High procalcitonin level is related to blood stream infections, gram-negative pathogens, and ICU admission in infections of adult febrile cancer patients.

BACKGROUND

Blood stream infection (BSI) represent a life-threatening condition. Thus, we aimed to investigate the role of procalcitonin (PCT) and C-reactive protein (CRP) tests in adult febrile patients with BSI and other clinical infections in hospitalized cancer cases.

METHODS

Blood culture (BC) testing was performed using BACTEC 9120. Identification and antibiotic susceptibility were done by Vitek 2®. Multiplex PCR for the detection of carbapenemases genes produced by Enterobacteriaceae was carried out including KPC, NDM, IMP, VIM, and Oxa-48 genes. Measurement of CRP was done via particle-enhanced immunoturbidimetric assay using Cobas C6000 autoanalyzer. PCT level was measured using the electrochemiluminescence immunoassay.

RESULTS

Out of 101 febrile hospitalized adult cancer cases with clinical infection, 50 had positive BC, and 51 were positive for other infections (27 localized bacterial and 24 viral infections) with a negative BC. At a PCT cut-off value of 0.5 ng/mL, PCT median values were significantly higher in BSI patients than those with other infections (p = 0.004), specifically with gram-negative BSIs (p = 0.007). Higher PCT values were significantly related to ICU admission and poor response to therapy, p = 0.004 and 0.002, respectively. The difference in CRP values between patients with BSI and other febrile cases was not statistically significant, p = 0.922.

CONCLUSION

Higher PCT values were significantly related to blood stream infections, gram-negative pathogens, ICU admission, and poor response to therapy. Procalcitonin could be used to assign severity of infection and monitor response to antimicrobial therapy in high-risk patients, thus reducing days of antibiotics days.