The predictive value of procalcitonin, C-reactive protein, presepsin, and soluble-triggering receptor expressed on myeloid cell levels in bloodstream infections in pediatric patients with febrile neutropenia

Özet

The present study investigates the predictive value of procalcitonin (PCT),C-reactive protein (CRP), presepsin (PRE-SEP) and soluble-triggeringreceptor, as expressed on myeloid cells (sTREM-1) levels in bloodstreaminfections in pediatric patients with febrile neutropenia. A total of 47 episodesof febrile neutropenia that developed in 30 children with malignancy wereanalyzed in this study, while the control group comprised 27 children who hadundergone chemotherapy for malignancy (completed ≥2 years ago) withoutneutropenia, fever or drug use. Median PCT, CRP, PRE-SEP and sTREM-1 levelson admission were found to be significantly higher in the patient group than inthe control group, while in the blood cultures, the microbiological agent wasisolated in 13 (27.7%) of the 47 episodes. Median PCT and CRP levels on days1, 2 and 7 were higher in the blood culture-positive episodes than in the bloodculture-negative episodes. There was no significant difference in the PRE-SEPand sTREM-1 levels on days 1, 2 and 7 between the blood culture-positive andblood culture-negative episodes. The results of the study suggest that PRESEP and sTREM-1 are at measurable levels upon admission in children withfebrile neutropenia, but that these markers may not be appropriate for thepredicting of bloodstream infections, although CRP and PCT levels within thefirst 24 hours may serve as a guide for clinicians.