Factors affecting inflammatory markers in neutropenic patients with bacteremia: An international ID-IRI study

We aimed to determine factors that elevate procalcitonin (PCT), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) levels in neutropenic patients with bacteremia. We enrolled 130 diagnosed patients from 41 centers in 16 countries: malignancies (n=104, 80%), and solid tumors (n=26, 20%). An infection source was identified in (n=44) 33.8% and Gram-negative bacteremia occurred in (n=98) 75.4%. High CRP levels were associated with hematological malignancies [OR 4.43, p=0.023]. PCT was higher in hematopoietic stem cell transplant recipients [OR 6.71, p=0.023] but lower without deep neutropenia [OR 0.30, p=0.029] or in the absence of an obvious infection source [OR 0.31, p=0.034]. No factors significantly affected ESR. PCT, CRP, and ESR have decreased utility in identifying infections in neutropenic bacteremia patients. High CRP indicates hematological malignancies. PCT is elevated after stem cell transplant, with deep neutropenia and a detectable infection source. ESR is not significantly affected by patient factors in this setting