Diagnostic performance of serum high-sensitivity procalcitonin and serum C-reactive protein tests for detecting bacterial infection in febrile neutropenia

Aimoto, Mizuki; Koh, Hideo; Katayama, Takako; Okamura, Hiroshi; Yoshimura, Takuro; Koh, Shiro; Nanno, Satoru; Nishimoto, Mitsutaka; Hirose, Asao; Nakamae, Mika; Nakane, Takahiko; Nakamae, Hirohisa; Kakeya, Hiroshi; Hino, Masayuki

doi:10.1007/s15010-014-0657-6

Cited by 24 publications

(19 citation statements)

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“…[1,6,9,12] E.coli and pseudomonas spp are the most common GN isolates in our center like in earlier reports. [1,3,12] Factors that might predict GN bacteremia included the presences of shock in the patients and prior use of quinones as prophylaxis in afebrile granulocytopenia. [ 9] With the low positivity rate of BC in patients with FN in most centers other biomarkers of bacteremia are now been considered as surrogate for bacteremia in these patients.…”

Section: Discussionsupporting

confidence: 82%

“…High levels of hs-CRP and hs-PCT levels have been reported to be sensitive in detecting bacterial infection in cancer patients with FN (67% and 82% respectively). [12] Von Lilienfeld-Toal et al [13] also reported that hs-PCT of > 1.8 ng/l and IL6 >942pg/l are highly suggestive of bacteremia in those cancer patients with post chemotherapy FN. The findings in this audit support these propositions as the CRP was more significantly higher in those with positive BC.…”

Section: Discussionmentioning

confidence: 98%

“…[6,11] Significant number of the GPC isolated in this audit like those in earlier reports. [6,7,9,12] were coagulase negative staphylococci (50%), and about half were MR (50%).The increase prevalence of MR staphylococci is said to be due to increase use of prophylactic antibiotics especially in non-febrile neutropenic patients. [1,6,9,12] E.coli and pseudomonas spp are the most common GN isolates in our center like in earlier reports.…”

Section: Discussionmentioning

confidence: 99%

“…[6,7,9,12] were coagulase negative staphylococci (50%), and about half were MR (50%).The increase prevalence of MR staphylococci is said to be due to increase use of prophylactic antibiotics especially in non-febrile neutropenic patients. [1,6,9,12] E.coli and pseudomonas spp are the most common GN isolates in our center like in earlier reports. [1,3,12] Factors that might predict GN bacteremia included the presences of shock in the patients and prior use of quinones as prophylaxis in afebrile granulocytopenia.…”

Section: Discussionmentioning

confidence: 99%

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Bacteremia Pattern in Febrile Neutropenia among Adults Cancer Patients Receiving Chemotherapy in an Australia Regional Hospital

Ibrahim¹,

Pang²

2017

ujph

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Background: Febrile neutropenia (FN) remains one of the most concerning complications of cancer chemotherapy, and is a major cause of morbidity and mortality, consuming significant healthcare resource .This audit was carried out to determine the pattern of microbial pathogens responsible for FN in our institution as this will result in the appropriate choice of empirical antibiotic(s) for treatment of FN in the future. Methods: This is a retrospective audit of adult patients with cancer admitted with FN post chemotherapy in Goulburn valley base hospital, Shepparton, Australia between 2011-2013.Only patients who met the diagnostic criteria of FN as defined by the Infectious diseases society of America (IDSA) were included in the audit. Results: Twenty six patients presented with 31 episodes of FN between January 2013 and January 2014. 65 blood cultures (BC) were obtained with an average of 2.5 sets of BC per patients, 10.8% of these were positive. 66.7% of the BC yielded Gram Positive Cocci (GPC) (50% of which were coagulase positive staphylococci), 33.7% of the BC yielded gram negative bacilli (GNB) and 2 yielded multiple organisms. The mean neutrophil count on admission for all the 26 patients was 0.303 ± 0.25/ul. Those with positive BCs had significantly higher hs-CRP with the mean value of 223.83±94.27 mg/l, compared to those with negative BCs with 89.37±79.53 mg/l (t-test = -3.489, p=0.002).The most common malignancies were hematological and breast cancers with 8 patients each. The presumed focus of infection was mostly in the respiratory tract accounting for 42% of the cases. 30.8% of the 26 patients with FN had central venous access device(CVAD) in-situ but all had negative BCs however the odd ratio of developing FN if CVAD is present is high at 4.3(95% CI 1.01-18.0). Conclusions: the prevalence rate of bacteremia in post chemotherapy FN in our center is relatively low and GPC are the most commonly isolated organisms. Our study also support the notion that hs-CRP may be a sensitive biomaker of bacterial infection in cancer patients with post chemotherapy FN as it is significantly

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Bacteremia Pattern in Febrile Neutropenia among Adults Cancer Patients Receiving Chemotherapy in an Australia Regional Hospital

Ibrahim¹,

Pang²

2017

ujph

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“…showed that PCT had additional diagnostic value for detecting bacteremia/sepsis in pediatric patients with febrile neutropenia. However, Aimoto et al . reported that neither PCT nor CRP levels were useful for determining the cause of a fever.…”

Section: Discussionmentioning

confidence: 99%