Affordable Access

deepdyve-link
Publisher Website

Significance of biomarkers in stewardship program in pediatric patients infected with Aspergillus species

Authors
  • Badiee, Parisa
  • Amanati, Ali
  • Ghasemi, Fatemeh
  • Jafarian, Hadis
Type
Published Article
Journal
Italian Journal of Pediatrics
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Jun 25, 2022
Volume
48
Identifiers
DOI: 10.1186/s13052-022-01306-6
PMID: 35752831
PMCID: PMC9233773
Source
PubMed Central
Keywords
Disciplines
  • Research
License
Unknown

Abstract

Background The potential use of biomarkers in the diagnosis of fungal infections is a challenge. The aim of this study was to evaluate the role of a biomarker-guided antifungal stewardship program for hospitalized pediatrics suffering from invasive aspergillosis (IA). Methods Pediatric patients with suspected probable or proven IA were enrolled in this study. Demographic data were collected from their records. Clinical samples were examined by wet mount KOH smear, culture, galactomannan Ag test, and real-time PCR. Patients’ sera were evaluated for procalcitonin (PCT) and soluble-triggering receptor expressed on myeloid cells -1 (sTREM-1) levels by ELISA Kits. Results A total of 73 children were entered in this study with a mean age of 5 years and the male to female ratio 39/34. The most predisposing factors were hematologic disorders (71.2%). The area under the curves (95% confidence interval) for each biomarker were 0.9 (0.85% to 97%) for lactate de hydrogenase (LDH), 0.9 (0.85% to 0.94%) for C-reactive protein, 0.8 (0.75% to 0.84%) for PCT, 0.8 (0.73% to 0.85%) for erythrocyte sedimentation rate, 0.7 (0.6% to 0.8%) for sTREM-1, and 0.5 (0.45% to 0.58%) for white blood cell count. During the study period, 27.4% patients died. The LDH and sTREM-1 levels were significant increase in died patient ( p < 0.05). Conclusions According to our data, evaluation of biomarkers along with radiologic and clinical signs and symptoms of pediatric patients can lead to proper antifungal therapy and decreased side effects, antifungal resistance, and cost. The combined measurements could be better than a single marker in the prediction of IA.

Report this publication

Statistics

Seen <100 times