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SCIENTIFIC-PRACTICAL PEER-REVIEWED MONTHLY JOURNAL.
INSTITUTION OF MINISTRY OF PUBLIC HEALTH OF THE REPUBLIC OF BELARUS

CLINICAL VALUE OF BIOLOGICAL MARKERS FOR DIAGNOSING INVASIVE MYCOSIS IN PATIENTS SUFFERING FROM TUMOROUS DISEASES OF HEMATOPOIETIC TISSUES

Objective. To assess the diagnostic characteristics of sepsis biological markers combinations for early diagnosis of invasive mycosis in immunocompromised patients.

Materials and methods. The study involved 64 adult patients including 53 persons with verified bacterial infections and eleven subjects with invasive mycosis getting chemotherapy for tumorous diseases of hematopoietic tissue. The
C-reactive protein as well as procalcitonin or presepsin levels were identified in the patient’s fresh blood assays within 48 hours after the febrile period start. For determining biological markers combinations characteristics, ROC-analysis accompanied by logistic regression was applied.

Results. C-reactive protein >120 mg/l accompanied by procalcitonin <1.25 ng/ml or presepsin <170 pg/ml served the early combined diagnostic sign of invasive mycosis in immunocompromised patients. The ROC curve AUC values were 0.962 (95% CI (0.868—0.995)) for combination with procalcitonin and 0.907 (95% CI (0.692—0.990)) for combination with presepsin.

Conclusion. An evidently elevated C-reactive protein accompanied by low levels of procalcitonin or presepsin is found to be highly informative in diagnosing invasive mycosis against immunosuppression and this should be taken into account in the clinical practice when prescribing empirical antifungal therapy at an early stage.