Significance of biomarkers in stewardship program in pediatric patients infected with Aspergillus species
Abstract Background The potential use of biomarkers in the diagnosis of fungal infections is a challenge. The aim of this study was to evaluate the role of a biomarker-guided antifungal stewardship program for hospitalized pediatrics suffering from invasive aspergillosis (IA). Methods Pediatric pati...
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | Italian Journal of Pediatrics |
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| Online Access: | https://doi.org/10.1186/s13052-022-01306-6 |
| _version_ | 1811227058880118784 |
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| author | Parisa Badiee Ali Amanati Fatemeh Ghasemi Hadis Jafarian |
| author_facet | Parisa Badiee Ali Amanati Fatemeh Ghasemi Hadis Jafarian |
| author_sort | Parisa Badiee |
| collection | DOAJ |
| description | Abstract Background The potential use of biomarkers in the diagnosis of fungal infections is a challenge. The aim of this study was to evaluate the role of a biomarker-guided antifungal stewardship program for hospitalized pediatrics suffering from invasive aspergillosis (IA). Methods Pediatric patients with suspected probable or proven IA were enrolled in this study. Demographic data were collected from their records. Clinical samples were examined by wet mount KOH smear, culture, galactomannan Ag test, and real-time PCR. Patients’ sera were evaluated for procalcitonin (PCT) and soluble-triggering receptor expressed on myeloid cells -1 (sTREM-1) levels by ELISA Kits. Results A total of 73 children were entered in this study with a mean age of 5 years and the male to female ratio 39/34. The most predisposing factors were hematologic disorders (71.2%). The area under the curves (95% confidence interval) for each biomarker were 0.9 (0.85% to 97%) for lactate de hydrogenase (LDH), 0.9 (0.85% to 0.94%) for C-reactive protein, 0.8 (0.75% to 0.84%) for PCT, 0.8 (0.73% to 0.85%) for erythrocyte sedimentation rate, 0.7 (0.6% to 0.8%) for sTREM-1, and 0.5 (0.45% to 0.58%) for white blood cell count. During the study period, 27.4% patients died. The LDH and sTREM-1 levels were significant increase in died patient (p < 0.05). Conclusions According to our data, evaluation of biomarkers along with radiologic and clinical signs and symptoms of pediatric patients can lead to proper antifungal therapy and decreased side effects, antifungal resistance, and cost. The combined measurements could be better than a single marker in the prediction of IA. |
| first_indexed | 2024-04-12T09:34:54Z |
| format | Article |
| id | doaj.art-d4be26c5be9a4b248b00023c3ddd633f |
| institution | Directory Open Access Journal |
| issn | 1824-7288 |
| language | English |
| last_indexed | 2024-04-12T09:34:54Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Italian Journal of Pediatrics |
| spelling | doaj.art-d4be26c5be9a4b248b00023c3ddd633f2022-12-22T03:38:15ZengBMCItalian Journal of Pediatrics1824-72882022-06-014811710.1186/s13052-022-01306-6Significance of biomarkers in stewardship program in pediatric patients infected with Aspergillus speciesParisa Badiee0Ali Amanati1Fatemeh Ghasemi2Hadis Jafarian3Clinical Microbiology Research Center, Shiraz University of Medical SciencesClinical Microbiology Research Center, Shiraz University of Medical SciencesClinical Microbiology Research Center, Shiraz University of Medical SciencesClinical Microbiology Research Center, Shiraz University of Medical SciencesAbstract Background The potential use of biomarkers in the diagnosis of fungal infections is a challenge. The aim of this study was to evaluate the role of a biomarker-guided antifungal stewardship program for hospitalized pediatrics suffering from invasive aspergillosis (IA). Methods Pediatric patients with suspected probable or proven IA were enrolled in this study. Demographic data were collected from their records. Clinical samples were examined by wet mount KOH smear, culture, galactomannan Ag test, and real-time PCR. Patients’ sera were evaluated for procalcitonin (PCT) and soluble-triggering receptor expressed on myeloid cells -1 (sTREM-1) levels by ELISA Kits. Results A total of 73 children were entered in this study with a mean age of 5 years and the male to female ratio 39/34. The most predisposing factors were hematologic disorders (71.2%). The area under the curves (95% confidence interval) for each biomarker were 0.9 (0.85% to 97%) for lactate de hydrogenase (LDH), 0.9 (0.85% to 0.94%) for C-reactive protein, 0.8 (0.75% to 0.84%) for PCT, 0.8 (0.73% to 0.85%) for erythrocyte sedimentation rate, 0.7 (0.6% to 0.8%) for sTREM-1, and 0.5 (0.45% to 0.58%) for white blood cell count. During the study period, 27.4% patients died. The LDH and sTREM-1 levels were significant increase in died patient (p < 0.05). Conclusions According to our data, evaluation of biomarkers along with radiologic and clinical signs and symptoms of pediatric patients can lead to proper antifungal therapy and decreased side effects, antifungal resistance, and cost. The combined measurements could be better than a single marker in the prediction of IA.https://doi.org/10.1186/s13052-022-01306-6Invasive aspergillosisPediatricsProcalcitoninsTREM-1C-reactive protein |
| spellingShingle | Parisa Badiee Ali Amanati Fatemeh Ghasemi Hadis Jafarian Significance of biomarkers in stewardship program in pediatric patients infected with Aspergillus species Italian Journal of Pediatrics Invasive aspergillosis Pediatrics Procalcitonin sTREM-1 C-reactive protein |
| title | Significance of biomarkers in stewardship program in pediatric patients infected with Aspergillus species |
| title_full | Significance of biomarkers in stewardship program in pediatric patients infected with Aspergillus species |
| title_fullStr | Significance of biomarkers in stewardship program in pediatric patients infected with Aspergillus species |
| title_full_unstemmed | Significance of biomarkers in stewardship program in pediatric patients infected with Aspergillus species |
| title_short | Significance of biomarkers in stewardship program in pediatric patients infected with Aspergillus species |
| title_sort | significance of biomarkers in stewardship program in pediatric patients infected with aspergillus species |
| topic | Invasive aspergillosis Pediatrics Procalcitonin sTREM-1 C-reactive protein |
| url | https://doi.org/10.1186/s13052-022-01306-6 |
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