title: Serial procalcitonin levels to detect bacteremia in febrile neutropenia.
abstract: BACKGROUND
  Our objective was to evaluate serial procalcitonin (PCT) levels compared with an initial PCT level at admission in predicting bacteremia in pediatric febrile neutropenic oncology patients.
  
  
  METHODS
  Serum PCT levels were measured at admission (t0) and within 24 hours of admission (t1) in pediatric oncology patients presenting with fever and neutropenia. A blood culture was collected at t0 and monitored for 5 days for bacterial growth. PCT value of 0.5 ng/mL at either t0 or t1 was considered predictive for bacteremia.
  
  
  RESULTS
  PCT levels were significantly higher in children with positive blood cultures than with negative blood cultures. Serial PCT values mirrored t1 values. Serial PCT showed 76% specificity and negative predictive value of 93% in ruling out bacteremia.
  
  
  CONCLUSIONS
  Elevated PCT levels are predictive of bacteremia. Using serial PCT levels within 24 hours allowed a better prediction of bacteremia than the PCT level at t0.
authors.affiliation: University of California, San Francisco-Fresno, Fresno, CA 90027, USA. Aaron@DrReitman.com
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Reitman
authors.forename: Rhonda M
authors.initials: RM
authors.lastname: Pisk
authors.forename: John V
authors.initials: JV
authors.lastname: Gates
authors.forename: J Daniel
authors.initials: JD
authors.lastname: Ozeran
mesh_terms: D000293:Adolescent; D019540:Area Under Curve; D016470:Bacteremia / Q000097:blood / Q000175:diagnosis*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002140:California; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005334:Fever / Q000097:blood; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D009503:Neutropenia / Q000097:blood* / Q000139:chemically induced / Q000175:diagnosis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide