Diagnostic performance of serum high-sensitivity procalcitonin and serum C-reactive protein tests for detecting bacterial infection in febrile neutropenia
| Autor: | Hiroshi Okamura, Hiroshi Kakeya, Shiro Koh, Hideo Koh, Takako Katayama, Mizuki Aimoto, Takuro Yoshimura, Takahiko Nakane, Satoru Nanno, Hirohisa Nakamae, Mika Nakamae, Asao Hirose, Masayuki Hino, Mitsutaka Nishimoto |
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| Rok vydání: | 2013 |
| Předmět: |
Microbiology (medical)
Adult Calcitonin Male Adolescent Calcitonin Gene-Related Peptide Bacteremia Procalcitonin Young Adult parasitic diseases Medicine Humans Prospective Studies Young adult Protein Precursors Prospective cohort study Aged Febrile Neutropenia biology business.industry Septic shock C-reactive protein General Medicine Middle Aged bacterial infections and mycoses medicine.disease Shock Septic Infectious Diseases C-Reactive Protein ROC Curve Immunology biology.protein Biomarker (medicine) Female business hormones hormone substitutes and hormone antagonists Febrile neutropenia Biomarkers |
| Zdroj: | Infection. 42(6) |
| ISSN: | 1439-0973 |
| Popis: | Although a few prospective studies have addressed the question as to which biomarker of infection in adult patients with febrile neutropenia (FN) is superior, procalcitonin (PCT) or C-reactive protein (CRP), the results have been inconsistent and inconclusive. This was possibly due to the poor sensitivity of previous PCT tests that have a functional sensitivity of 0.5 ng/ml.Between November 2010 and February 2012, we prospectively compared the diagnostic utility of serum high-sensitivity (hs) PCT (lower limit of detection, 0.02 ng/ml) and CRP levels for detecting bacterial infection in patients with FN. Serum was collected within 72 h after the onset of FN in patients with hematological disorders.Seventy-five febrile episodes were evaluable. The areas under the receiver operating characteristic curves for life-threatening infection defined as septic shock and bacteremia caused by non-coagulase negative staphylococcus were 0.824 (95% CI 0.711-0.937; P = 0.001) for hsPCT and 0.673 (0.505-0.842; P = 0.068) for CRP, respectively. In contrast, CRP, but not hsPCT, tended to increase significantly with the clinical severity, as indicated by the diagnostic classification (P = 0.002 for trend).The serum hsPCT test may be more useful than the serum CRP test in the detection of life-threatening infection at an early phase after the onset of FN. In contrast, the serum CRP test may be more useful in diagnosing the severity of infection. However, neither of these tests was able to differentiate the cause of FN with a low probability of fatal outcome. |
| Databáze: | OpenAIRE |
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