BMC Infectious Diseases
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Research articlePerformance of Interleukin-6 and Interleukin-8 serum levels in pediatric oncology patients with neutropenia and fever for the assessment of low-riskMiriam Diepold1 , Peter Noellke2 , Ulrich Duffner2 , Udo Kontny2 and Reinhard Berner3  1
Department of Pediatric Oncology and Hematology, University Hospital of Bern, 3010 Bern, Switzerland 2
Department of Pediatric Oncology and Hematology, University Hospital of Freiburg, Mathildenstrasse 1, 79106 Freiburg, Germany 3
Department of Pediatrics and Adolescent Medicine, University Hospital of Freiburg, Mathildenstrasse 1, 79106 Freiburg, Germany author email corresponding author email
BMC Infectious Diseases 2008,
8:28doi:10.1186/1471-2334-8-28 Abstract
Background
Patients with chemotherapy-related neutropenia and fever are usually hospitalized and treated on empirical intravenous broad-spectrum antibiotic regimens. Early diagnosis of sepsis in children with febrile neutropenia remains difficult due to non-specific clinical and laboratory signs of infection. We aimed to analyze whether IL-6 and IL-8 could define a group of patients at low risk of septicemia.
Methods
A prospective study was performed to assess the potential value of IL-6, IL-8 and C-reactive protein serum levels to predict severe bacterial infection or bacteremia in febrile neutropenic children with cancer during chemotherapy. Statistical test used: Friedman test, Wilcoxon-Test, Kruskal-Wallis H test, Mann-Whitney U-Test and Receiver Operating Characteristics.
Results
The analysis of cytokine levels measured at the onset of fever indicated that IL-6 and IL-8 are useful to define a possible group of patients with low risk of sepsis. In predicting bacteremia or severe bacterial infection, IL-6 was the best predictor with the optimum IL-6 cut-off level of 42 pg/ml showing a high sensitivity (90%) and specificity (85%).
Conclusion
These findings may have clinical implications for risk-based antimicrobial treatment strategies. |