BACTERIAL DNA AND INTERLEUKIN-6 IN CANCER CHIDLREN WITH A POSITIVE BLOOD CULTURE

Hesseling PB¹, Bouic P², Wessels G¹, Nel ED¹, Loxton A^{2

1}Paediatrics, Tygerberg Children�s Hospital, Tygerberg, South Africa
²Microbiology, Tygerberg Children�s Hospital, Tygerberg, South Africa

Objective: To determine the value of Interleukin 6 (IL-6) levels and the presence of DNA in febrile children on cancer treatment in predicting bacterial sepsis.

Methods: We prospectively measured serum bacterial DNA and IL-6 while routinely collecting blood from peripheral veins and indwelling catheters for aerobic and anaerobic radiometric blood culture assays (Bactec 640). Bacterial DNA in serum was measured by amplifying the DNA encoding the 16 sr RNA (861 bp fragment) of bacteria. IL-6 was measured by ELISA in wells coated with rabbit anti IL-6 (Sigma Maxisdorp). A coulter blood count was performed routinely. Parents gave informed consent.

Results: 25 children (8 lymphoma, 7 leukaemia, 8 solid tumours, 2 Fanconi anaemia) had 81 episodes of pyrexia between February and August 2000 with known blood culture results. 17 postivie cultures consisted of Staph aureus (2), Klebs pneumonia (5), Acinetobacter baumani (1), Streptococcus vestibularis (1), Pseudomonas aeruginosa (1), Neisseria sp (1), Salmonella Group B (2), coagulase negative Staphylococci (3) and a gram negative Bacillus. Bacterial DNA was positive in 9/17 (53%) positive and in 16/63 (52%) negative blood cultures. IL-6 was positive in 12/17 (70%) positive blood cultures, (p.0087). All of the parameters tested were not influenced by the level of neutropenia. Conclusion: A positive blood culture remains the golden standard to confirm bacterial infection in blood.

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