Can procalcitonin help identify associated bacterial infection in patients with severe influenza pneumonia? A multicentre study View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2011-03-03

AUTHORS

E. Cuquemelle, F. Soulis, D. Villers, F. Roche-Campo, C. Ara Somohano, M. Fartoukh, A. Kouatchet, B. Mourvillier, J. Dellamonica, W. Picard, M. Schmidt, T. Boulain, C. Brun-Buisson

ABSTRACT

PURPOSE: To determine whether procalcitonin (PCT) levels could help discriminate isolated viral from mixed (bacterial and viral) pneumonia in patients admitted to the intensive care unit (ICU) during the A/H1N1v2009 influenza pandemic. METHODS: A retrospective observational study was performed in 23 French ICUs during the 2009 H1N1 pandemic. Levels of PCT at admission were compared between patients with confirmed influenzae A pneumonia associated or not associated with a bacterial co-infection. RESULTS: Of 103 patients with confirmed A/H1N1 infection and not having received prior antibiotics, 48 (46.6%; 95% CI 37-56%) had a documented bacterial co-infection, mostly caused by Streptococcus pneumoniae (54%) or Staphylococcus aureus (31%). Fifty-two patients had PCT measured on admission, including 19 (37%) having bacterial co-infection. Median (range 25-75%) values of PCT were significantly higher in patients with bacterial co-infection: 29.5 (3.9-45.3) versus 0.5 (0.12-2) μg/l (P < 0.01). For a cut-off of 0.8 μg/l or more, the sensitivity and specificity of PCT for distinguishing isolated viral from mixed pneumonia were 91 and 68%, respectively. Alveolar condensation combined with a PCT level of 0.8 μg/l or more was strongly associated with bacterial co-infection (OR 12.9, 95% CI 3.2-51.5; P < 0.001). CONCLUSIONS: PCT may help discriminate viral from mixed pneumonia during the influenza season. Levels of PCT less than 0.8 μg/l combined with clinical judgment suggest that bacterial infection is unlikely. More... »

PAGES

796-800

References to SciGraph publications

  • 2010-01-13. Procalcitonin and C-reactive protein in severe 2009 H1N1 influenza infection in INTENSIVE CARE MEDICINE
  • 2008-08-02. Prognostic value of procalcitonin in Legionella pneumonia in EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
  • Journal

    TITLE

    Intensive Care Medicine

    ISSUE

    5

    VOLUME

    37

    Clinical Trials linked to this publication

    Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00134-011-2189-1

    DOI

    http://dx.doi.org/10.1007/s00134-011-2189-1

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1045268683

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/21369807


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