Pro-adrenomedullin as a Novel Biomarker for Predicting Infections and Response to Antimicrobials in Febrile Patients With Hematologic Malignancies
Background. Health professionals and researchers have become increasingly interested in biomarkers that help them in diagnosis of infections with recent growing attention to procalcitonin (PCT) and pro-adrenomedullin (proADM). Methods. This study compares proADM to PCT as diagnostic and prognostic b...
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| Veröffentlicht in: | Clinical infectious diseases 2013-04, Vol.56 (7), p.943-950 |
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| creator | Al Shuaibi, Munirah Bahu, Ramez R. Chaftari, Anne-Marie Al Wohoush, Iba Shomali, William Jiang, Ying Debiane, Labib Raad, Sammy Jabbour, Joseph Al Akhrass, Fady Hachem, Ray Y. Raad, Issam |
| description | Background. Health professionals and researchers have become increasingly interested in biomarkers that help them in diagnosis of infections with recent growing attention to procalcitonin (PCT) and pro-adrenomedullin (proADM). Methods. This study compares proADM to PCT as diagnostic and prognostic biomarkers of infection in febrile patients with hematologic malignancies (HMs). From June 2009 to December 2010, 340 febrile HM patients were evaluated for presence of sepsis, systemic inflammatory response syndrome (SIRS), documented infections, and response to antimicrobial therapy. Results. ProADM and PCT levels were measured at onset of fever and then on days 4–7 afterward. Of the 340 patients, 103 had definite sepsis, and 159 had SIRS. Only proADM initial levels were significantly higher in patients with localized bacterial infections than in those with no documented infection (P = .019) and in patients with definite sepsis than those with SIRS (P = .023). The initial proADM and PCT levels were significantly higher in neutropenic patients with BSIs than in those without documented infections (P = .010 and P =. 011, respectively). Follow-up, proADM, and PCT levels decreased significantly in response to antimicrobial therapy in patients with bacterial infections (BSIs or localized; P = .007 and P = .002, respectively). Conclusions. ProADM and PCT have promising roles in assisting clinicians in managing febrile HM patients. However, proADM appears to have the advantage of predicting localized bacterial infection and differentiating sepsis from SIRS. |
| doi_str_mv | 10.1093/cid/cis1029 |
| format | Article |
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Health professionals and researchers have become increasingly interested in biomarkers that help them in diagnosis of infections with recent growing attention to procalcitonin (PCT) and pro-adrenomedullin (proADM). Methods. This study compares proADM to PCT as diagnostic and prognostic biomarkers of infection in febrile patients with hematologic malignancies (HMs). From June 2009 to December 2010, 340 febrile HM patients were evaluated for presence of sepsis, systemic inflammatory response syndrome (SIRS), documented infections, and response to antimicrobial therapy. Results. ProADM and PCT levels were measured at onset of fever and then on days 4–7 afterward. Of the 340 patients, 103 had definite sepsis, and 159 had SIRS. Only proADM initial levels were significantly higher in patients with localized bacterial infections than in those with no documented infection (P = .019) and in patients with definite sepsis than those with SIRS (P = .023). The initial proADM and PCT levels were significantly higher in neutropenic patients with BSIs than in those without documented infections (P = .010 and P =. 011, respectively). Follow-up, proADM, and PCT levels decreased significantly in response to antimicrobial therapy in patients with bacterial infections (BSIs or localized; P = .007 and P = .002, respectively). Conclusions. ProADM and PCT have promising roles in assisting clinicians in managing febrile HM patients. However, proADM appears to have the advantage of predicting localized bacterial infection and differentiating sepsis from SIRS.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1093/cid/cis1029</identifier><identifier>PMID: 23288950</identifier><identifier>CODEN: CIDIEL</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Adolescent ; Adrenomedullin - blood ; Adult ; Aged ; Aged, 80 and over ; Anti-Infective Agents - administration & dosage ; Antibiotics ; Antimicrobial agents ; Antimicrobials ; ARTICLES AND COMMENTARIES ; Bacteremia ; Bacterial infections ; Biological and medical sciences ; Biological markers ; Biomarkers ; Biomarkers - blood ; Calcitonin - blood ; Calcitonin Gene-Related Peptide ; Child ; Child, Preschool ; Comparative studies ; Critical care ; Disease management ; Drug Monitoring - methods ; Female ; Fever ; Fever of Unknown Origin - diagnosis ; Fever of Unknown Origin - drug therapy ; Hematologic Neoplasms - complications ; Humans ; Infections ; Infectious diseases ; Male ; Medical sciences ; Middle Aged ; Neutropenia ; Peptides ; Protein Precursors - blood ; Sepsis ; Young Adult</subject><ispartof>Clinical infectious diseases, 2013-04, Vol.56 (7), p.943-950</ispartof><rights>Copyright © 2013 Oxford University Press on behalf of the Infectious Diseases Society of America</rights><rights>2014 INIST-CNRS</rights><rights>Copyright Oxford University Press, UK Apr 1, 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-996d534d9c6f74d6aa7b9378b0c26449e75c62cdf55f31e1cf8e2b3c9b128e173</citedby><cites>FETCH-LOGICAL-c439t-996d534d9c6f74d6aa7b9378b0c26449e75c62cdf55f31e1cf8e2b3c9b128e173</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/23481975$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/23481975$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,776,780,799,27901,27902,57992,58225</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27140473$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23288950$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Al Shuaibi, Munirah</creatorcontrib><creatorcontrib>Bahu, Ramez R.</creatorcontrib><creatorcontrib>Chaftari, Anne-Marie</creatorcontrib><creatorcontrib>Al Wohoush, Iba</creatorcontrib><creatorcontrib>Shomali, William</creatorcontrib><creatorcontrib>Jiang, Ying</creatorcontrib><creatorcontrib>Debiane, Labib</creatorcontrib><creatorcontrib>Raad, Sammy</creatorcontrib><creatorcontrib>Jabbour, Joseph</creatorcontrib><creatorcontrib>Al Akhrass, Fady</creatorcontrib><creatorcontrib>Hachem, Ray Y.</creatorcontrib><creatorcontrib>Raad, Issam</creatorcontrib><title>Pro-adrenomedullin as a Novel Biomarker for Predicting Infections and Response to Antimicrobials in Febrile Patients With Hematologic Malignancies</title><title>Clinical infectious diseases</title><addtitle>Clin Infect Dis</addtitle><description>Background. Health professionals and researchers have become increasingly interested in biomarkers that help them in diagnosis of infections with recent growing attention to procalcitonin (PCT) and pro-adrenomedullin (proADM). Methods. This study compares proADM to PCT as diagnostic and prognostic biomarkers of infection in febrile patients with hematologic malignancies (HMs). From June 2009 to December 2010, 340 febrile HM patients were evaluated for presence of sepsis, systemic inflammatory response syndrome (SIRS), documented infections, and response to antimicrobial therapy. Results. ProADM and PCT levels were measured at onset of fever and then on days 4–7 afterward. Of the 340 patients, 103 had definite sepsis, and 159 had SIRS. Only proADM initial levels were significantly higher in patients with localized bacterial infections than in those with no documented infection (P = .019) and in patients with definite sepsis than those with SIRS (P = .023). The initial proADM and PCT levels were significantly higher in neutropenic patients with BSIs than in those without documented infections (P = .010 and P =. 011, respectively). Follow-up, proADM, and PCT levels decreased significantly in response to antimicrobial therapy in patients with bacterial infections (BSIs or localized; P = .007 and P = .002, respectively). Conclusions. ProADM and PCT have promising roles in assisting clinicians in managing febrile HM patients. However, proADM appears to have the advantage of predicting localized bacterial infection and differentiating sepsis from SIRS.</description><subject>Adolescent</subject><subject>Adrenomedullin - blood</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-Infective Agents - administration & dosage</subject><subject>Antibiotics</subject><subject>Antimicrobial agents</subject><subject>Antimicrobials</subject><subject>ARTICLES AND COMMENTARIES</subject><subject>Bacteremia</subject><subject>Bacterial infections</subject><subject>Biological and medical sciences</subject><subject>Biological markers</subject><subject>Biomarkers</subject><subject>Biomarkers - blood</subject><subject>Calcitonin - blood</subject><subject>Calcitonin Gene-Related Peptide</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Comparative studies</subject><subject>Critical care</subject><subject>Disease management</subject><subject>Drug Monitoring - methods</subject><subject>Female</subject><subject>Fever</subject><subject>Fever of Unknown Origin - diagnosis</subject><subject>Fever of Unknown Origin - drug therapy</subject><subject>Hematologic Neoplasms - complications</subject><subject>Humans</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neutropenia</subject><subject>Peptides</subject><subject>Protein Precursors - blood</subject><subject>Sepsis</subject><subject>Young Adult</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0cuKFDEUBuAginPRlWslIIIgpUklqSTLcZhxBkZtRHFZpFKn2rSppE1Sgq_hE5u22wtuXIScxZcfcn6EHlDynBLNXlg31pMpafUtdEwFk00nNL1dZyJUwxVTR-gk5w0hlCoi7qKjlrVKaUGO0fdVio0ZE4Q4w7h47wI2GRv8Jn4Fj1-6OJv0GRKeYsKrBKOzxYU1vg4T1CmGasOI30He1hlwifgsFDc7m-LgjM-4Bl7CkJwHvDLFQSgZf3TlE76C2ZTo49pZ_Np4tw4mWAf5Hroz1Ydw_3Cfog-XF-_Pr5qbt6-uz89uGsuZLo3W3SgYH7XtJsnHzhg5aCbVQGzbca5BCtu1dpyEmBgFaicF7cCsHmirgEp2ip7uc7cpflkgl3522YL3JkBcck-lZKrlVNH_U0YFZYzxHX38D93EJYX6kZ-qZZITVdWzvapryjnB1G-Tq5v-1lPS71rta6v9odWqHx0yl6G29Nv-qrGCJwdgsjV-SrtN5j9OUk64ZNU93LtNLjH9lcMV1VKwH3DBtcU</recordid><startdate>20130401</startdate><enddate>20130401</enddate><creator>Al Shuaibi, Munirah</creator><creator>Bahu, Ramez R.</creator><creator>Chaftari, Anne-Marie</creator><creator>Al Wohoush, Iba</creator><creator>Shomali, William</creator><creator>Jiang, Ying</creator><creator>Debiane, Labib</creator><creator>Raad, Sammy</creator><creator>Jabbour, Joseph</creator><creator>Al Akhrass, Fady</creator><creator>Hachem, Ray Y.</creator><creator>Raad, Issam</creator><general>Oxford University Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T2</scope><scope>7T7</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20130401</creationdate><title>Pro-adrenomedullin as a Novel Biomarker for Predicting Infections and Response to Antimicrobials in Febrile Patients With Hematologic Malignancies</title><author>Al Shuaibi, Munirah ; Bahu, Ramez R. ; Chaftari, Anne-Marie ; Al Wohoush, Iba ; Shomali, William ; Jiang, Ying ; Debiane, Labib ; Raad, Sammy ; Jabbour, Joseph ; Al Akhrass, Fady ; Hachem, Ray Y. ; Raad, Issam</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-996d534d9c6f74d6aa7b9378b0c26449e75c62cdf55f31e1cf8e2b3c9b128e173</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adrenomedullin - blood</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anti-Infective Agents - administration & dosage</topic><topic>Antibiotics</topic><topic>Antimicrobial agents</topic><topic>Antimicrobials</topic><topic>ARTICLES AND COMMENTARIES</topic><topic>Bacteremia</topic><topic>Bacterial infections</topic><topic>Biological and medical sciences</topic><topic>Biological markers</topic><topic>Biomarkers</topic><topic>Biomarkers - blood</topic><topic>Calcitonin - blood</topic><topic>Calcitonin Gene-Related Peptide</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Comparative studies</topic><topic>Critical care</topic><topic>Disease management</topic><topic>Drug Monitoring - methods</topic><topic>Female</topic><topic>Fever</topic><topic>Fever of Unknown Origin - diagnosis</topic><topic>Fever of Unknown Origin - drug therapy</topic><topic>Hematologic Neoplasms - complications</topic><topic>Humans</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neutropenia</topic><topic>Peptides</topic><topic>Protein Precursors - blood</topic><topic>Sepsis</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Al Shuaibi, Munirah</creatorcontrib><creatorcontrib>Bahu, Ramez R.</creatorcontrib><creatorcontrib>Chaftari, Anne-Marie</creatorcontrib><creatorcontrib>Al Wohoush, Iba</creatorcontrib><creatorcontrib>Shomali, William</creatorcontrib><creatorcontrib>Jiang, Ying</creatorcontrib><creatorcontrib>Debiane, Labib</creatorcontrib><creatorcontrib>Raad, Sammy</creatorcontrib><creatorcontrib>Jabbour, Joseph</creatorcontrib><creatorcontrib>Al Akhrass, Fady</creatorcontrib><creatorcontrib>Hachem, Ray Y.</creatorcontrib><creatorcontrib>Raad, Issam</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Al Shuaibi, Munirah</au><au>Bahu, Ramez R.</au><au>Chaftari, Anne-Marie</au><au>Al Wohoush, Iba</au><au>Shomali, William</au><au>Jiang, Ying</au><au>Debiane, Labib</au><au>Raad, Sammy</au><au>Jabbour, Joseph</au><au>Al Akhrass, Fady</au><au>Hachem, Ray Y.</au><au>Raad, Issam</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pro-adrenomedullin as a Novel Biomarker for Predicting Infections and Response to Antimicrobials in Febrile Patients With Hematologic Malignancies</atitle><jtitle>Clinical infectious diseases</jtitle><addtitle>Clin Infect Dis</addtitle><date>2013-04-01</date><risdate>2013</risdate><volume>56</volume><issue>7</issue><spage>943</spage><epage>950</epage><pages>943-950</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><coden>CIDIEL</coden><abstract>Background. Health professionals and researchers have become increasingly interested in biomarkers that help them in diagnosis of infections with recent growing attention to procalcitonin (PCT) and pro-adrenomedullin (proADM). Methods. This study compares proADM to PCT as diagnostic and prognostic biomarkers of infection in febrile patients with hematologic malignancies (HMs). From June 2009 to December 2010, 340 febrile HM patients were evaluated for presence of sepsis, systemic inflammatory response syndrome (SIRS), documented infections, and response to antimicrobial therapy. Results. ProADM and PCT levels were measured at onset of fever and then on days 4–7 afterward. Of the 340 patients, 103 had definite sepsis, and 159 had SIRS. Only proADM initial levels were significantly higher in patients with localized bacterial infections than in those with no documented infection (P = .019) and in patients with definite sepsis than those with SIRS (P = .023). The initial proADM and PCT levels were significantly higher in neutropenic patients with BSIs than in those without documented infections (P = .010 and P =. 011, respectively). Follow-up, proADM, and PCT levels decreased significantly in response to antimicrobial therapy in patients with bacterial infections (BSIs or localized; P = .007 and P = .002, respectively). Conclusions. ProADM and PCT have promising roles in assisting clinicians in managing febrile HM patients. However, proADM appears to have the advantage of predicting localized bacterial infection and differentiating sepsis from SIRS.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>23288950</pmid><doi>10.1093/cid/cis1029</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adrenomedullin - blood Adult Aged Aged, 80 and over Anti-Infective Agents - administration & dosage Antibiotics Antimicrobial agents Antimicrobials ARTICLES AND COMMENTARIES Bacteremia Bacterial infections Biological and medical sciences Biological markers Biomarkers Biomarkers - blood Calcitonin - blood Calcitonin Gene-Related Peptide Child Child, Preschool Comparative studies Critical care Disease management Drug Monitoring - methods Female Fever Fever of Unknown Origin - diagnosis Fever of Unknown Origin - drug therapy Hematologic Neoplasms - complications Humans Infections Infectious diseases Male Medical sciences Middle Aged Neutropenia Peptides Protein Precursors - blood Sepsis Young Adult |
| title | Pro-adrenomedullin as a Novel Biomarker for Predicting Infections and Response to Antimicrobials in Febrile Patients With Hematologic Malignancies |
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