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Open Access 01-10-2011 | Original Article

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

Authors: Karin G. E. Miedema, 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

Published in: Supportive Care in Cancer | Issue 10/2011

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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Title: The diagnostic value of CRP, IL-8, PCT, and sTREM-1 in the detection of bacterial infections in pediatric oncology patients with febrile neutropenia
Authors: Karin G. E. Miedema
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
Publication date: 01-10-2011
Publisher: Springer-Verlag
Published in: Supportive Care in Cancer / Issue 10/2011
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-010-0987-6

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