PD022 - VALUE OF PROCALCITONIN AND C-REACTIVE PROTEIN DURING SYSTEMIC INFLAMMATORY RESPONSE SYNDROME: DIFFERENTIAL DIAGNOSIS UTILITY (ID 348)
Abstract
Backgrounds:
There is still some debate concerning the problem of differential diagnosis between etiology of infections in pediatric patients with oncological diseases. PCT and CRP could be helpful for optimization of antimicrobial therapy and better infection control evaluation.
Methods
Retrospective analysis of 125 episodes of fever during neutropenia in 70 pediatric with solid tumor (52,8%) or hemoblastosis (47,2%) was made. Laboratory diagnostics included microscopy, cultural, serological analysis of body fluids and visualizing diagnostics. CRP and PCT levels were measured in onset of fever, on 1-2 day after initiation of antimicrobial therapy. Two groups were identified: 1 group - nonbacterial infection/ other etiology of fever (n=54) and 2 group - – verified bacterial infection (n=70). The 2nd group was subdivided into severe bacterial infection and non-severe according clinical data, ICU hospitalization, outcome.
Results:
The median CRP and PCT in groups 1 and 2 were 157.0 g/l vs 159.7 g/l (p=0.67) and 0.4 ng/ml vs 1.47 ng/ml (p=0.000) respectively. The area under the ROC curves for CRP and PCT differed significantly (p=0.004) that indicates the higher values of PCT in diagnosing bacterial infection. In groups of severe and non-severe bacterial infections the values of CRP also had no significant difference – 162.3 ng/ml vs 152.3 ng/ml (p=0.121), but for PCT we revealed positive significant correlation (2.7 ng/ml vs 0.23 ng/ml, p=0.000). We noted more rapid (1-2 day after antibacterial therapy was started) and significant decrease of PCT (0.68 vs 0.5, p=0.011) compared to CRP (159.9 vs 145.3, p=0.7) in case of infection control achievement.
Conclusions/Learning Points:
We consider that usage of PCT can be helpful for earlier diagnostic of infections, differential diagnosis of etiology of fever, better control of response to antimicrobial therapy and prevention of inappropriate antibiotic usage.
