[Procalcitonin for early diagnosis of bacteraemia in children with cancer].
BACKGROUND
Fever and infections are common complications in children with cancer during chemotherapy. The purpose of this study was to investigate the usefulness of procalcitonin (PCT) in the identification of children with bacteraemia at time of admission with febrile episodes. Furthermore, we compared the usefulness of procalcitonin with that of C-reactive protein (CRP).


METHODS
We evaluated 55 febrile episodes in 34 children in treatment for cancer. We found 24 episodes of bacteraemia and 31 episodes with negative blood cultures.


RESULTS
The median PCT and CRP levels in children with positive blood cultures were significantly higher compared with children with negative blood cultures. The optimum cut-off level to predict bacteraemia was 1 mg/l for PCT and 50 mg/l for CRP. In distinguishing between febrile episodes with and without bacteraemia, PCT was found to have higher positive predictive value and similar negative predictive value as compared to CRP at the optimum cut-off level.


CONCLUSIONS
These results show the potential usefulness of PCT as an early indicator for bacteraemia in febrile children with cancer and furthermore indicate that PCT may be more sensitive than CRP in the assessment of the cause of fever in these children.
Chawes
Bo Lund
BL
Paediatrisk Klinik II og Klinisk Mikrobiologisk Afdeling, Diagnostisk Center. b_chawes@hotmail.com
Rechnitzer
Catherine
C
Schmiegelow
Kjeld
K
Tvede
Michael
M
D000293:Adolescent; D016470:Bacteremia / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002648:Child; D002675:Child, Preschool; D042241:Early Diagnosis; D005260:Female; D005334:Fever / Q000097:blood / Q000175:diagnosis / Q000382:microbiology; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000188:drug therapy / Q000276:immunology* / Q000382:microbiology; D011237:Predictive Value of Tests; D011498:Protein Precursors / Q000097:blood*; D012680:Sensitivity and Specificity
D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide