Procalcitonin til tidlig diagnostik af bakteriaemi hos børn med cancer

INTRODUCTION: Fever and infections are common complications in children with cancer during chemotherapy. The purpose of this study was to investigate the usefulness of procalcitonin (PCT) in the identification of children with bacteraemia at time of admission with febrile episodes. Furthermore, we compared the usefulness of procalcitonin with that of C-reactive protein (CRP).

MATERIAL AND METHODS: We evaluated 55 febrile episodes in 34 children in treatment for cancer. We found 24 episodes of bacteraemia and 31 episodes with negative blood cultures.

RESULTS: The median PCT and CRP levels in children with positive blood cultures were significantly higher compared with children with negative blood cultures. The optimum cut-off level to predict bacteraemia was 1 mg/l for PCT and 50 mg/l for CRP. In distinguishing between febrile episodes with and without bacteraemia, PCT was found to have higher positive predictive value and similar negative predictive value as compared to CRP at the optimum cut-off level.

CONCLUSION: These results show the potential usefulness of PCT as an early indicator for bacteraemia in febrile children with cancer and furthermore indicate that PCT may be more sensitive than CRP in the assessment of the cause of fever in these children.