Serum
cytokine profiles were analyzed before and after
infection in children with hemopathy in the bone marrow inhibition phase to explore the utility of
cytokine variations for detecting
infections. Serum Th1/Th2
cytokine levels, including
tumor necrosis factor,
interleukin (IL)-2,
IL-4,
IL-6,
IL-10, and
interferon, were quantitatively determined by cytometric bead array technology in 480 cases (230 children) of children with hemopathy in the bone marrow inhibition phase with signs of
infection, such as
fever, and without, to establish baseline and affected levels for comparison with healthy control children. We used the
cytokine profile of infected, blood culture-positive children to establish a
bacterial infection-related
cytokine profile (BIRCP) for predicting
infections by pathogens in blood culture-negative children. Overall, 82.9% of children with
Gram-negative bacterial infections were accompanied by marked increases of
IL-6 and
IL-10 levels [>10 times (means ± SD)], whereas only a mild increase of
IL-6 levels occurred in Gram-positive bacteria-infected children [>2 times (means ± SD)] and only a mild increase of IFN-γ levels occurred in fungal culture-positive children [>2 times (means ± SD)]. Gram-positive bacterial and
fungal infections did not cause a marked increase in
IL-6 or IL- 10 levels. The effective rate (86.05%, N = 43) of infectious cases predicted by BIRCP was significantly higher than that obtained using traditional methods for selecting
antibiotics based on clinical indications (65.45%, N = 55, P < 0.05). In summary, BIRCP can be used to predict the
infections by pathogens in children with hemopathy and to select appropriate
antibiotics.