title: No association between protein C levels and bacteremia in children with febrile neutropenia.
abstract: BACKGROUND
  Little is known about protein C levels and outcomes of pediatric febrile neutropenia. The primary aim was to evaluate the relationship between markers of activated coagulation including protein C levels and bacteremia in pediatric oncology patients with febrile neutropenia.
  
  
  METHODS
  In this prospective cohort study, we collected a blood specimen from pediatric oncology patients who were admitted to a tertiary care hospital between October 2, 2002 and February 3, 2006 with febrile neutropenia. Levels of protein C, soluble thrombomodulin, soluble endothelial protein C receptor, thrombin-antithrombin complex, fibrinogen degradation products and activated protein C were measured. Associations between markers of activated coagulation and bacteremia were examined using univariate logistic regression.
  
  
  RESULTS
  Of the 73 evaluable patients, 10 had bacteremia. None of the above measured markers of activated coagulation were associated with bacteremia. More specifically, the median level of protein C in those with bacteremia was 0.64 U/mL (interquartile range: 0.58 to 0.72) in comparison with the median level in those without bacteremia of 0.73 U/mL (interquartile range: 0.61 to 0.92), odds ratio 0.18 (95% confidence interval 0.00 to 8.33); P=0.38.
  
  
  CONCLUSIONS
  Protein C levels do not differ between pediatric febrile neutropenic patients with and without bacteremia.
authors: Department of Paediatrics, Division of Haematology/Oncology, The Hospital for Sick Children, McMaster University, Hamilton, Ontario, Canada.
authors: Alisha
authors: A
authors: Kassam
authors: Anthony K C
authors: AK
authors: Chan
authors: Biljana
authors: B
authors: Dzolganovski
authors: Julie
authors: J
authors: Constantin
authors: Raveena
authors: R
authors: Ramphal
authors: Ronald
authors: R
authors: Grant
authors: Lillian
authors: L
authors: Sung
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015703:Antigens, CD / Q000097:blood; D000990:Antithrombin III; D016470:Bacteremia / Q000097:blood* / Q000188:drug therapy / Q000453:epidemiology; D001777:Blood Coagulation; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D000074283:Endothelial Protein C Receptor; D005260:Female; D005334:Fever / Q000209:etiology*; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications*; D009503:Neutropenia / Q000150:complications*; D010447:Peptide Hydrolases / Q000097:blood; D011446:Prospective Studies; D011486:Protein C / Q000032:analysis*; D011956:Receptors, Cell Surface / Q000097:blood; D018180:Thrombomodulin / Q000097:blood
chemical_list: D000900:Anti-Bacterial Agents; D015703:Antigens, CD; D000074283:Endothelial Protein C Receptor; D005338:Fibrin Fibrinogen Degradation Products; C478370:PROCR protein, human; D011486:Protein C; D011956:Receptors, Cell Surface; D018180:Thrombomodulin; C046193:antithrombin III-protease complex; D000990:Antithrombin III; D010447:Peptide Hydrolases