Procalcitonin: A Diagnostic Marker of Bacterial Infection in Neutropenic Cancer Patients with Fever?

Bont, Esjm de; Vellenga, Edo; Swaanenburg, Jcjm; Kamps, WA

doi:10.1007/s150100070014

Cited by 43 publications

(5 citation statements)

References 3 publications

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“…In addition to the studies reporting high PCT levels in bacteremia ( Giamarellou et al , 2004 ; Jimeno et al , 2004 ; von Lilienfeld-Toal et al , 2006 ; Schuttrumpf et al , 2006 ), there are studies defending just the opposite. de Bont et al (2000) reported that PCT level showed no difference between bacteremia/sepsis group and the group with unknown fever among the patients with neutropenic fever but that there was significant difference in terms of CRP level.…”

Section: Discussionmentioning

confidence: 95%

Procalcitonin and C-reactive protein in differantiating to contamination from bacteremia

Öksüz¹,

Somer²,

Salman³

et al. 2014

Braz. J. Microbiol.

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Procalcitonin (PCT) and C-reactive protein (CRP) are important biological markers used in the diagnosis of severe infections. The aim of this study was to evaluate the consistency of blood culture with PCT and CRP in differentiating contamination and non-bacteremia from true bacteremia. In this study blood samples were obtained from 809 febrile patients and analyzed using BACTEC 9120 system. All of positive blood cultures were performed Gram staining. The microorganisms were identified with conventional methods and automated systems. Antibiotic susceptibility tests were made by disc diffusion. PCT levels were analyzed by mini VIDAS device and PCT kit. PCT and CRP levels were analyzed with blood cultures in same times. Kruskal Wallis test, Mann-Whitney U test, Spearman’s rho test and ROC curve were used for statistical analyses. The bacteremia group was found to be significantly different from non-bacteremia group and contamination group in terms of both PCT and CRP (p<0.0001). The p values of PCT and CRP in differentiating bacteremia from non-bacteremia were p<0.001 for PCT, p=0.002 for CRP and in differentiating bacteremia from contamination were p<0.001 for PCT, p<0.001 for CRP. PCT is a more useful marker than CRP in the differentiating of true bacteremia from contamination according to the results of this study.

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Section: Discussionmentioning

confidence: 95%

Procalcitonin and C-reactive protein in differantiating to contamination from bacteremia

Öksüz¹,

Somer²,

Salman³

et al. 2014

Braz. J. Microbiol.

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“…Although Svaldi et al [17] reported that PCT levels did not significantly differ whether gram-negative or gram-positive bacteria were present when leukocyte count was <1.0x109/L, PCT levels were found to be higher in bacteremic patients than nonbacteremic patients and were more rapidly decreased in nondocumented infections in the studies of Akçay [13] and Secmeer et al [18]. Nevertheless, de Bont et al [19] reported similar levels of initial PCT levels at the onset of fever in bacteremic and nonbacteremic patients in a cohort of 66 patients. In the same study, cases with coagulase-negative staphylococci bacteremia were found not to have significant rises in PCT levels.…”

Section: Discussionmentioning

confidence: 99%

Early Changes of Mannose-Binding Lectin, H-Ficolin, and Procalcitonin in Patients with Febrile Neutropenia: A Prospective Observational Study

S¹,

Saltoğlu²,

Balkan

et al. 2016

Tjh

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Objective:The significance of mannose-binding lectin (MBL) and H-ficolin deficiency in febrile neutropenic (FN) patients and the correlation of these markers along with consecutive C-reactive protein (CRP) and procalcitonin (PCT) levels during the infectious process are investigated.Materials and Methods:Patients with any hematological malignancies who were defined to have “microbiologically confirmed infection”, “clinically documented infection”, or “fever of unknown origin” were included in this single-center prospective observational study. Serum levels of CRP, PCT, MBL, and H-ficolin were determined on 3 separate occasions: at baseline (between hospital admission and chemotherapy), at the onset of fever, and at the 72nd hour of fever.Results:Forty-six patients (54% male, mean age 41.7 years) with 61 separate episodes of FN were evaluated. Eleven patients (23.9%) had “microbiologically confirmed infection”, 17 (37%) had “clinically documented infection”, and 18 (39.1%) had “fever of unknown origin”. Fourteen (30.4%) patients had low (<500 ng/mL) initial MBL levels and 7 (15.21%) had low (<12,000 ng/mL) H-ficolin levels. Baseline MBL and H-ficolin levels did not significantly change on the first and third days of fever (p=0.076). Gram-negative bacteremia more frequently occurred in those with low initial MBL levels (p=0.006). PCT levels were significantly higher in those with microbiologically documented infections. Mean and median PCT levels were significantly higher in cases with bacteremia. There was no significant difference between hemoculture-positive and-negative patients in terms of CRP levels.Conclusion:Monitoring serum H-ficolin levels was shown to be of no benefit in terms of predicting severe infection. Low baseline MBL levels were correlated with high risk of gram-negative bacteremia; however, no significant correlation was shown in the follow-up. Close monitoring of PCT levels is warranted to provide more accurate and specific data while monitoring cases of bacteremia.

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“…Infection and Drug Resistance 2023:16 results showed that PCT was sensitive and specific for the prediction of bacteremia, in accordance with the previous studies. 2,[41][42][43][44][45] Engel et al 46 measured the peak PCT levels after 32 hours after the onset of fever in over 75% of febrile episodes. In the case of procalcitonin, it was impossible to confirm the antibiotic treatment's mitigating effect alone.…”

Section: Dovepressmentioning

confidence: 99%

Characteristics, Outcomes, and Clinical Indicators of Bloodstream Infections in Neutropenic Patients with Hematological Malignancies: A 7-Year Retrospective Study

Wang¹,

Song²,

Song³

et al. 2023

IDR

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The aim of this study was to investigate the current epidemiology, its changes during the study years, and inflammatory biomarkers of bacterial bloodstream infections (BSIs) in neutropenic patients with hematological malignancies. We assessed mortality risk factors and multidrug-resistant (MDR) gram-negative BSI predictors. Patients and Methods:We conducted a retrospective study from January 2015 to December 2021, which included adult neutropenic oncohematological patients with confirmed BSIs. We used univariable and multivariable analyses to analyze the risk factors. Each index's reliability for bacterial BSI diagnosis was assessed using the receiver-operating characteristic curve and area under the curve. Results: A total of 514 isolates were obtained from the 452 patients. The average mortality was 17.71%. Gram-negative organisms were the predominant causes of BSI. Escherichia coli was the most common microorganism (49.90%). The overall variation trend of the isolation rate of MDR and carbapenem-resistant gram-negative bacteria increased. Multivariate analysis indicated that: 1) neutropenia that lasted for more than 7 days, patients ≥ 60 years of age, septic shock, hospitalization for >20 days, BSI with a carbapenem-resistant strain, and treatment with linezolid or vancomycin in infections lasting less than 30 days were independent mortality risk factors; 2) severe neutropenia exceeding 7 days, unreasonable empirical therapy, and receipt of aminoglycosides or 3rd or 4th generation cephalosporins in infections lasting less than 30 days were independent risk factors of MDR gram-negative bacteria. Procalcitonin, absolute neutrophil count, and white blood cell indicate higher diagnostic accuracy for BSIs. Moreover, bacteria time to detection was better at differentiating Gram-negative and Gram-positive bacterial infections. Conclusion:We analyzed the risk factors for BSI neutropenic patients with hematological malignancies, the distribution of bacteria, antibiotic resistance, and the changes in clinical parameters. This single-center retrospective study may provide clinicians with novel insights into the diagnosis and treatment of BSI to improve future clinical outcomes.

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Procalcitonin: A Diagnostic Marker of Bacterial Infection in Neutropenic Cancer Patients with Fever?

Cited by 43 publications

References 3 publications

Procalcitonin and C-reactive protein in differantiating to contamination from bacteremia

Procalcitonin and C-reactive protein in differantiating to contamination from bacteremia

Early Changes of Mannose-Binding Lectin, H-Ficolin, and Procalcitonin in Patients with Febrile Neutropenia: A Prospective Observational Study

Characteristics, Outcomes, and Clinical Indicators of Bloodstream Infections in Neutropenic Patients with Hematological Malignancies: A 7-Year Retrospective Study

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