A Dynamic Approach for Early Risk Prediction of Gram-Negative Bloodstream Infection and Systemic Inflammatory Response Syndrome in Febrile Pediatric Hemato-Oncology Patients
Background: The aim of this study was to evaluate the usefulness of C-Reactive Protein (CRP), Procalcitonin (PCT), and Interleukine 6 (IL6) biomarkers in predicting the existence of high-risk episodes (HRE) during the first 24 h of fever in pediatric cancer patients. HRE were defined as the presence...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-06-01
|
| Series: | Children |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9067/9/6/833 |
| _version_ | 1797488778200219648 |
|---|---|
| author | José Antonio Villegas Rubio Pilar Palomo Moraleda Ana De Lucio Delgado Gonzalo Solís Sánchez Belén Prieto García Corsino Rey Galán |
| author_facet | José Antonio Villegas Rubio Pilar Palomo Moraleda Ana De Lucio Delgado Gonzalo Solís Sánchez Belén Prieto García Corsino Rey Galán |
| author_sort | José Antonio Villegas Rubio |
| collection | DOAJ |
| description | Background: The aim of this study was to evaluate the usefulness of C-Reactive Protein (CRP), Procalcitonin (PCT), and Interleukine 6 (IL6) biomarkers in predicting the existence of high-risk episodes (HRE) during the first 24 h of fever in pediatric cancer patients. HRE were defined as the presence of Gram-negative bloodstream infections or Systemic Inflammatory Response Syndrome. Methods: The study included 103 consecutive fever episodes in 44 hemato-oncological pediatric patients, from whom samples for biomarkers were taken upon initial evaluation (CRP-1, PCT-1 and IL6-1) and then between 12 and 24 h afterward (CRP-2, PCT-2 and IL6-2). Results: An IL6-1 value higher than 164 pg/mL showed an area under the curve (AUC) of 0.890 (0.791–0.989) and OR of 48.68 (7.92–951.42, <i>p</i> < 0.001) to detect HRE in multivariate analysis. A PCT-1 higher than 0.32 ng/mL showed an AUC of 0.805 (0.700–0.910) and OR of 4.55 (0.90–27.84, <i>p</i> = 0.076). A PCT-2 higher than 0.94 ng/mL showed an AUC of 0.836 (0.725–0.947) and OR of 13.01 (1.82–149.13, <i>p</i> = 0.018), and an increase in CRP between the first and second sample (CRP-2vs1) higher than 291% also showed an AUC of 0.785 (0.655–0.915) and OR of 31.09 (4.87–355.33, <i>p</i> = 0.001). Conclusions<i>:</i> IL6-1, PCT-2, and CRP-2vs1 showed a strong and independent correlation with HREs in pediatric cancer patients. CRP variations over the first 24 h provide an improvement in predictive models that are especially useful if IL-6 and PCT are not available. |
| first_indexed | 2024-03-10T00:07:09Z |
| format | Article |
| id | doaj.art-66cc5f45fd104583afc8afbcde178765 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-10T00:07:09Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-66cc5f45fd104583afc8afbcde1787652023-11-23T16:05:32ZengMDPI AGChildren2227-90672022-06-019683310.3390/children9060833A Dynamic Approach for Early Risk Prediction of Gram-Negative Bloodstream Infection and Systemic Inflammatory Response Syndrome in Febrile Pediatric Hemato-Oncology PatientsJosé Antonio Villegas Rubio0Pilar Palomo Moraleda1Ana De Lucio Delgado2Gonzalo Solís Sánchez3Belén Prieto García4Corsino Rey Galán5Pediatric Oncology Unit, Pediatrics Department, Central University Hospital of Asturias, Avda, Roma s/n, 330011 Oviedo, SpainPediatric Hematology Unit, Hematology Department, Central University Hospital of Asturias, 330011 Oviedo, SpainPediatric Oncology Unit, Pediatrics Department, Central University Hospital of Asturias, Avda, Roma s/n, 330011 Oviedo, SpainNeonatology Unit, Pediatrics Department, Central University Hospital of Asturias, 330011 Oviedo, SpainClinical Biochemistry, Laboratory of Medicine, Central University Hospital of Asturias, 330011 Oviedo, SpainPrimary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin Network (RICORS), Instituto de Salud Carlos III, RD21/0012/0020, 28028 Madrid, SpainBackground: The aim of this study was to evaluate the usefulness of C-Reactive Protein (CRP), Procalcitonin (PCT), and Interleukine 6 (IL6) biomarkers in predicting the existence of high-risk episodes (HRE) during the first 24 h of fever in pediatric cancer patients. HRE were defined as the presence of Gram-negative bloodstream infections or Systemic Inflammatory Response Syndrome. Methods: The study included 103 consecutive fever episodes in 44 hemato-oncological pediatric patients, from whom samples for biomarkers were taken upon initial evaluation (CRP-1, PCT-1 and IL6-1) and then between 12 and 24 h afterward (CRP-2, PCT-2 and IL6-2). Results: An IL6-1 value higher than 164 pg/mL showed an area under the curve (AUC) of 0.890 (0.791–0.989) and OR of 48.68 (7.92–951.42, <i>p</i> < 0.001) to detect HRE in multivariate analysis. A PCT-1 higher than 0.32 ng/mL showed an AUC of 0.805 (0.700–0.910) and OR of 4.55 (0.90–27.84, <i>p</i> = 0.076). A PCT-2 higher than 0.94 ng/mL showed an AUC of 0.836 (0.725–0.947) and OR of 13.01 (1.82–149.13, <i>p</i> = 0.018), and an increase in CRP between the first and second sample (CRP-2vs1) higher than 291% also showed an AUC of 0.785 (0.655–0.915) and OR of 31.09 (4.87–355.33, <i>p</i> = 0.001). Conclusions<i>:</i> IL6-1, PCT-2, and CRP-2vs1 showed a strong and independent correlation with HREs in pediatric cancer patients. CRP variations over the first 24 h provide an improvement in predictive models that are especially useful if IL-6 and PCT are not available.https://www.mdpi.com/2227-9067/9/6/833infectionbiomarkerpediatriconcologyhematology |
| spellingShingle | José Antonio Villegas Rubio Pilar Palomo Moraleda Ana De Lucio Delgado Gonzalo Solís Sánchez Belén Prieto García Corsino Rey Galán A Dynamic Approach for Early Risk Prediction of Gram-Negative Bloodstream Infection and Systemic Inflammatory Response Syndrome in Febrile Pediatric Hemato-Oncology Patients Children infection biomarker pediatric oncology hematology |
| title | A Dynamic Approach for Early Risk Prediction of Gram-Negative Bloodstream Infection and Systemic Inflammatory Response Syndrome in Febrile Pediatric Hemato-Oncology Patients |
| title_full | A Dynamic Approach for Early Risk Prediction of Gram-Negative Bloodstream Infection and Systemic Inflammatory Response Syndrome in Febrile Pediatric Hemato-Oncology Patients |
| title_fullStr | A Dynamic Approach for Early Risk Prediction of Gram-Negative Bloodstream Infection and Systemic Inflammatory Response Syndrome in Febrile Pediatric Hemato-Oncology Patients |
| title_full_unstemmed | A Dynamic Approach for Early Risk Prediction of Gram-Negative Bloodstream Infection and Systemic Inflammatory Response Syndrome in Febrile Pediatric Hemato-Oncology Patients |
| title_short | A Dynamic Approach for Early Risk Prediction of Gram-Negative Bloodstream Infection and Systemic Inflammatory Response Syndrome in Febrile Pediatric Hemato-Oncology Patients |
| title_sort | dynamic approach for early risk prediction of gram negative bloodstream infection and systemic inflammatory response syndrome in febrile pediatric hemato oncology patients |
| topic | infection biomarker pediatric oncology hematology |
| url | https://www.mdpi.com/2227-9067/9/6/833 |
| work_keys_str_mv | AT joseantoniovillegasrubio adynamicapproachforearlyriskpredictionofgramnegativebloodstreaminfectionandsystemicinflammatoryresponsesyndromeinfebrilepediatrichematooncologypatients AT pilarpalomomoraleda adynamicapproachforearlyriskpredictionofgramnegativebloodstreaminfectionandsystemicinflammatoryresponsesyndromeinfebrilepediatrichematooncologypatients AT anadeluciodelgado adynamicapproachforearlyriskpredictionofgramnegativebloodstreaminfectionandsystemicinflammatoryresponsesyndromeinfebrilepediatrichematooncologypatients AT gonzalosolissanchez adynamicapproachforearlyriskpredictionofgramnegativebloodstreaminfectionandsystemicinflammatoryresponsesyndromeinfebrilepediatrichematooncologypatients AT belenprietogarcia adynamicapproachforearlyriskpredictionofgramnegativebloodstreaminfectionandsystemicinflammatoryresponsesyndromeinfebrilepediatrichematooncologypatients AT corsinoreygalan adynamicapproachforearlyriskpredictionofgramnegativebloodstreaminfectionandsystemicinflammatoryresponsesyndromeinfebrilepediatrichematooncologypatients AT joseantoniovillegasrubio dynamicapproachforearlyriskpredictionofgramnegativebloodstreaminfectionandsystemicinflammatoryresponsesyndromeinfebrilepediatrichematooncologypatients AT pilarpalomomoraleda dynamicapproachforearlyriskpredictionofgramnegativebloodstreaminfectionandsystemicinflammatoryresponsesyndromeinfebrilepediatrichematooncologypatients AT anadeluciodelgado dynamicapproachforearlyriskpredictionofgramnegativebloodstreaminfectionandsystemicinflammatoryresponsesyndromeinfebrilepediatrichematooncologypatients AT gonzalosolissanchez dynamicapproachforearlyriskpredictionofgramnegativebloodstreaminfectionandsystemicinflammatoryresponsesyndromeinfebrilepediatrichematooncologypatients AT belenprietogarcia dynamicapproachforearlyriskpredictionofgramnegativebloodstreaminfectionandsystemicinflammatoryresponsesyndromeinfebrilepediatrichematooncologypatients AT corsinoreygalan dynamicapproachforearlyriskpredictionofgramnegativebloodstreaminfectionandsystemicinflammatoryresponsesyndromeinfebrilepediatrichematooncologypatients |