not cause considerable changes in PCT levels.

Conclusions: IL-8 is the most useful marker for the early detection of bacterial infections, compared with CRP, PCT, and sTREM-1. IL-8 in combination with clinical parameters or PCT might be even more useful. Gastrointestinal mucositis alone does not affect PCT levels, in contrast to IL-8 levels, and therefore, PCT might be more useful for the detection of bacterial infections during mucositis than IL-8.

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Figures

Fig. 1
Fig. 1
CRP, IL-8, PCT, and sTREM-1 at presentation with febrile neutropenia in patients with and without bacterial infection. The horizontal lines represent the median. sTREM-1 is shown by log 10 at the y-axis, because of the widespread values
Fig. 2
Fig. 2
ROC-curve for CRP, IL-8, and PCT at presentation with febrile neutropenia
Fig. 3
Fig. 3
CRP, IL-8, PCT, and sTREM-1 in the presence and in the absence of mucositis. The horizontal lines represent the median. The markers are shown by log 10 at the y-axis, because of the widespread values
See this image and copyright information in PMC

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References

    1. Bodey GP, Buckley M, Sathe YS, Freireich EJ. Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia. Ann Intern Med. 1966;64:328–340. - PubMed
    1. Hann I, Viscoli C, Paesmans M, Gaya H, Glauser M. A comparison of outcome from febrile neutropenic episodes in children compared with adults: results from four EORTC studies. International Antimicrobial Therapy Cooperative Group (IATCG) of the European Organization for Research and Treatment of Cancer (EORTC) Br J Haematol. 1997;99:580–588. doi: 10.1046/j.1365-2141.1997.4453255.x. - DOI - PubMed
    1. Hughes WT, Armstrong D, Bodey GP, et al. 2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Clin Infect Dis. 2002;34:730–751. doi: 10.1086/339215. - DOI - PubMed
    1. Oude Nijhuis C, Kamps WA, Daenen SM, et al. Feasibility of withholding antibiotics in selected febrile neutropenic cancer patients. J Clin Oncol. 2005;23:7437–7444. doi: 10.1200/JCO.2004.00.5264. - DOI - PubMed
    1. Hodgson-Viden H, Grundy PE, Robinson JL. Early discontinuation of intravenous antimicrobial therapy in pediatric oncology patients with febrile neutropenia. BMC Pediatr. 2005;5:10. doi: 10.1186/1471-2431-5-10. - DOI - PMC - PubMed

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