| Autor: |
Stoma I; a Department of Infectious Diseases , Belarusian State Medical University , Minsk , Belarus.; b Minsk Scientific Practical Center of Surgery, Transplantation and Hematology , Minsk , Belarus., Karpov I; a Department of Infectious Diseases , Belarusian State Medical University , Minsk , Belarus., Uss A; b Minsk Scientific Practical Center of Surgery, Transplantation and Hematology , Minsk , Belarus., Krivenko S; b Minsk Scientific Practical Center of Surgery, Transplantation and Hematology , Minsk , Belarus., Iskrov I; b Minsk Scientific Practical Center of Surgery, Transplantation and Hematology , Minsk , Belarus., Milanovich N; b Minsk Scientific Practical Center of Surgery, Transplantation and Hematology , Minsk , Belarus., Vlasenkova S; b Minsk Scientific Practical Center of Surgery, Transplantation and Hematology , Minsk , Belarus., Lendina I; b Minsk Scientific Practical Center of Surgery, Transplantation and Hematology , Minsk , Belarus., Belyavskaya K; b Minsk Scientific Practical Center of Surgery, Transplantation and Hematology , Minsk , Belarus., Cherniak V; b Minsk Scientific Practical Center of Surgery, Transplantation and Hematology , Minsk , Belarus. |
| Abstrakt: |
Background: Invasive fungal infections are a major threat to a large cohort of immunocompromised patients, including patients with chemotherapy-associated neutropenia. Early differential diagnosis with bacterial infections is often complicated, which leads to a delay in empirical antifungal therapy and increases risk for adverse outcome. Accessibility and performance of specific fungal antigen and PCR-tests are still limited, while sepsis biomarkers are more broadly used in most settings currently. Methods: Haematological patients hospitalized to receive chemotherapy with proven or probable invasive fungal infection or microbiologically proven bacterial bloodstream infection were included in the study. C-reactive protein was assessed daily during the profound neutropenia period, while procalcitonin or presepsin were measured during the first 48 hours after the onset of febrile episode. Results: There were totally 64 patients included in the study, 53 with bacterial bloodstream infections and 11 with invasive fungal infections. Combination of CRP >120 with PCT <1.25 or presepsin <170 was shown to be a possible combined biomarker for invasive fungal infections in immunocompromised patients, with areas under the ROC-curves: 0.962 (95% CI 0.868 to 0.995) for PCT-based combination and 0.907 (95% CI 0.692 to 0.990) for presepsin-based combination. |
