Role of procalcitonin and C-reactive protein in differentiation of mixed bacterial infection from 2009 H1N1 viral pneumonia

Influenza and other Respiratory Viruses

Volumn 5, Issue 6, 2011, Pages 398-403

  Ahn, Shin ^a   Kim, Won Young ^a   Kim, Sung Han ^a   Hong, Sangbum ^a   Lim, Chae Man ^a   Koh, Younsuck ^a   Lim, Kyung Soo ^a   Kim, Won ^a  

^a University of Ulsan College of Medicine   (South Korea)

Author keywords

C reactive protein; H1N1 subtype; Influenza; Pneumonia; Procalcitonin

Indexed keywords

C REACTIVE PROTEIN; PROCALCITONIN;

2009 H1N1 INFLUENZA; ADULT; ARTICLE; BACTERIAL INFECTION; BACTERIUM IDENTIFICATION; CLINICAL ASSESSMENT; CLINICAL FEATURE; COMMUNITY ACQUIRED PNEUMONIA; CONTROLLED STUDY; DIAGNOSTIC ACCURACY; EMERGENCY WARD; FEMALE; HAEMOPHILUS INFLUENZAE; HUMAN; HUMAN TISSUE; INFLUENZA VIRUS A H1N1; KLEBSIELLA PNEUMONIAE; MAJOR CLINICAL STUDY; MALE; MIXED BACTERIAL INFECTION; MIXED INFECTION; PREDICTIVE VALUE; PRIORITY JOURNAL; PROTEIN BLOOD LEVEL; PROTEIN FUNCTION; PSEUDOMONAS AERUGINOSA; RETROSPECTIVE STUDY; SENSITIVITY AND SPECIFICITY; SPUTUM CULTURE; STAPHYLOCOCCUS AUREUS; STREPTOCOCCUS PNEUMONIAE; VIRUS PNEUMONIA;

ADULT; AGED; BACTERIA; C-REACTIVE PROTEIN; CALCITONIN; COINFECTION; FEMALE; HUMANS; INFLUENZA A VIRUS, H1N1 SUBTYPE; MALE; MIDDLE AGED; PNEUMONIA, BACTERIAL; PNEUMONIA, VIRAL; PROTEIN PRECURSORS; RETROSPECTIVE STUDIES; YOUNG ADULT;

EID: 80054782329     PISSN: 17502640     EISSN: 17502659     Source Type: Journal    
DOI: 10.1111/j.1750-2659.2011.00244.x     Document Type: Article

References (27)

1. Perez-Padilla R, de la Rosa-Zamboni D, Ponce de Leon S et al. Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico. N Engl J Med 2009; 361:680-689.
2. WHO. Pandemic (H1N1) 2009 - update 87. Available at (Accessed 18 February 2010).
3. Thompson WW, Shay DK, Weintraub E et al. Influenza-associated hospitalizations in the United States. JAMA 2004; 292:1333-1340.
4. Thompson WW, Shay DK, Weintraub E et al. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA 2003; 289:179-186.
5. Choi WJ, Kim WY, Kim SH et al. Clinical characteristics of pneumonia in hospitalized patients with novel influenza A (H1N1) in Korea. Scand J Infect Dis 2010; 42:311-314.
6. Choi SS, Kim WY, Kim SH et al. Associated factor related to major complications of patients with hospitalized for 2009 H1N1 influenza pneumonia. Tuberc Respir Dis 2010; 68:162-167.
7. Brundage JF, Shanks GD. Deaths from bacterial pneumonia during 1918-19 influenza pandemic. Emerg Infect Dis 2008; 14:1193-1199.
8. Morens DM, Taubenberger JK, Fauci AS. Predominant role of bacterial pneumonia as a cause of death in pandemic influenza: implications for pandemic influenza preparedness. J Infect Dis 2008; 198:962-970.
9. Assicot M, Gendrel D, Carsin H, Raymond J, Guilbaud J, Bohuon C. High serum procalcitonin concentrations in patients with sepsis and infection. Lancet 1993; 341:515-518.
10. Christ-Crain M, Jaccard-Stolz D, Bingisser R et al. Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single-blinded intervention trial. Lancet 2004; 363:600-607.
11. Stolz D, Christ-Crain M, Bingisser R et al. Antibiotic treatment of exacerbations of COFD - a randomized, controlled trial comparing procalcitonin-guidance with standard therapy. Chest 2007; 131:9-19.
12. Guervilly C, Coisel Y, Botelho-Nevers E et al. Significance of high levels of procalcitonin in patients with influenza A (H1N1) pneumonia. J Infect 2010; 61:355-358.
13. Ingram PR, Inglis T, Moxon D, Speers D. Procalcitonin and C-reactive protein in severe 2009 H1N1 influenza infection. Intensive Care Med 2010; 36:528-532.
14. Piacentini E, Sanchez B, Arauzo V, Calbo E, Cuchi E, Nava JM. Procalcitonin levels are lower in intensive care unit patients with H1N1 influenza A virus pneumonia than in those with community-acquired bacterial pneumonia. A pilot study. J Crit Care 2010; [Epub ahead of print].
15. Duncan C, Guthrie JL, Tijet N et al. Analytical and clinical validation of novel real-time reverse transcriptase-polymerase chain reaction assays for the clinical detection of swine-origin H1N1 influenza viruses. Diagn Microbiol Infect Dis 2011; 69:167-171.
16. Soler N, Torres A, Ewig S et al. Bronchial microbial patterns in severe exacerbations of chronic obstructive pulmonary disease (COPD) requiring mechanical ventilation. Am J Respir Crit Care Med 1998; 157:1498-1505.
17. Murata Y, Walsh EE, Falsey AR. Pulmonary complications of interpandemic influenza A in hospitalized adults. J Infect Dis 2007; 195:1029-1037.
18. McCullers JA. Insights into the interaction between influenza virus and pneumococcus. Clin Microbiol Rev 2006; 19:571.
19. Chirouze C, Schuhmacher H, Rabaud C et al. Low serum procalcitonin level accurately predicts the absence of bacteremia in adult patients with acute fever. Clin Infect Dis 2002; 35:156-161.
20. Chua AP, Lee KH. Procalcitonin in severe acute respiratory syndrome (SARS). J Infect 2004; 48:303-306.
21. Toikka P, Irjala K, Juven T et al. Serum procalcitonin, C-reactive protein and interleukin-6 for distinguishing bacterial and viral pneumonia in children. Pediatr Infect Dis J 2000; 19:598-602.
22. Lacour AG, Gervaix A, Zamora SA et al. Procalcitonin, IL-6, IL-8, IL-1 receptor antagonist and C-reactive protein as identificators of serious bacterial infections in children with fever without localising signs. Eur J Pediatr 2001; 160:95-100.
23. Moulin F, Raymond J, Lorrot M et al. Procalcitonin in children admitted to hospital with community acquired pneumonia. Arch Dis Child 2001; 84:332-336.
24. Simon L, Gauvin F, Amre DK, Saint-Louis P, Lacroix J. Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: a systematic review and meta-analysis. Clin Infect Dis 2004; 39:206-217.
25. Wright PF, Kirkland KB, Modlin JF. When to consider the use of antibiotics in the treatment of 2009 H1N1 influenza-associated pneumonia. N Engl J Med 2009; 361:e112.
26. Boussekey N, Leroy O, Alfandari S, Devos P, Georges H, Guery B. Procalcitonin kinetics in the prognosis of severe community-acquired pneumonia. Intensive Care Med 2006; 32:469-472.
27. Christ-Crain M, Stolz D, Bingisser R et al. Procalcitonin guidance of antibiotic therapy in community-acquired pneumonia a randomized trial. Am J Respir Crit Care Med 2006; 174:84-93.