Low Levels of Procalcitonin or Presepsin Combined with Significantly Elevated C‐reactive Protein May Suggest an Invasive Fungal Infection in Hematological Patients With Febrile Neutropenia

Stoma, Igor; Karpov, Igor; Uss, Anatoly; Krivenko, Svetlana; Искров, И. А.; Миланович, Н. Ф.; Vlasenkova, Svetlana; Лендина, И. Ю.; Belyavskaya, Kristina; Charniak, Veranika

doi:10.1097/hs9.0000000000000170

Cited by 6 publications

(8 citation statements)

References 23 publications

(34 reference statements)

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“…Children with signs and symptoms of bacterial infections or pneumonia had elevated PCT levels [ 13 ]. The PCT level ≥ 0.5 µg/l (500 pg/l) was reported significant in children with severe bacterial pneumonia [ 13 ] and the level in patients with invasive fungal infection was not increased in Stoma et al [ 14 ]. C reactive protein is an acute-phase protein that increased in any inflammatory condition and in patients with invasive fungal infections [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Significance of biomarkers in stewardship program in pediatric patients infected with Aspergillus species

et al. 2022

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Background The potential use of biomarkers in the diagnosis of fungal infections is a challenge. The aim of this study was to evaluate the role of a biomarker-guided antifungal stewardship program for hospitalized pediatrics suffering from invasive aspergillosis (IA). Methods Pediatric patients with suspected probable or proven IA were enrolled in this study. Demographic data were collected from their records. Clinical samples were examined by wet mount KOH smear, culture, galactomannan Ag test, and real-time PCR. Patients’ sera were evaluated for procalcitonin (PCT) and soluble-triggering receptor expressed on myeloid cells -1 (sTREM-1) levels by ELISA Kits. Results A total of 73 children were entered in this study with a mean age of 5 years and the male to female ratio 39/34. The most predisposing factors were hematologic disorders (71.2%). The area under the curves (95% confidence interval) for each biomarker were 0.9 (0.85% to 97%) for lactate de hydrogenase (LDH), 0.9 (0.85% to 0.94%) for C-reactive protein, 0.8 (0.75% to 0.84%) for PCT, 0.8 (0.73% to 0.85%) for erythrocyte sedimentation rate, 0.7 (0.6% to 0.8%) for sTREM-1, and 0.5 (0.45% to 0.58%) for white blood cell count. During the study period, 27.4% patients died. The LDH and sTREM-1 levels were significant increase in died patient (p < 0.05). Conclusions According to our data, evaluation of biomarkers along with radiologic and clinical signs and symptoms of pediatric patients can lead to proper antifungal therapy and decreased side effects, antifungal resistance, and cost. The combined measurements could be better than a single marker in the prediction of IA.

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Section: Discussionmentioning

confidence: 99%

Significance of biomarkers in stewardship program in pediatric patients infected with Aspergillus species

et al. 2022

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“…There are publications on an increased level of CRP and a low level of PCT in adult hematological patients with fungal infection in the study of the etiology of febrile neutropenia. 41 The levels of PCT and CRP have not been studied in patients without signs of infection. This study design was chosen due to the need to distinguish etiological factors of infectious complications in oncology and hematology.…”

Section: Discussionmentioning

confidence: 99%

“…13 There are publications on the results of an increased level of CRP and a low level of PCT in adult hematological patients with fungal infection in the study of the etiology of febrile neutropenia. 14 The determination of galactomannan in body fluids was identified in 2002 by the EORTC/MSG as a diagnostic criterion that was evaluated in value as equal to the isolation of fungi of the genus Aspergillus or microscopic detection of hyphae from potentially sterile loci. Galactomannan test, together with clinical and radiological studies, complements the diagnosis of IA.…”

Section: Introductionmentioning

confidence: 99%

The use of biomarkers in the diagnostics of fungal infections complications in children with oncological and hematological diseases

Kandaurava¹,

Tchernovetski²,

Алейникова³

2021

JMEN

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Background and purpose: Patients with hematological malignancies are at risk of fungal infections and require quick diagnostics infection complications. The following study aimed to evaluate the effectiveness and relevance of the use of biomarkers of procalcitonin (PCT), C-reactive protein (CRP), galactomannan (GM), and bis (methylthio) gliotoxin (BMGT) in the diagnosis of fungal infections in patients with oncological and hematological diseases. Materials and methods:The prospective study was conducted at the Belarusian Research Center for Pediatric Oncology, Hematology, and Immunology from April 2015 to January 2020. The study included 66 children with malignant hematological diseases aged 1 to 17 years. Clinical, microbiological, and statistical methods were used in the study. Results:In the case of fungemia in children with oncological and hematological diseases, the PCT level during the infectious episode was significantly lower than with bacterial infections of the bloodstream (p = 0.0063); and the СРR level in cases of fungal and bacterial infections did not differ significantly (p = 0.1719). Diagnostic study of GM in bronchoalveolar lavage had a high predictive value of a negative result (91.7%). The method's sensitivity was higher than in the study of GM in serum (50% versus 0%). There was no correlation between serum BMGT levels as measured by HPLC and the presence of invasive aspergillosis in children. Conclusion:An increase in СRP levels with normal PCT levels in immunocompromised children with clinical signs of bloodstream infection is indicative of a fungal etiology of the disease. Determination of the optical density index of galactomannan in the bronchoalveolar fluid is a sensitive marker for diagnosing invasive pulmonary aspergillosis in children. We cannot recommend BMGT for the diagnostics of invasive aspergillosis in children.

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“…and it is represented as a vector where every component is a physical measurement that captures a salient aspect (e.g., the distance between the hands, the speed of hand movements, etc.). After such a process, each video is converted into a sequence of feature vectors that can be modelled with Long Short Term Memory Networks [36], one of the most common models for the classification of sequential data. Given the computational issues resulting from training such networks, the sequence of feature vectors is segmented into non-overlapping windows that account for roughly 4.25 seconds (every window corresponds to 128 feature vectors).…”

Section: Plos Onementioning

confidence: 99%

The School Attachment Monitor—A novel computational tool for assessment of attachment in middle childhood

et al. 2021

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Background Attachment research has been limited by the lack of quick and easy measures. We report development and validation of the School Attachment Monitor (SAM), a novel measure for largescale assessment of attachment in children aged 5–9, in the general population. SAM offers automatic presentation, on computer, of story-stems based on the Manchester Child Attachment Story Task (MCAST), without the need for trained administrators. SAM is delivered by novel software which interacts with child participants, starting with warm-up activities to familiarise them with the task. Children’s story completion is video recorded and augmented by ‘smart dolls’ that the child can hold and manipulate, with movement sensors for data collection. The design of SAM was informed by children of users’ age range to establish their task understanding and incorporate their innovative ideas for improving SAM software. Methods 130 5–9 year old children were recruited from mainstream primary schools. In Phase 1, sixty-one children completed both SAM and MCAST. Inter-rater reliability and rating concordance was compared between SAM and MCAST. In Phase 2, a further 44 children completed SAM complete and, including those children completing SAM in Phase 1 (total n = 105), a machine learning algorithm was developed using a “majority vote” procedure where, for each child, 500 non-overlapping video frames contribute to the decision. Results Using manual rating, SAM-MCAST concordance was excellent (89% secure versus insecure; 97% organised versus disorganised; 86% four-way). Comparison of human ratings of SAM versus the machine learning algorithm showed over 80% concordance. Conclusions We have developed a new tool for measuring attachment at the population level, which has good reliability compared to a validated attachment measure and has the potential for automatic rating–opening the door to measurement of attachment in large populations.

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Low Levels of Procalcitonin or Presepsin Combined with Significantly Elevated C‐reactive Protein May Suggest an Invasive Fungal Infection in Hematological Patients With Febrile Neutropenia

Cited by 6 publications

References 23 publications

Significance of biomarkers in stewardship program in pediatric patients infected with Aspergillus species

Significance of biomarkers in stewardship program in pediatric patients infected with Aspergillus species

The use of biomarkers in the diagnostics of fungal infections complications in children with oncological and hematological diseases

The School Attachment Monitor—A novel computational tool for assessment of attachment in middle childhood

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