977. Comparing Biomarkers Procalcitonin (PCT)  and Pro-adrenomedullin (proADM)  as a Predictor of Response to Antibiotics in Critically Ill Cancer Patients with Bacteremia and Sepsis
Session: Poster Abstract Session: Clinical Studies of Bacterial Infection
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
  • 977_LauraClaburn_sm.pdf (1.9 MB)
  • Background: Procalcitonin and Pro-adrenomedullin have been proposed as prognostic biomarkers in critically ill patients with sepsis. We compared both biomarkers and examined their role for diagnosis and management of bacterial infection and sepsis in critically ill cancer patients with fever.

    Methods: Between July 2009 and July 2010, we studied 124 critically ill ICU patients with fever (≥38.3°C) including patients with febrile neutropenia, critical care patients and hematopoietic stem cell transplant recipients. Febrile patients were classified as having definite bacterial infections or sepsis. Patients’ response to antimicrobial therapy was defined as defervescence and or microbiological eradication within 96 hrs of therapy.  Pro-ADM and PCT were tested on plasma on the day of the fever and 4-7 days thereafter. All samples were measured in the Kryptor machine.

    Results: In critically ill patients with bacterial infections, response to antibiotic therapy correlated with a significant decrease of PCT level (P=0.003) but not significant with proADM levels (p=0.33) after 4-7 days of therapy. Sepsis patients had higher PCT values (median: 1.73 vs. 0 .33 p=.015) and pro-ADM values (median: 2.21 vs. 1.37, P=0.008) when compared to non-sepsis patients. In patients with bacteremia the PCT and proADM levels were higher than patients without bacteremia with p=0.003 and p=0.008, respectively.

    Conclusion: PCT is a predictor of response to antibiotics in critically ill cancer patients with bacterial infections. Both biomarkers PCT and proADM were predictors of bacteremia and sepsis in critically ill cancer patients.


    Subject Category: D. Diagnostic microbiology

    Ray Hachem, MD, Labib Debiane, MD, William Shomali, MD, Ramez Bahu, MD, Iba Al Wohoush, MD, Ying Jiang, MS, Alex Hanania, Sammy Raad, Anne-Marie Chaftari, MD and Issam Raad, MD, Infectious Diseases, Infection Control & Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX

    Disclosures:

    R. Hachem, None

    L. Debiane, None

    W. Shomali, None

    R. Bahu, None

    I. Al Wohoush, None

    Y. Jiang, None

    A. Hanania, None

    S. Raad, None

    A. M. Chaftari, None

    I. Raad, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.