[C reactive protein and procalcitonin levels for the diagnosis of invasive bacterial infections in allogenic hematopoietic stem cell transplantation recipients].
BACKGROUND
The main causes of complications of allogenic hematopoietic stem cell transplantation are infections and graft versus host disease.


OBJECTIVE
To assess the predictive value of C reactive protein (CRP) and procalcitonin (PCT) in the diagnosis of invasive bacterial infections in children with febrile neutropenia after an allogenic hematopoietic stem cell transplantation.


METHODS
Prospective follow up of patients aged 18 years or less, with febrile neutropenia after an allogenic hematopoietic stem cell transplantation. In all patients, cultures from sterile sites, CRP and PCT determinations were done. CRP levels were also measured prior to transplantation and three times per week for 30 days after the procedure. An independent evaluator, blinded to the results of CRP and PCT, classified children as with or without invasive bacterial infection.


RESULTS
Thirty three patients aged 9+/-5 years (21 males) were studied. Eight had an invasive bacterial infection. Sensitivity, specificity, positive and negative predictive values of a CRP > or = 90 mg/L for the diagnosis of invasive bacterial infection were 25, 80, 29 and 77%, respectively. The figures for a PCT > or = 0.7 ng/ml were 43, 78, 38 and 82%, respectively. No differences in repeated CRP values measured during evolution, were observed.


CONCLUSIONS
A CRP > or = 90 mg/L or a PCT > or = 0.7 ng/ml had a high specificity and negative predictive value but low sensitivity for the diagnosis of invasive bacterial infections in recipients of allogenic hematopoietic stem cell transplantation.
Schmidt
Nadia
N
Departamento de Pediatría Oriente, Facultad de Medicina, Universidad de Chile, Chile. nadiaschmidt@gmail.com
Palma
Julia
J
King
Alejandra
A
Santolaya
María Elena
ME
D000293:Adolescent; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002648:Child; D002675:Child, Preschool; D005260:Female; D005335:Fever of Unknown Origin / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009503:Neutropenia / Q000097:blood / Q000382:microbiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D018805:Sepsis / Q000097:blood / Q000175:diagnosis; D012772:Shock, Septic / Q000097:blood / Q000175:diagnosis
D000890:Anti-Infective Agents; D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide