Journal
JOURNAL OF PEDIATRIC HEMATOLOGY ONCOLOGY
Volume 43, Issue 4, Pages E596-E600Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MPH.0000000000001935
Keywords
children; bloodstream infection; hematology; oncology; inflammatory biomarker
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Funding
- Science and Technology Project from the Science Technology and Innovation Committee of Shenzhen Municipality [JCYJ20170817170110940]
- Sanming Project of Medicine in Shenzhen [SZSM201512033]
- Shenzhen Key Medical Discipline
- Shenzhen Public Service Platform of Molecular Medicine in Pediatric Hematology and Oncology
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The study investigated the clinical significance of CRP, PCT, albumin, fibrinogen, and D-dimer as potential biomarkers for classifying BSIs in pediatric hematology-oncology patients, revealing that PCT levels were significantly lower in neutropenic and Gram-positive BSI episodes. PCT may potentially serve as a biomarker for differentiating between Gram-positive and Gram-negative BSIs in pediatric hematology-oncology patients.
Bloodstream infection (BSI) is a serious complication in pediatric hematology-oncology patients. To evaluate the clinical significance of C-reactive protein (CRP), procalcitonin (PCT), albumin, fibrinogen, and D-dimer as potential biomarkers to differentiate among various subtypes of BSIs in pediatric patients with hematologic and oncologic diseases, we retrieved and analyzed the medical records of pediatric hematology-oncology patients diagnosed with BSI at our hospital between January 2016 and December 2017. The demographic (sex and age) and clinical (primary diseases) characteristics, and laboratory test results (white blood cell and absolute neutrophil counts, and serum CRP, PCT, albumin, fibrinogen, and D-dimer levels) were compared between nosocomial and non-nosocomial; neutropenic and non-neutropenic; and Gram-positive and Gram-negative BSI episodes. A total of 125 BSI episodes were included, including 69 (55.2%) nosocomial cases, 94 (75.2%) neutropenic cases, and 49 (39.2%) Gram-positive episodes. Of the 5 potential biomarkers evaluated (CRP, PCT, albumin, fibrinogen, and D-dimer), PCT levels were significantly lower in neutropenic episodes and Gram-positive BSIs (P=0.008 and P=0.001, respectively). At a cutoff value of 0.67 ng/mL, the diagnostic sensitivity, specificity, and positive/negative predictive values of PCT for the differentiation of Gram-positive and Gram-negative bacterial sepsis were 74.2%, 64.6%, 70.8%, and 65.2%, respectively. We concluded that PCT might potentially serve as a biomarker to differentiate between Gram-positive and Gram-negative BSIs in pediatric hematology-oncology patients.
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