Procalcitonin as an early marker of bacterial infection in neutropenic febrile children with acute lymphoblastic leukemia
Procalcitonin as an early marker of bacterial infection in neutropenic febrile children with acute lymphoblastic leukemia
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DOI：
10.1007/s00011-009-0100-0
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发表时间：
2010-05-01
影响因子：
6.7
通讯作者：
Catriu, Dorothea
中科院分区：
文献类型：
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作者：
Hatzistilianou, Maria;Rekliti, Aleka;Catriu, Dorothea
本研究旨在探讨降钙素原(PCT)、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-a)、白介素1b(IL-1b)、白介素8(IL-8)和可溶性肿瘤坏死因子受体II(STNFRII)在急性淋巴细胞白血病(ALL)患儿感染早期快速诊断中的价值，以及细菌感染与病毒感染的鉴别。A组和B组分别为中性粒细胞减少合并细菌和病毒感染的儿童。C组和D组分别由非中性粒细胞减少的细菌和病毒感染的儿童组成。E组为无中性粒细胞减少和不发热的儿童，入院时采血，每日采血7天。检测所有血样中的CRP、PCT、TNF-a、IL-1b、IL-8和sTNFRII水平，发现PCT水平在细菌性和非细菌性之间有非常显著的差异。PCT的敏感性和特异性分别为94%和96.5%，每日连续测定PCT水平似乎有助于早期预测严重细菌感染，监测有关抗生素治疗的发热事件，以及早期发现感染过程中的并发症。
The aim of this study was to assess the value of procalcitonin (PCT), C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-a), interleukin (IL)-1b, IL-8, and soluble TNF receptor II (sTNFRII) in early and rapid diagnosis of infection in neutropenic children with acute lymphoblastic leukemia (ALL) and to distinguish bacterial from viral infections.The study included five groups (A, B, C, D, and E) of children with ALL undergoing intensive chemotherapy. Groups A and B consisted of neutropenic children with bacterial and viral infection, respectively. Groups C and D consisted of nonneutropenic children with bacterial and viral infection, respectively. Group E consisted of children without neutropenia and without fever.In all groups, blood samples were collected upon admission and then for 7 days on a daily basis. Levels of CRP, PCT, TNF-a, IL-1b, IL-8, and sTNFRII were determined in all blood samples.We found a highly significant difference in PCT levels between bacterial and nonbacterial episodes. Sensitivity and specificity of PCT were 94 and 96.5%, respectively.Serial measurement of PCT levels on a daily basis seems to be helpful for early prediction of severe bacterial infections, monitoring febrile episodes regarding response to antibiotic therapy, and early detection of complications in the infectious process.