Diagnostic accuracy of Interleukin-6, Interleukin-8 and Interleukin-10 for predicting bacteremia in children with febrile neutropenia

Bal, Zümrüt Şahbudak; Özdemir, Nihal; Şen, Semra; Karapınar, Deniz Yılmaz; Azarsız, Elif; Aydemir, Şöhret; Vardar, Fadıl

doi:10.4274/tjh.2016.0434

Cited by 11 publications

(10 citation statements)

References 10 publications

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“…At a cut-off value of 170 pg/ml, IL-8 correlated with all cases of gram-positive bacteraemia and 6/7 of gram-negative bacteraemia. Our result is consistent with recent evidence correlating IL-8 with bacteraemia in paediatric haematological patients, especially in Gram-negative bacteraemia 18–21…”

Section: Discussionsupporting

confidence: 93%

Comparison of Presepsin, Procalcitonin, Interleukin-8 and C-Reactive Protein in Predicting Bacteraemia in Febrile Neutropenic Adult Patients With Haematological Malignancies

Kostić

Gurrieri

Piva

et al. 2019

Mediterr J Hematol Infect Dis

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Bacterial infections represent life-threatening complications in patients with febrile neutropenia (FN). Biomarkers of infections may help to differentiate bacteraemia from non-bacteraemia FN. We aimed to evaluate the utility of procalcitonin (PCT), presepsin (PS), C-reactive protein (CRP) and interleukin-8 (IL-8) as biomarkers of bacteraemia in adult FN patients with haematological malignancies. Thirty-six FN episodes experienced by 28 oncohematological patients were considered. 11 out of 36 episodes were classified as bacteraemia. PCT was the best biomarker to predict bacteraemia with area under the curve (AUC) ROC of 0,9; while the most sensitive was IL-8 (90,9%) with AUC ROC of 0,88. All patients with PCT concentrations above 1,6 μg/l had bacteraemia. Patients with IL-8 concentrations > 170 pg/ml or PS concentrations superior then 410 pg/ml had 40 times and 24 times higher risk for bacteraemia, respectively. PCT remains better than IL-8 and PS in predicting bacteraemia in adult hematological patients with FN.

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Section: Discussionsupporting

confidence: 93%

Comparison of Presepsin, Procalcitonin, Interleukin-8 and C-Reactive Protein in Predicting Bacteraemia in Febrile Neutropenic Adult Patients With Haematological Malignancies

Kostić

Gurrieri

Piva

et al. 2019

Mediterr J Hematol Infect Dis

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“…Sixteen of these (41.6%) found significant associations between elevated CRP and bacterial infection, either microbiologically or clinically confirmed. Moreover, 14/16 significant studies provided predictive data with various cutoff values (range: 5–120 mg/L) ( 6 , 9 , 31 , 33 , 35 , 37 , 39 , 40 , 48 , 53 , 55 , 62 , 63 , 74 ).…”

Section: Resultsmentioning

confidence: 99%

“…Two studies report the predictive data. Sahbudak et al ( 62 ) reported a sensitivity of 92.9% and specificity of 44.4% for a cutoff of 5.04 pg/ml in predicting a bacterial infection.…”

Section: Resultsmentioning

confidence: 99%

Biomarkers for Diagnosing Febrile Illness in Immunocompromised Children: A Systematic Review of the Literature

2022

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ObjectiveThis study aims to assess the performance of biomarkers used for the prediction of bacterial, viral, and fungal infection in immunocompromised children upon presentation with fever.MethodsWe performed a literature search using PubMed and MEDLINE and In-Process & Other Non-indexed Citations databases. Cohort and case–control studies assessing biomarkers for the prediction of bacterial, viral, or fungal infection in immunocompromised children vs. conventional microbiological investigations were eligible. Studies including adult patients were eligible if pediatric data were separately assessable. Data on definitions used for infections, fever, and neutropenia and predictive values were collected. Risk of bias was assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool.ResultsFifty-two studies involving 13,939 febrile episodes in 7,059 children were included. In total, 92.2% were in cancer patients (n = 48), and 15.7% also included hematopoietic stem cell transplantation patients (n = 8). Forty-three biomarkers were investigated, of which 6 (CRP, PCT, IL-8, IL-6, IL-10, and TNFα) were significantly associated with bacterial infection at admission, studied in multiple studies, and provided predictive data. Literature on the prediction of viral and fungal infection was too limited. Eight studies compared C-reactive protein (CRP) and procalcitonin (PCT), with PCT demonstrating superiority in 5. IL-6, IL-8, and IL-10 were compared with CRP in six, four, and one study, respectively, with mixed results on diagnostic superiority. No clear superior biomarker comparing PCT vs. IL-6, IL-8, or IL-10 was identified.DiscussionThere is great heterogeneity in the biomarkers studied and cutoff values and definitions used, thus complicating the analysis. Literature for immunocompromised children with non-malignant disease and for non-bacterial infection is sparse. Literature on novel diagnostics was not available. We illustrated the challenges of diagnosing fever adequately in this study population and the need for improved biomarkers and clinical decision-making tools.

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“…Interleukin-10, an anti-inflammatory cytokine, has a crucial role in limiting the immune response to infection thereby preventing inflammation and excessive damage to the host (22) Several groups have previously identified prognostic values for IL-10 for prediction of bacteraemia, either on its own in FN in children (23)(24)(25)(26) or in combination with PCT in FN in adult patients (27). However, the vast majority of these data are generated from small, single centre studies that have investigated the various markers in isolation.…”

Section: Discussionmentioning

confidence: 99%

Procalcitonin and Interleukin-10 May Assist in Early Prediction of Bacteraemia in Children With Cancer and Febrile Neutropenia

et al. 2021

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ObjectivesFebrile neutropenia (FN) causes treatment disruption and unplanned hospitalization in children with cancer. Serum biomarkers are infrequently used to stratify these patients into high or low risk for serious infection. This study investigated plasma abundance of cytokines in children with FN and their ability to predict bacteraemia.MethodsThirty-three plasma cytokines, C-reactive protein (CRP) and procalcitonin (PCT) were measured using ELISA assays in samples taken at FN presentation (n = 79) and within 8–24 h (Day 2; n = 31). Optimal thresholds for prediction of bacteraemia were identified and the predictive ability of biomarkers in addition to routinely available clinical variables was assessed.ResultsThe median age of included FN episodes was 6.0 years and eight (10%) had a bacteraemia. On presentation, elevated PCT, IL-10 and Mip1-beta were significantly associated with bacteraemia, while CRP, IL-6 and IL-8 were not. The combination of PCT (≥0.425 ng/ml) and IL-10 (≥4.37 pg/ml) had a sensitivity of 100% (95% CI 68.8–100%) and specificity of 89% (95% CI 80.0–95.0%) for prediction of bacteraemia, correctly identifying all eight bacteraemia episodes and classifying 16 FN episodes as high-risk. There was limited additive benefit of incorporating clinical variables to this model. On Day 2, there was an 11-fold increase in PCT in episodes with a bacteraemia which was significantly higher than that observed in the non-bacteraemia episodes.ConclusionElevated PCT and IL-10 accurately identified all bacteraemia episodes in our FN cohort and may enhance the early risk stratification process in this population. Prospective validation and implementation is required to determine the impact on health service utilisation.

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Diagnostic accuracy of Interleukin-6, Interleukin-8 and Interleukin-10 for predicting bacteremia in children with febrile neutropenia

Cited by 11 publications

References 10 publications

Comparison of Presepsin, Procalcitonin, Interleukin-8 and C-Reactive Protein in Predicting Bacteraemia in Febrile Neutropenic Adult Patients With Haematological Malignancies

Comparison of Presepsin, Procalcitonin, Interleukin-8 and C-Reactive Protein in Predicting Bacteraemia in Febrile Neutropenic Adult Patients With Haematological Malignancies

Biomarkers for Diagnosing Febrile Illness in Immunocompromised Children: A Systematic Review of the Literature

Procalcitonin and Interleukin-10 May Assist in Early Prediction of Bacteraemia in Children With Cancer and Febrile Neutropenia

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