Procalcitonin as an early marker of bacterial infection in neutropenic febrile children with acute lymphoblastic leukemia

Abstract

Serial measurement of PCT levels on a daily basis seems to be helpful for early prediction of severe bacterial infections, monitoring febrile episodes regarding response to antibiotic therapy, and early detection of complications in the infectious process.

Perbedaan Skor Sepsis Modifikasi Tollner dan Kadar Procalsitonin Serum Sebelum dengan Setelah Pemberian Antibiotik Empiris pada Sepsis Neonatorum

“…[10][11][12] Tujuan penelitian ini adalah menentukan perbedaan skor sepsis modifikasi Tollner dan kadar PCT serum sebelum dengan setelah mendapat antibiotik empiris, serta korelasi perubahan skor sepsis dengan perubahan kadar PCT serum pasca pemberian antibiotik empiris pada sepsis neonatorum.…”

Sepsis in Children

“…More importantly, in children with duration of fever <8 hours, PCT was the biomarker with the highest predictive value. CRP and PCT may also be useful in predicting bacterial infection in patients with fever and neutropenia [27,28].…”

“…They found a highly significant difference in PCT levels between bacterial and nonbacterial episodes. Sensitivity and specificity of PCT were 94 and 96.5%, respectively [27]. In a study by Samransamruajkit and colleagues, they investigated the prognostic value of initial plasma N-terminal (NT) pro-B-type Natriuretic Peptide (BNP) and procalcitonin in children.…”

Immune regulation of procalcitonin: a biomarker and mediator of infection

“…Further, Linscheid and colleagues [35] were unable to detect production of PTC mRNA in LPS-activated macrophages or in freshly isolated PBMC, yet a transient expression could be induced following monocytes adhesion [36]. Several investigators showed an increased serum PCT in neutropenic patients [37][38][39], as well as immunodeficient patients [40,41], emphasizing an indispensable role for hematopoietic cells in induction of PCT. The fact that leukopenia had no influence on the rise of PCT on admission to day 2 for sepsis patients with immunosuppression may confirm these conclusions [42].…”

“…Both clinical and animal studies have confirmed that a straight LPS injection induces production of PCT in the blood stream [44][45][46], and several investigators have revealed that the addition of LPS to in vitro cell culture can lead to the cellular induction of PCT [29]. Although the highest level of blood PCT ([10 ng/ml) is mainly induced by gram-negative bacteria versus gram-positive bacteria [38,47], LPS is clearly not the only molecule with the capacity to induce PCT production, since gram-positive bacteria lacking LPS can also provoke massive PCT stimulation [48,49]. Can bacterial components, such as DNA, fimbriae or peptidoglycans stimulate PCT release?…”