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Combination of Interleukin-6, C-Reactive Protein and Procalcitonin Values as Predictive Index of Sepsis in Course of Fever Episode in Adult Haematological Patients: Observational and Statistical Study

Haematological patients represent a vulnerable population to opportunistic infections, mainly due to the disease itself and chemotherapy-induced neutropenia. The level of immune suppression strongly increases the importance of timely antibiotic treatment in order to prevent sepsis-related mortality....

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Autores principales: Carcò, Daniela, Castorina, Paolo, Guardo, Paola, Iachelli, Valeria, Pace, Tecla, Scirè, Paola, Stanco, Rosaria, Markovic, Uros, Milone, Giulio Antonio, Galbo, Federica, Moschetti, Gaetano, Martorana, Emanuele
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9694618/
https://www.ncbi.nlm.nih.gov/pubmed/36431277
http://dx.doi.org/10.3390/jcm11226800
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author Carcò, Daniela
Castorina, Paolo
Guardo, Paola
Iachelli, Valeria
Pace, Tecla
Scirè, Paola
Stanco, Rosaria
Markovic, Uros
Milone, Giulio Antonio
Galbo, Federica
Moschetti, Gaetano
Martorana, Emanuele
author_facet Carcò, Daniela
Castorina, Paolo
Guardo, Paola
Iachelli, Valeria
Pace, Tecla
Scirè, Paola
Stanco, Rosaria
Markovic, Uros
Milone, Giulio Antonio
Galbo, Federica
Moschetti, Gaetano
Martorana, Emanuele
author_sort Carcò, Daniela
collection PubMed
description Haematological patients represent a vulnerable population to opportunistic infections, mainly due to the disease itself and chemotherapy-induced neutropenia. The level of immune suppression strongly increases the importance of timely antibiotic treatment in order to prevent sepsis-related mortality. During the initial fever episode, serum biomarkers are usually used to estimate the probability of blood stream infection prior to the results of microbial diagnosis. A new serum biomarker combination study on a febrile haematological population, including C-reactive protein (CRP), interleukin-6 (IL−6) and procalcitonin (PCT), is proposed in order to improve their predictive accuracy. In our prospective study, CRP, IL−6 and PCT were evaluated in 34 immunosuppressed haematological patients immediately after the onset of 51 fever episodes, either during the course of standard chemotherapy or high-dose chemotherapy and autologous stem cell transplant. The fever episodes were divided into documented infections and fever alone. Receiver operating characteristic analysis (ROC) was performed for each biomarker and a combination of all three biomarkers (multiROC) to define a new predictive index. Significant differences were evidenced between the two groups (documented infection and no infection) for both PCT and IL−6 (p = 0.03 and p = 0.035, respectively), but none for CRP (p = 0.1). The composite parameter is more reliable than any single biomarker alone, with an area under the curve (AUC) of 79% and with high sensitivity and specificity. IL−6 gave the closest response compared to the composite index. Composite parameters of serum biomarkers could be used for an early diagnosis of infection at fever onset in haematological patients.
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spelling pubmed-96946182022-11-26 Combination of Interleukin-6, C-Reactive Protein and Procalcitonin Values as Predictive Index of Sepsis in Course of Fever Episode in Adult Haematological Patients: Observational and Statistical Study Carcò, Daniela Castorina, Paolo Guardo, Paola Iachelli, Valeria Pace, Tecla Scirè, Paola Stanco, Rosaria Markovic, Uros Milone, Giulio Antonio Galbo, Federica Moschetti, Gaetano Martorana, Emanuele J Clin Med Article Haematological patients represent a vulnerable population to opportunistic infections, mainly due to the disease itself and chemotherapy-induced neutropenia. The level of immune suppression strongly increases the importance of timely antibiotic treatment in order to prevent sepsis-related mortality. During the initial fever episode, serum biomarkers are usually used to estimate the probability of blood stream infection prior to the results of microbial diagnosis. A new serum biomarker combination study on a febrile haematological population, including C-reactive protein (CRP), interleukin-6 (IL−6) and procalcitonin (PCT), is proposed in order to improve their predictive accuracy. In our prospective study, CRP, IL−6 and PCT were evaluated in 34 immunosuppressed haematological patients immediately after the onset of 51 fever episodes, either during the course of standard chemotherapy or high-dose chemotherapy and autologous stem cell transplant. The fever episodes were divided into documented infections and fever alone. Receiver operating characteristic analysis (ROC) was performed for each biomarker and a combination of all three biomarkers (multiROC) to define a new predictive index. Significant differences were evidenced between the two groups (documented infection and no infection) for both PCT and IL−6 (p = 0.03 and p = 0.035, respectively), but none for CRP (p = 0.1). The composite parameter is more reliable than any single biomarker alone, with an area under the curve (AUC) of 79% and with high sensitivity and specificity. IL−6 gave the closest response compared to the composite index. Composite parameters of serum biomarkers could be used for an early diagnosis of infection at fever onset in haematological patients. MDPI 2022-11-17 /pmc/articles/PMC9694618/ /pubmed/36431277 http://dx.doi.org/10.3390/jcm11226800 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Carcò, Daniela
Castorina, Paolo
Guardo, Paola
Iachelli, Valeria
Pace, Tecla
Scirè, Paola
Stanco, Rosaria
Markovic, Uros
Milone, Giulio Antonio
Galbo, Federica
Moschetti, Gaetano
Martorana, Emanuele
Combination of Interleukin-6, C-Reactive Protein and Procalcitonin Values as Predictive Index of Sepsis in Course of Fever Episode in Adult Haematological Patients: Observational and Statistical Study
title Combination of Interleukin-6, C-Reactive Protein and Procalcitonin Values as Predictive Index of Sepsis in Course of Fever Episode in Adult Haematological Patients: Observational and Statistical Study
title_full Combination of Interleukin-6, C-Reactive Protein and Procalcitonin Values as Predictive Index of Sepsis in Course of Fever Episode in Adult Haematological Patients: Observational and Statistical Study
title_fullStr Combination of Interleukin-6, C-Reactive Protein and Procalcitonin Values as Predictive Index of Sepsis in Course of Fever Episode in Adult Haematological Patients: Observational and Statistical Study
title_full_unstemmed Combination of Interleukin-6, C-Reactive Protein and Procalcitonin Values as Predictive Index of Sepsis in Course of Fever Episode in Adult Haematological Patients: Observational and Statistical Study
title_short Combination of Interleukin-6, C-Reactive Protein and Procalcitonin Values as Predictive Index of Sepsis in Course of Fever Episode in Adult Haematological Patients: Observational and Statistical Study
title_sort combination of interleukin-6, c-reactive protein and procalcitonin values as predictive index of sepsis in course of fever episode in adult haematological patients: observational and statistical study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9694618/
https://www.ncbi.nlm.nih.gov/pubmed/36431277
http://dx.doi.org/10.3390/jcm11226800
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