No association between protein C levels and bacteremia in children with febrile neutropenia.
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.
Kassam
Alisha
A
Department of Paediatrics, Division of Haematology/Oncology, The Hospital for Sick Children, McMaster University, Hamilton, Ontario, Canada.
Chan
Anthony K C
AK
Dzolganovski
Biljana
B
Constantin
Julie
J
Ramphal
Raveena
R
Grant
Ronald
R
Sung
Lillian
L
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
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