Urbonas Vincas, Eidukaitė Audronė, Tamulienė Indrė
Department of Immunology, Center for Innovative Medicine, National Research Institute, Vilnius University Children's Hospital, Vilnius, Lithuania.
J Pediatr Hematol Oncol. 2012 Mar;34(2):122-7. doi: 10.1097/MPH.0b013e3182446a60.
Early diagnosis of sepsis in children with febrile neutropenia and cancer still remains a challenge for modern medicine because of lack of specific laboratory markers and clinical signs especially at the beginning of the infection. The objective of this study was to evaluate the ability of interleukin-6 and interleukin-8 to predict bacteremia and sepsis during the first 2 days in oncohematologic patients with febrile neutropenia.
A total of 61 febrile neutropenic episodes in 37 children were studied. Serum samples were collected on day 1 and day 2 from the onset of fever and analyzed using an automated random access analyzer.
Neutropenic children with febrile episodes were classified into the following 2 groups: (1) fever of unknown origin group--patients with a negative blood culture--and (2) bacteremia/sepsis group--patients with a positive blood culture or clinical sepsis. High negative predictive values were found on day 1 for interleukin-6 and interleukin-8 (89% and 82%, respectively) for exclusion of bacteremia/sepsis.
These interleukins could be used as a screening tool for the rejection of sepsis or bacteremia on the first day of fever in neutropenic children with cancer.
由于缺乏特异性实验室指标和临床体征，尤其是在感染初期，对发热性中性粒细胞减少症患儿及癌症患儿的脓毒症进行早期诊断仍是现代医学面临的一项挑战。本研究的目的是评估白细胞介素-6和白细胞介素-8在发热性中性粒细胞减少症的肿瘤血液学患者发病后头2天内预测菌血症和脓毒症的能力。
对37例儿童的61次发热性中性粒细胞减少发作进行了研究。从发热开始的第1天和第2天采集血清样本，并使用自动随机存取分析仪进行分析。
发热性中性粒细胞减少症患儿被分为以下2组：（1）不明原因发热组——血培养阴性的患者，以及（2）菌血症/脓毒症组——血培养阳性或临床诊断为脓毒症的患者。在第1天，白细胞介素-6和白细胞介素-8排除菌血症/脓毒症的阴性预测值较高（分别为89%和82%）。
这些白细胞介素可作为排除癌症中性粒细胞减少症发热患儿第一天脓毒症或菌血症的筛查工具。
