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| Objective: A prospective study of cytokine patterns to predict Gram-positive and Gram-negative bacteremia (GPB and GNB) in pediatric cases of febrile neutropenia diagnosed with hematological diseases and cancer was conducted. Method: A total of 277 hospitalized patients with microbiologically documented bacteremia were enrolled, including 114 (41.2%) with GPB and 163 (58.8%) with GNB. Results: The median levels of IL-6, IL-10, and TNF-α of GNB were 404.8 pg/ml, 118.0 pg/ml and 4.8 pg/ml, respectively, which were significantly higher than those of GPB measured at 110.5 pg/ml, 18.3 pg/ml and 3.5 pg/ml, respectively. The cut-off values of IL-6, IL-10 and TNF-α for GNB in patients without septic shock were 140.0 pg/ml, 30.0 pg/ml and 3.5 pg/ml, respectively, with sensitivities and specificities of 73.0%, 75.2%, 60.3% and 62.6%, 69.4%, 51.4%, respectively. Conclusion: The cytokine patterns provide a useful tool for clinicians to distinguish GNB form GPB in febrile neutropenia associated with hematological and oncological disorders without septic shock for early intervention and accurate antibiotic therapy.????? |
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| Keywords:bacteremia; gram-positive; gram-negative; cytokine. |
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