Abstract 551P
Background
During cancer treatment,fevers are common but no always due to bacterial infections.Without reliable prediction tools,treatment delays occur,risking effectiveness and increasing antibiotic resistance.This study aims to identify clinical features and procalcitonin levels(PCT) as indicators of bacterial infection in febrile cancer patients.
Methods
This retrospective study enrolled 225 solid organ cancer patients with fever at Maharat Nakorn Ratchasima Hospital.Clinical characteristics,symptoms,cancer type and stage,performance status,lab results,and bacterial cultures were collected.Associations were analyzed using logistic regression,and the appropriate PCT cut-point was determined using ROC analysis.
Results
Of 225 cancer patients with fever, 54(24%) had positive bacterial cultures, primarily from sputum and urine, with Klebsiella pneumoniae being the most common pathogen. Significant clinical features linked to bacterial infection included increased heart rate (OR 1.04, 95%Cl 1.02-1.07) and localizing symptoms (OR 5.5, 95%Cl 2.11-14.35). Key laboratory findings were absolute neutrophil count (OR 1.09, 95%Cl 1.0-1.2) and PCT level (OR 1.33, 95%Cl 1.05-1.67). The appropriate PCT cut-point for predicting bacterial infection was analyzed using various methods,resulting in 1.045, 0.546, 0.546, and 0.4025 ng/ml. The Youden Index suggested a rounded cut-point of 1.0ng/ml, which provides a sensitivity of 55%, specificity of 84%, PPV of 53%, and NPV of 86%. The AUC for PCT was 0.702, indicating moderate accuracy. In addition to clinical evaluation,procalcitonin levels can help identify bacterial infections in febrile cancer patients.
Conclusions
In addition to clinical evaluation,Procalcitonin level may be used as an additional factor to classify the cause of febrile in cancer patients.Additionally,the clinical predictive model may be helpful in the future.
Clinical trial identification
TCTR20221112003.
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
P. Patipatdontri: Non-Financial Interests, Personal and Institutional, Non-financial benefits: Maharat Nakornratchasima Hospital, Thailand. J. Thanestada, R. Kajeekul: Financial Interests, Personal, Advisory Board: Maharat Nakornratchasima Hospital.