Pediatric Oncology and Hematology "Lalla Seràgnoli", IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Giuseppe Massarenti 11, 40138, Bologna, Italy.
Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138, Bologna, Italy.
Sci Rep. 2023 Apr 20;13(1):6464. doi: 10.1038/s41598-023-33094-2.
Febrile neutropenia (FN) represents one of the main complications of pediatric patients with oncological and hematological diseases. In these patients, it is crucial to identify bacterial infections. The aim of this study is to evaluate presepsin as an early biomarker of bacterial infections during FN. We compared patients with oncological and hematological diseases and a 2:1 age-matched healthy control group. In the FN group, we evaluated 4 biomarkers, namely, C reactive protein (CRP), procalcitonin (PCT), interleukin 6 (IL6) and presepsin at the onset of fever (T0) and 48 h after T0 (T1). In the control group, we only evaluated presepsin. We enrolled a total of 41 children with oncological and hematological diseases disease experiencing 50 FN episodes and 100 healthy patients in the control group. In patients with FN, we found that presepsin was significantly higher than in the control group (p < 0.001). However, in the FN group, we did not find a statistically significant difference between patients with and without bacteremia (p = 0.989 at T0, p = 0.619 at T1). Presepsin values at T1 were higher in patients experiencing an unfavorable outcome (p = 0.025). This study shows that presepsin increases in neutropenic patients, but it only revealed useful in predicting an unfavorable outcome 48 h from the onset of fever.
发热性中性粒细胞减少症（FN）是儿科肿瘤和血液系统疾病患者的主要并发症之一。在这些患者中，识别细菌感染至关重要。本研究旨在评估降钙素原前肽（presepsin）作为 FN 期间细菌感染的早期生物标志物。我们比较了肿瘤和血液系统疾病患者与年龄匹配的 2:1 健康对照组。在 FN 组中，我们在发热时（T0）和 T0 后 48 小时（T1）评估了 4 种生物标志物，即 C 反应蛋白（CRP）、降钙素原（PCT）、白细胞介素 6（IL6）和降钙素原前肽。在对照组中，我们仅评估了降钙素原前肽。我们共纳入了 41 名患有肿瘤和血液系统疾病的儿童，这些儿童经历了 50 次 FN 发作和 100 名健康对照组患者。在 FN 患者中，我们发现降钙素原前肽明显高于对照组（p<0.001）。然而，在 FN 组中，我们未发现菌血症患者与非菌血症患者之间存在统计学差异（T0 时 p=0.989，T1 时 p=0.619）。在预后不良的患者中，T1 时的降钙素原前肽值更高（p=0.025）。本研究表明，降钙素原前肽在中性粒细胞减少症患者中升高，但仅在发热后 48 小时预测不良预后方面具有一定的预测价值。
