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Comparison of use of PCT with other inflammatory markers (IL-6 e PCR) for diagnosis, and prognosis of febrile neutropenic hematology transplant patients

Grant number: 09/07399-0
Support type:Regular Research Grants
Duration: July 01, 2009 - August 31, 2011
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal Investigator:Silvia Figueiredo Costa
Grantee:Silvia Figueiredo Costa
Home Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Infections are the major cause of morbidity and mortality among stem cell transplant patients. The issue is to differentiate other causes of fever such as graft versus host diseases (GVHD) and venous occlusive diseases VOD of infections. The diagnosis and outcome of infections could improve through the use of early, sensitive and specific inflammatory markers of bacteria and fungi infections. The aim of this study is to compare the use of procalcitonin (PCT) with other markers of Systemic Inflammatory Response Syndrome (SIRS) such as PCR and IL-6 for diagnosing infection among SCT. It is a prospective multicenter cohort study. Two hundred patients hospitalized in Hospital das Clinicas of FMUSP and Hospital São Paulo (UNIFESP) undergoing to SCT will be enrolled. Blood samples during the neutropenic period will be colleted and analyzed in the following moments:D0: First Day of neutropenia D1: Fever or Hypothermia D2: 24 hours after D3: 48 hours afterD4: 72 hours afterD5: 48 hours after the end of Fever or Hypothermia. Procalcitonin, PCR, IL-6 will be measure and microbiology cultures will be performed. Blood and urine cultures, tracheal secretion and thorax image, will be done before the beginning of antibiotic. Neutropenia should be confirming by white cell count exam. The cause of infection will be classified in bacteria, fungi and virus the according to the results of cultures and other diagnosis methods. The patients will be categorized in 04 groups: bacterial, viral, fungi and those with negative cultures. (AU)