Procalcitonin and C-Reactive Protein As Markers of Bacteremia in Patients With Febrile Neutropenia Who Receive Chemotherapy for Acute Leukemia: A Prospective Study From Nepal.

Procalcitonina y proteína C reactiva como marcadores de bacteriemia en pacientes con neutropenia febril que reciben quimioterapia por leucemia aguda: un estudio prospectivo de Nepal.

Clicks: 428
ID: 61149
2019
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Abstract
The purpose of this study was to evaluate the clinical significance of the biomarkers procalcitonin (PCT) and C-reactive protein (CRP) in patients with febrile neutropenia (FN) undergoing chemotherapy for acute leukemia.We conducted a prospective, observational study in patients who developed FN while undergoing chemotherapy for acute leukemia. PCT and CRP were obtained in patients who presented with FN. Blood cultures also were obtained. The primary goals were to evaluate the ability of PCT and CRP to predict bacteremia in patients with FN. The secondary goals were to assess the prognostic role of PCT and CRP and to assess the microbiologic profile and culture sensitivity patterns in the study population.A total of 124 episodes of FN that involved 67 patients with acute leukemia occurred in the study. PCT was superior to CRP in the prediction of bacteremia. The median PCT level in the bacteremia group was 3.25 ng/mL compared with 0.51 ng/mL in the group without bacteremia ( < .01). The median values of CRP in the bacteremia and without-bacteremia groups were 119.3 mg/L and 94.5 mg/L, respectively ( = .07). There were no differences in median PCT and CRP in patients who died and those who improved. Of the 42 positive cultures, Gram-negative bacteremia was common (86%), and was the most frequent organism isolated. Carbapenem resistance was seen in 39% of positive cultures.PCT is an effective biomarker to predict bacteremia in patients with FN undergoing chemotherapy for acute leukemia.
El propósito de este estudio fue evaluar la significación clínica de los biomarcadores procalcitonina (PCT) y proteína C reactiva (PCR) en pacientes con neutropenia febril (NF) sometidos a quimioterapia por leucemia aguda. Realizamos un estudio prospectivo y observacional en pacientes que desarrollaron NF durante la quimioterapia por leucemia aguda. Se determinaron la PCT y la PCR en los pacientes que presentaron NF. También se obtuvieron hemocultivos. Los objetivos principales fueron evaluar la capacidad de la PCT y la PCR para predecir la bacteriemia en pacientes con NF. Los objetivos secundarios consistieron en evaluar el papel pronóstico de la PCT y la PCR, así como analizar el perfil microbiológico y los patrones de sensibilidad de los cultivos en la población de estudio. En el estudio se produjo un total de 124 episodios de NF en 67 pacientes con leucemia aguda. La PCT fue superior a la PCR en la predicción de la bacteriemia. La mediana del nivel de PCT en el grupo con bacteriemia fue de 3,25 ng/ml, en comparación con 0,51 ng/ml en el grupo sin bacteriemia ( < 0,01). Los valores medianos de PCR en los grupos con bacteriemia y sin bacteriemia fueron de 119,3 mg/l y 94,5 mg/l, respectivamente ( = 0,07). No hubo diferencias en las medianas de PCT y PCR entre los pacientes que fallecieron y los que mejoraron. De los 42 cultivos positivos, la bacteriemia por gramnegativos fue frecuente (86 %) y fue el microorganismo aislado con mayor frecuencia. Se observó resistencia a los carbapenémicos en el 39 % de los cultivos positivos. La PCT es un biomarcador eficaz para predecir la bacteriemia en pacientes con NF sometidos a quimioterapia por leucemia aguda.
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shilpakar2019procalcitoninjournal Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Shilpakar, Ramila;Paudel, Bishnu Dutta;Neupane, Prakash;Shah, Aarati;Acharya, Bibek;Dulal, Soniya;Wood, Lori Anne;Shahi, Rukmani;Khanal, Usha;Poudyal, Bishesh Sharma;
Journal journal of global oncology
Year 2019
DOI
10.1200/JGO.19.00147
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