title: Th1/Th2 cytokine profiles in G+/G- bacteremia in pediatric hematology/oncology patients.
abstract: BACKGROUND
  Early diagnosis of infection and appropriate choice of antibiotics are essential not only to improve the prognosis of the patients but also to prevent from the abuse of the antibiotics in hematology/oncology children at the time of neutropenia after intensive chemotherapy.
  
  
  METHODS
  We evaluated the quantification of Th1/Th2 cytokines with flow cytometry bead assay (CBA) in 145 hospitalized febrile hematology/oncology children with positive blood culture to seek for a rapid diagnostic method to determine the type of infection.
  
  
  RESULTS
  IL-4, IL-6, IL-10, TNF-α, and IFN-γ levels from both G- and G+ bacteremia groups were significantly higher than those of controls (P < 0.001). The median levels of IL-6, IL-10, TNF-α of Group G- were 525.4, 96.0, and 6.9 pg/ml, respectively, significantly higher than those of Group G+ (150.0, 22.6, and 4.5 pg/ml, respectively, P < 0.001). According to the different degrees of increased IL-6 and IL-10 levels, we named the G- bacterial infection related cytokine profile G- BIRCP and the G+ BIRCP. The specificity and sensitivity of BIRCP prediction for G- and G+ bacteria cultures were 60.2% and 75.4%, 66.8% and 70.1%, respectively. Similar therapeutic efficacy was achieved between BIRCP-based and broad-spectrum antibiotics groups (86.1% vs. 89.3%, P > 0.05), which was significantly increased as compared with that (65.5%, P < 0.05) of empirical group.
  
  
  CONCLUSIONS
  These results showed the promising use of the IL-6/IL-10/TNF-α determination with CBA technology for the early and rapid diagnosis, evaluation of G+/G- bacteremia in pediatric hematology/oncology patients.
authors.affiliation: Division of Hematology-Oncology, Zhejiang Key Laboratory for Neonatal Diseases, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, PR China. y_m_tang@zju.edu.cn
authors.forename: Yongmin
authors.initials: Y
authors.lastname: Tang
authors.forename: Chan
authors.initials: C
authors.lastname: Liao
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Xu
authors.forename: Hua
authors.initials: H
authors.lastname: Song
authors.forename: Shuwen
authors.initials: S
authors.lastname: Shi
authors.forename: Shilong
authors.initials: S
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D016470:Bacteremia / Q000097:blood / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood*; D005260:Female; D006090:Gram-Negative Bacteria / Q000276:immunology / Q000378:metabolism; D006094:Gram-Positive Bacteria / Q000276:immunology / Q000378:metabolism; D006405:Hematology; D006801:Humans; D007223:Infant; D008297:Male; D008495:Medical Oncology; D009369:Neoplasms / Q000097:blood / Q000276:immunology*; D010372:Pediatrics; D018417:Th1 Cells / Q000276:immunology*; D018418:Th2 Cells / Q000276:immunology*
chemical_list: D016207:Cytokines