Procalcitonin in 2009 H1N1 Influenza Pneumonia: Role in Differentiating from Bacterial Pneumonia.

Tuberculosis and Respiratory Diseases

article

Ahn, Shin¹  Kim, Won Young¹  Yoon, Ji Young¹  Sohn, Chang Hwan¹  Seo, Dong Woo¹  Kim, Sung Han²  Hong, Sang Bum³  Lim, Chae Man³  Koh, Youn Suck³  Kim, Won¹ 

[1] Departments of Asan Medical Center, University of Ulsan College of Medicine;Departments of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine;Departments of Respiratory and Critical Care Medicine, University of Ulsan College of Medicine

关键词: Influenza A Virus;    H1N1 Subtype;    Procalcitonin;    Pneumonia;   

DOI  :  10.4046/trd.2010.68.4.205

学科分类：医学（综合）

来源: The Korean Academy of Tuberculosis and Respiratory Diseases

【 摘 要 】

BACKGROUND Procalcitonin is a well known marker in infection that plays a role in distinguishing between bacterial and viral infections in screening. The aim of the present study was to evaluate the role of procalcitonin in differentiating between 2009 H1N1 influenza pneumonia and community acquired pneumonia of bacterial origin, or mixed bacterial origin and 2009 H1N1 influenza infection. METHODS: A retrospective observational study was performed over the 6-month winter period during the 2009 H1N1 influenza pandemic. Ninety-six patient-subjects were enrolled, all of whom had been diagnosed with community acquired pneumonia in emergency department during the study period. On admission, laboratory studies were performed, which included 2009 H1N1 influenza real-time polymerase chain reaction of nasal secretions and procalcitonin on serum; the laboratory values were compared between the study groups. Receiver operating characteristic curve analyses were performed on the resulting data. RESULTS: Compared to those with bacterial or mixed infections (n=62) and bacterial pneumonia with confirmed organisms (n=30), patients with 2009 H1N1 pneumonia (n=34) were significantly more likely to have low procalcitonin levels (p=0.008, 0.001). Using cutoff of value >0.3 ng/mL, the sensitivity and specificity of procalcitonin for detection of patients with confirmed bacterial pneumonia were 76.2% and 60.6%, respectively. A significant difference in procalcitonin was found between 2009 H1N1 pneumonia and pneumonia caused by mixed influenza viral and bacterial infections (0.15 [0.05~0.84] vs. 10.3 [0.05~22.87] ng/mL, p=0.045). CONCLUSION: Serum procalcitonin measurement may assist in the discrimination between pneumonia of bacterial and of 2009 H1N1 influenza origin. High values of procalcitonin suggest that bacterial infection or mixed infection of bacteria and 2009 H1N1 influenza is more likely.

【 授权许可】

CC BY-NC