Microbial translocation contribute to febrile episodes in adults with chemotherapy-induced neutropenia.

In this study we sought to determine the contribution of microbial translocation to febrile episodes with no attributable microbiological cause (Fever of Unknown Origin, FUO) in an adult febrile neutropaenic cohort. Endotoxin concentrations were measured with the chromogenic Limulus Amoebocyte Assay...

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Main Authors: Michelle Wong, Babilonia Barqasho, Lars Ohrmalm, Thomas Tolfvenstam, Piotr Nowak
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3712968?pdf=render
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author Michelle Wong
Babilonia Barqasho
Lars Ohrmalm
Thomas Tolfvenstam
Piotr Nowak
author_facet Michelle Wong
Babilonia Barqasho
Lars Ohrmalm
Thomas Tolfvenstam
Piotr Nowak
author_sort Michelle Wong
collection DOAJ
description In this study we sought to determine the contribution of microbial translocation to febrile episodes with no attributable microbiological cause (Fever of Unknown Origin, FUO) in an adult febrile neutropaenic cohort. Endotoxin concentrations were measured with the chromogenic Limulus Amoebocyte Assay and used as a direct measure of bacterial products whilst soluble CD14 (sCD14), measured with ELISA was selected as an indicator of the early host response to endotoxins. Endotoxin concentrations in this cohort were generally elevated but did not differ with the presentation of fever. Further stratification of the febrile episodes based on the microbiological findings revealed significantly (p = 0.0077) elevated endotoxin concentrations in FUO episodes compared with episodes with documented bacterial and viral findings. sCD14 concentrations were however, elevated in febrile episodes (p = 0.0066) and no association was observed between sCD14 concentration and microbiological findings. However, FUO episodes and episodes with Gram-negative bacteraemia were associated with higher median sCD14 concentrations than episodes with Gram-positive bacteraemia (p = 0.030). In conclusion, our findings suggest that in the absence of microbiological findings, microbial translocation could contribute to febrile episodes in an adult neutropaenic cohort. We further observed an association between prophylactic antibiotic use and increased plasma endotoxin concentrations (p = 0.0212).
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spelling doaj.art-a90d6acc8b714c85a1a941401b63adc62022-12-21T19:58:04ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0187e6805610.1371/journal.pone.0068056Microbial translocation contribute to febrile episodes in adults with chemotherapy-induced neutropenia.Michelle WongBabilonia BarqashoLars OhrmalmThomas TolfvenstamPiotr NowakIn this study we sought to determine the contribution of microbial translocation to febrile episodes with no attributable microbiological cause (Fever of Unknown Origin, FUO) in an adult febrile neutropaenic cohort. Endotoxin concentrations were measured with the chromogenic Limulus Amoebocyte Assay and used as a direct measure of bacterial products whilst soluble CD14 (sCD14), measured with ELISA was selected as an indicator of the early host response to endotoxins. Endotoxin concentrations in this cohort were generally elevated but did not differ with the presentation of fever. Further stratification of the febrile episodes based on the microbiological findings revealed significantly (p = 0.0077) elevated endotoxin concentrations in FUO episodes compared with episodes with documented bacterial and viral findings. sCD14 concentrations were however, elevated in febrile episodes (p = 0.0066) and no association was observed between sCD14 concentration and microbiological findings. However, FUO episodes and episodes with Gram-negative bacteraemia were associated with higher median sCD14 concentrations than episodes with Gram-positive bacteraemia (p = 0.030). In conclusion, our findings suggest that in the absence of microbiological findings, microbial translocation could contribute to febrile episodes in an adult neutropaenic cohort. We further observed an association between prophylactic antibiotic use and increased plasma endotoxin concentrations (p = 0.0212).http://europepmc.org/articles/PMC3712968?pdf=render
spellingShingle Michelle Wong
Babilonia Barqasho
Lars Ohrmalm
Thomas Tolfvenstam
Piotr Nowak
Microbial translocation contribute to febrile episodes in adults with chemotherapy-induced neutropenia.
PLoS ONE
title Microbial translocation contribute to febrile episodes in adults with chemotherapy-induced neutropenia.
title_full Microbial translocation contribute to febrile episodes in adults with chemotherapy-induced neutropenia.
title_fullStr Microbial translocation contribute to febrile episodes in adults with chemotherapy-induced neutropenia.
title_full_unstemmed Microbial translocation contribute to febrile episodes in adults with chemotherapy-induced neutropenia.
title_short Microbial translocation contribute to febrile episodes in adults with chemotherapy-induced neutropenia.
title_sort microbial translocation contribute to febrile episodes in adults with chemotherapy induced neutropenia
url http://europepmc.org/articles/PMC3712968?pdf=render
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AT thomastolfvenstam microbialtranslocationcontributetofebrileepisodesinadultswithchemotherapyinducedneutropenia
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