Interleukin-6, interleukin-8, and a rapid and sensitive assay for calcitonin precursors for the determination of bacterial sepsis in febrile neutropenic children

Stryjewski, Glenn; Nylen, Eric; Bell, Michael J.; Snider, Richard H.; Becker, Kenneth L.; Wu, Amy; Lawlor, Christopher; Dalton, Heidi

doi:10.1097/01.pcc.0000149317.15274.48

Cited by 85 publications

(59 citation statements)

References 42 publications

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“…It is therefore not surprising that we found a significant difference in serum NGAL concentration between critically ill children with SIRS versus septic shock, even in the absence of AKI. In this regard, serum NGAL may also be a marker of MODS, similar to C-reactive protein, procalcitonin, or interleukin (IL)-6 (36,37). Future studies are needed to address this question further, but it is tempting to speculate that serum NGAL could be used as a biomarker of severity of illness in critically ill children with septic shock and MODS.…”

Section: Discussionmentioning

confidence: 99%

Serum neutrophil gelatinase-associated lipocalin (NGAL) as a marker of acute kidney injury in critically ill children with septic shock

Wheeler

Devarajan²,

Ma³

et al. 2008

Critical Care Medicine

300

182

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Objective-To validate serum neutrophil gelatinase-associated lipocalin (NGAL) as an early biomarker for acute kidney injury (AKI) in critically ill children with septic shock.Design-Observational cohort study. Setting-15 North American pediatric intensive care units (PICU).Patients-A total of 143 critically ill children with SIRS or septic shock and 25 healthy controls. Interventions-None.Measurements and Main Results-Serum NGAL was measured during the first 24 hours of admission to the PICU. AKI was defined as a blood urea nitrogen (BUN) concentration > 100 mg/ dL, serum creatinine > 2 mg/dL in the absence of pre-existing renal disease, or the need for dialysis. There was a significant difference in serum NGAL between healthy children (median 80 ng/mL, IQR 55.5-85.5 ng/mL), critically ill children with SIRS (median 107.5 ng/mL, IQR 89-178.5 ng/mL), and critically ill children with septic shock (median 302 ng/mL, IQR 151-570 ng/mL; p<0.001). AKI developed in 22 out of 143 (15.4%) critically ill children. Serum NGAL was significantly increased in critically ill children with AKI (median 355 ng/mL, IQR 166-1322 ng/mL) compared to those without AKI (median 186 ng/mL, IQR 98-365 ng/mL; p=0.009).Conclusions-Serum NGAL is a highly sensitive, but nonspecific predictor of AKI in critically ill children with septic shock. Further validation of serum NGAL as a biomarker of AKI in this population is warranted.

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Section: Discussionmentioning

confidence: 99%

Serum neutrophil gelatinase-associated lipocalin (NGAL) as a marker of acute kidney injury in critically ill children with septic shock

Wheeler

Devarajan²,

Ma³

et al. 2008

Critical Care Medicine

300

182

View full text Add to dashboard Cite

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“…Recently, plasma concentrations of acute phase proteins and cytokines have been proposed as diagnostic tools in febrile neutropenia . In addition, recent studies also indicate that a risk assessment model using clinical features in combination with a diagnostic biochemical parameter, such as the plasma interleukin-8 (IL-8), interleukin-6 (IL-6), procalcitonin (PCT) levels may be more helpful for selection of high-risk patients [16,19,20]. It has been demonstrated that plasma levels of IL-6 and IL-8 increase, even before elevation of the acute phase proteins in neutropenic patients' bacterial infections [13,19,22,24].…”

Section: Introductionmentioning

confidence: 99%

Cytokine concentrations are not predictive of bacteremia in febrile neutropenic patients

Büyükberber¹,

Büyükberber

Sevinç

et al. 2008

Med Oncol

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Assay of cytokines and C reactive protein (CRP) in different periods of febrile neutropenia may be helpful for early defining the risk in severe infections. We determined serum interleukin-6 (IL-6), interleukin-8 (IL-8), soluble interleukin-2 receptor (sIL-2R), tumor necrosis factor alpha (TNF-alpha), interleukin-1 beta (IL-1beta), and CRP in 22 previously untreated patients with various malignancies. Samples were obtained in four different clinical periods of febrile neutropenia; prior to chemotherapy, afebrile neutropenic period after chemotherapy, febrile neutropenic period, and recovery period. When compared to sex-and age-matched group of healthy subjects, IL-6, IL-8, sIL-2R, and CRP levels were found to be elevated in all periods. The highest levels were encountered in the febrile neutropenic period. For predictivity purposes, the afebrile neutropenic period was the most important period. Serum sIL-2R, IL-6, IL-8 and CRP levels were elevated in this period. IL-8 levels showed the most stable elevation through different stages of febrile neutropenia. Serum IL-8 levels were found to have the most reliable and stable elevation in different clinical stages of febrile neutropenia. Nevertheless, IL-8 is not able to discriminate among risk groups and cannot be used as a predictive factor.

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“…Although high C-reactive protein (CRP) values pointed at a bacterial infection, the interleukin (IL)-8 levels in serum remained normal on repeated testing [Oude Nijhuis et al, 2002]. Since IL-8 levels increase frequently during bacterial infection [Stryjewski et al, 2005], the initial symptoms at presentation can be attributed mainly to the sapovirus infection in both patients. The profound depletion of T CD4 lymphocytes, seen commonly in patients treated with chemotherapy [Lehrnbecher et al, 1997], likely has contributed to the susceptibility of the patients to viral infection.…”

Section: Resultsmentioning

confidence: 94%

Sapovirus as a gastrointestinal pathogen in febrile pediatric patients with cancer

Moser

Lück

Dilloo

et al. 2011

Journal of Medical Virology

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Human caliciviruses are the second most common cause of viral gastroenteritis after rotavirus in children. Unlike norovirus, sapovirus infection is less well characterized and defined in the clinical setting of gastrointestinal disease, and there are no reports of sapovirus infections in pediatric oncology patients receiving chemotherapy treatment. Stool samples from all pediatric oncology patients presenting with fever and diarrhea at one pediatric oncology unit were tested prospectively for sapovirus by real-time reverse transcription-PCR sapovirus genogrouping was performed by nested PCR. Sapovirus was detected in 2 of 100 stool specimens prospectively sampled from 58 symptomatic pediatric oncology inpatients between December 2008 and September 2009. Both patients received low-dose chemotherapy for their underlying conditions at the time of infection with sapovirus. Genogrouping of the viruses showed the presence of a GI.1 strain and GII.3 strain, unlike the most common GI.2 strain responsible for outbreaks in different European countries. The contribution of sapovirus infection to the morbidity of pediatric cancer patients and its potential for nosocomial spread is discussed. Sapovirus, an often unrecognized pathogen, should be considered along with other viruses in pediatric cancer patients suffering from gastrointestinal disease.

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Interleukin-6, interleukin-8, and a rapid and sensitive assay for calcitonin precursors for the determination of bacterial sepsis in febrile neutropenic children

Cited by 85 publications

References 42 publications

Serum neutrophil gelatinase-associated lipocalin (NGAL) as a marker of acute kidney injury in critically ill children with septic shock

Serum neutrophil gelatinase-associated lipocalin (NGAL) as a marker of acute kidney injury in critically ill children with septic shock

Cytokine concentrations are not predictive of bacteremia in febrile neutropenic patients

Sapovirus as a gastrointestinal pathogen in febrile pediatric patients with cancer

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