Can procalcitonin help identify associated bacterial infection in patients with severe influenza pneumonia? A multicentre study
Identifieur interne : 000705 ( France/Analysis ); précédent : 000704; suivant : 000706Can procalcitonin help identify associated bacterial infection in patients with severe influenza pneumonia? A multicentre study
Auteurs : E. Cuquemelle [France] ; F. Soulis [France] ; D. Villers [France] ; F. Roche-Campo [Espagne] ; C. Ara Somohano [France] ; M. Fartoukh [France] ; A. Kouatchet [France] ; B. Mourvillier [France] ; J. Dellamonica [France] ; W. Picard [France] ; M. Schmidt [France] ; T. Boulain [France] ; C. Brun-Buisson [France]Source :
- Intensive Care Medicine [ 0342-4642 ] ; 2011.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Calcitonine (sang), Femelle, France, Grippe humaine (diagnostic), Grippe humaine (physiopathologie), Grippe humaine (virologie), Humains, Indice de gravité médicale, Infections bactériennes (diagnostic), Infections bactériennes (physiopathologie), Infections bactériennes (sang), Marqueurs biologiques, Mâle, Neuropeptide CGRP, Pneumopathie infectieuse (diagnostic), Pneumopathie infectieuse (physiopathologie), Pneumopathie infectieuse (virologie), Précurseurs de protéines (sang), Sensibilité et spécificité, Sous-type H1N1 du virus de la grippe A, Études rétrospectives.
- MESH :
- diagnostic : Grippe humaine, Infections bactériennes, Pneumopathie infectieuse.
- physiopathologie : Grippe humaine, Infections bactériennes, Pneumopathie infectieuse.
- sang : Calcitonine, Infections bactériennes, Précurseurs de protéines.
- virologie : Grippe humaine, Pneumopathie infectieuse.
- Adulte, Adulte d'âge moyen, Femelle, France, Humains, Indice de gravité médicale, Marqueurs biologiques, Mâle, Neuropeptide CGRP, Sensibilité et spécificité, Sous-type H1N1 du virus de la grippe A, Études rétrospectives.
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Adult, Bacterial Infections (blood), Bacterial Infections (diagnosis), Bacterial Infections (physiopathology), Bacteriosis, Biomarkers, Calcitonin (blood), Calcitonin Gene-Related Peptide, Female, France, Human, Humans, Influenza A, Influenza A Virus, H1N1 Subtype, Influenza, Human (diagnosis), Influenza, Human (physiopathology), Influenza, Human (virology), Intensive care, Male, Middle Aged, Pneumonia, Pneumonia (diagnosis), Pneumonia (physiopathology), Pneumonia (virology), Procalcitonin, Protein Precursors (blood), Resuscitation, Retrospective Studies, Sensitivity and Specificity, Severity of Illness Index.
- MESH :
- chemical , blood : Calcitonin, Protein Precursors.
- chemical : Biomarkers, Calcitonin Gene-Related Peptide.
- blood : Bacterial Infections.
- diagnosis : Bacterial Infections, Influenza, Human, Pneumonia.
- physiopathology : Bacterial Infections, Influenza, Human, Pneumonia.
- virology : Influenza, Human, Pneumonia.
- Adult, Female, France, Humans, Influenza A Virus, H1N1 Subtype, Male, Middle Aged, Retrospective Studies, Sensitivity and Specificity, Severity of Illness Index.
Abstract
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.
Url:
- https://api.istex.fr/ark:/67375/VQC-P7CR3SK6-2/fulltext.pdf
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7080069
DOI: 10.1007/s00134-011-2189-1
Affiliations:
- Espagne, France
- Aquitaine, Auvergne-Rhône-Alpes, Catalogne, Centre-Val de Loire, Haute-Normandie, Nouvelle-Aquitaine, Pays de la Loire, Provence-Alpes-Côte d'Azur, Rhône-Alpes, Région Centre, Région Normandie, Île-de-France
- Angers, Barcelone, Créteil, Grenoble, Nantes, Nice, Orléans, Paris, Pau, Rouen
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ISTEX:AFE1C4D3A173615DDDB9DECF2E2EDF7694B27BABLe document en format XML
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Dellamonica</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Medical Intensive Care Unit, Centre Hospitalo-Universitaire Archet 1, Nice</wicri:regionArea><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Nice</settlement></placeName></affiliation></author><author><name sortKey="Picard, W" sort="Picard, W" uniqKey="Picard W" first="W." last="Picard">W. Picard</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Polyvalent Intensive Care Unit, Centre Hospitalier F. Mitterand, Pau</wicri:regionArea><placeName><region type="region">Nouvelle-Aquitaine</region><region type="old region">Aquitaine</region><settlement type="city">Pau</settlement></placeName></affiliation></author><author><name sortKey="Schmidt, M" sort="Schmidt, M" uniqKey="Schmidt M" first="M." last="Schmidt">M. Schmidt</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Medical Intensive Care Unit, APHP, Centre Hospitalo-Universitaire Pitié-Salpétrière, Paris, AP-HP, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Boulain, T" sort="Boulain, T" uniqKey="Boulain T" first="T." last="Boulain">T. Boulain</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Medical ICU, Centre Hospitalier Régional, Orléans</wicri:regionArea><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Orléans</settlement></placeName></affiliation></author><author><name sortKey="Brun Buisson, C" sort="Brun Buisson, C" uniqKey="Brun Buisson C" first="C." last="Brun-Buisson">C. Brun-Buisson</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Service de Réanimation médicale, Medical Intensive Care Unit, GH Henri Mondor, AP-HP, Université Paris-Est Créteil, Créteil</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Créteil</settlement></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">France</country></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Intensive Care Medicine</title><title level="j" type="abbrev">Intensive Care Med</title><idno type="ISSN">0342-4642</idno><idno type="eISSN">1432-1238</idno><imprint><publisher ref="https://scientific-publisher.data.istex.fr/ark:/67375/H02-SWLMH5L1-1">Springer-Verlag</publisher><pubPlace>Berlin/Heidelberg</pubPlace><date type="published" when="2011">2011</date><biblScope unit="vol" from="37" to="37">37</biblScope><biblScope unit="issue" from="5" to="5">5</biblScope><biblScope unit="page" from="796">796</biblScope><biblScope unit="page" to="800">800</biblScope></imprint><idno type="ISSN">0342-4642</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0342-4642</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Bacterial Infections (blood)</term><term>Bacterial Infections (diagnosis)</term><term>Bacterial Infections (physiopathology)</term><term>Bacteriosis</term><term>Biomarkers</term><term>Calcitonin (blood)</term><term>Calcitonin Gene-Related Peptide</term><term>Female</term><term>France</term><term>Human</term><term>Humans</term><term>Influenza A</term><term>Influenza A Virus, H1N1 Subtype</term><term>Influenza, Human (diagnosis)</term><term>Influenza, Human (physiopathology)</term><term>Influenza, Human (virology)</term><term>Intensive care</term><term>Male</term><term>Middle Aged</term><term>Pneumonia</term><term>Pneumonia (diagnosis)</term><term>Pneumonia (physiopathology)</term><term>Pneumonia (virology)</term><term>Procalcitonin</term><term>Protein Precursors (blood)</term><term>Resuscitation</term><term>Retrospective Studies</term><term>Sensitivity and Specificity</term><term>Severity of Illness Index</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Calcitonine (sang)</term><term>Femelle</term><term>France</term><term>Grippe humaine (diagnostic)</term><term>Grippe humaine (physiopathologie)</term><term>Grippe humaine (virologie)</term><term>Humains</term><term>Indice de gravité médicale</term><term>Infections bactériennes (diagnostic)</term><term>Infections bactériennes (physiopathologie)</term><term>Infections bactériennes (sang)</term><term>Marqueurs biologiques</term><term>Mâle</term><term>Neuropeptide CGRP</term><term>Pneumopathie infectieuse (diagnostic)</term><term>Pneumopathie infectieuse (physiopathologie)</term><term>Pneumopathie infectieuse (virologie)</term><term>Précurseurs de protéines (sang)</term><term>Sensibilité et spécificité</term><term>Sous-type H1N1 du virus de la grippe A</term><term>Études rétrospectives</term></keywords><keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Calcitonin</term><term>Protein Precursors</term></keywords><keywords scheme="MESH" type="chemical" xml:lang="en"><term>Biomarkers</term><term>Calcitonin Gene-Related Peptide</term></keywords><keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>Bacterial Infections</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Bacterial Infections</term><term>Influenza, Human</term><term>Pneumonia</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Grippe humaine</term><term>Infections bactériennes</term><term>Pneumopathie infectieuse</term></keywords><keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Grippe humaine</term><term>Infections bactériennes</term><term>Pneumopathie infectieuse</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Bacterial Infections</term><term>Influenza, Human</term><term>Pneumonia</term></keywords><keywords scheme="MESH" qualifier="sang" xml:lang="fr"><term>Calcitonine</term><term>Infections bactériennes</term><term>Précurseurs de protéines</term></keywords><keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Grippe humaine</term><term>Pneumopathie infectieuse</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Influenza, Human</term><term>Pneumonia</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Female</term><term>France</term><term>Humans</term><term>Influenza A Virus, H1N1 Subtype</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term><term>Sensitivity and Specificity</term><term>Severity of Illness Index</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>France</term><term>Humains</term><term>Indice de gravité médicale</term><term>Marqueurs biologiques</term><term>Mâle</term><term>Neuropeptide CGRP</term><term>Sensibilité et spécificité</term><term>Sous-type H1N1 du virus de la grippe A</term><term>Études rétrospectives</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Bactériose</term><term>Grippe A</term><term>Homme</term><term>Pneumonie</term><term>Procalcitonine</term><term>Réanimation</term><term>Soin intensif</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><affiliations><list><country><li>Espagne</li><li>France</li></country><region><li>Aquitaine</li><li>Auvergne-Rhône-Alpes</li><li>Catalogne</li><li>Centre-Val de Loire</li><li>Haute-Normandie</li><li>Nouvelle-Aquitaine</li><li>Pays de la Loire</li><li>Provence-Alpes-Côte d'Azur</li><li>Rhône-Alpes</li><li>Région Centre</li><li>Région Normandie</li><li>Île-de-France</li></region><settlement><li>Angers</li><li>Barcelone</li><li>Créteil</li><li>Grenoble</li><li>Nantes</li><li>Nice</li><li>Orléans</li><li>Paris</li><li>Pau</li><li>Rouen</li></settlement></list><tree><country name="France"><region name="Île-de-France"><name sortKey="Cuquemelle, E" sort="Cuquemelle, E" uniqKey="Cuquemelle E" first="E." last="Cuquemelle">E. Cuquemelle</name></region><name sortKey="Ara Somohano, C" sort="Ara Somohano, C" uniqKey="Ara Somohano C" first="C." last="Ara Somohano">C. Ara Somohano</name><name sortKey="Boulain, T" sort="Boulain, T" uniqKey="Boulain T" first="T." last="Boulain">T. Boulain</name><name sortKey="Brun Buisson, C" sort="Brun Buisson, C" uniqKey="Brun Buisson C" first="C." last="Brun-Buisson">C. Brun-Buisson</name><name sortKey="Brun Buisson, C" sort="Brun Buisson, C" uniqKey="Brun Buisson C" first="C." last="Brun-Buisson">C. Brun-Buisson</name><name sortKey="Dellamonica, J" sort="Dellamonica, J" uniqKey="Dellamonica J" first="J." last="Dellamonica">J. Dellamonica</name><name sortKey="Fartoukh, M" sort="Fartoukh, M" uniqKey="Fartoukh M" first="M." last="Fartoukh">M. Fartoukh</name><name sortKey="Kouatchet, A" sort="Kouatchet, A" uniqKey="Kouatchet A" first="A." last="Kouatchet">A. Kouatchet</name><name sortKey="Mourvillier, B" sort="Mourvillier, B" uniqKey="Mourvillier B" first="B." last="Mourvillier">B. Mourvillier</name><name sortKey="Picard, W" sort="Picard, W" uniqKey="Picard W" first="W." last="Picard">W. Picard</name><name sortKey="Schmidt, M" sort="Schmidt, M" uniqKey="Schmidt M" first="M." last="Schmidt">M. Schmidt</name><name sortKey="Soulis, F" sort="Soulis, F" uniqKey="Soulis F" first="F." last="Soulis">F. Soulis</name><name sortKey="Villers, D" sort="Villers, D" uniqKey="Villers D" first="D." last="Villers">D. Villers</name></country><country name="Espagne"><region name="Catalogne"><name sortKey="Roche Campo, F" sort="Roche Campo, F" uniqKey="Roche Campo F" first="F." last="Roche-Campo">F. Roche-Campo</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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