Can procalcitonin help identify associated bacterial infection in patients with severe influenza pneumonia? A multicentre study
Identifieur interne : 000549 ( Istex/Corpus ); précédent : 000548; suivant : 000550Can procalcitonin help identify associated bacterial infection in patients with severe influenza pneumonia? A multicentre study
Auteurs : 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-BuissonSource :
- Intensive Care Medicine [ 0342-4642 ] ; 2011.
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.
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DOI: 10.1007/s00134-011-2189-1
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A multicentre study</title><author><name sortKey="Cuquemelle, E" sort="Cuquemelle, E" uniqKey="Cuquemelle E" first="E." last="Cuquemelle">E. Cuquemelle</name><affiliation><mods:affiliation>Service de Réanimation médicale, Medical Intensive Care Unit, GH Henri Mondor, AP-HP, Université Paris-Est Créteil, Créteil, France</mods:affiliation></affiliation></author><author><name sortKey="Soulis, F" sort="Soulis, F" uniqKey="Soulis F" first="F." last="Soulis">F. Soulis</name><affiliation><mods:affiliation>Medical Intensive Care Unit, Centre Hospitalo-Universitaire Charles Nicolle, Rouen, France</mods:affiliation></affiliation></author><author><name sortKey="Villers, D" sort="Villers, D" uniqKey="Villers D" first="D." last="Villers">D. Villers</name><affiliation><mods:affiliation>Medical Intensive Care Unit, Centre Hospitalo-Universitaire Hotel-Dieu, Nantes, France</mods:affiliation></affiliation></author><author><name sortKey="Roche Campo, F" sort="Roche Campo, F" uniqKey="Roche Campo F" first="F." last="Roche-Campo">F. Roche-Campo</name><affiliation><mods:affiliation>Polyvalent Intensive Care Unit, Hospital Santa Creu I Sant Pau, Barcelona, Spain</mods:affiliation></affiliation></author><author><name sortKey="Ara Somohano, C" sort="Ara Somohano, C" uniqKey="Ara Somohano C" first="C." last="Ara Somohano">C. Ara Somohano</name><affiliation><mods:affiliation>Medical Intensive Care Unit, Centre Hospitalo-Universitaire A. Michallon, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Fartoukh, M" sort="Fartoukh, M" uniqKey="Fartoukh M" first="M." last="Fartoukh">M. Fartoukh</name><affiliation><mods:affiliation>Medical Intensive Care Unit, APHP, Centre Hospitalo-Universitaire Tenon, AP-HP, Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Kouatchet, A" sort="Kouatchet, A" uniqKey="Kouatchet A" first="A." last="Kouatchet">A. Kouatchet</name><affiliation><mods:affiliation>Medical Intensive Care Unit, Centre Hospitalo-Universitaire, Angers, France</mods:affiliation></affiliation></author><author><name sortKey="Mourvillier, B" sort="Mourvillier, B" uniqKey="Mourvillier B" first="B." last="Mourvillier">B. Mourvillier</name><affiliation><mods:affiliation>Medical Intensive Care Unit, APHP, Centre Hospitalo-Universitaire Bichat-Claude Bernard, AP-HP, Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Dellamonica, J" sort="Dellamonica, J" uniqKey="Dellamonica J" first="J." last="Dellamonica">J. Dellamonica</name><affiliation><mods:affiliation>Medical Intensive Care Unit, Centre Hospitalo-Universitaire Archet 1, Nice, France</mods:affiliation></affiliation></author><author><name sortKey="Picard, W" sort="Picard, W" uniqKey="Picard W" first="W." last="Picard">W. Picard</name><affiliation><mods:affiliation>Polyvalent Intensive Care Unit, Centre Hospitalier F. Mitterand, Pau, France</mods:affiliation></affiliation></author><author><name sortKey="Schmidt, M" sort="Schmidt, M" uniqKey="Schmidt M" first="M." last="Schmidt">M. Schmidt</name><affiliation><mods:affiliation>Medical Intensive Care Unit, APHP, Centre Hospitalo-Universitaire Pitié-Salpétrière, Paris, AP-HP, Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Boulain, T" sort="Boulain, T" uniqKey="Boulain T" first="T." last="Boulain">T. Boulain</name><affiliation><mods:affiliation>Medical ICU, Centre Hospitalier Régional, Orléans, France</mods:affiliation></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><mods:affiliation>Service de Réanimation médicale, Medical Intensive Care Unit, GH Henri Mondor, AP-HP, Université Paris-Est Créteil, Créteil, France</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: christian.brun-buisson@hmn.aphp.fr</mods:affiliation></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></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><istex><corpusName>springer-journals</corpusName><author><json:item><name>E. Cuquemelle</name><affiliations><json:string>Service de Réanimation médicale, Medical Intensive Care Unit, GH Henri Mondor, AP-HP, Université Paris-Est Créteil, Créteil, France</json:string></affiliations></json:item><json:item><name>F. Soulis</name><affiliations><json:string>Medical Intensive Care Unit, Centre Hospitalo-Universitaire Charles Nicolle, Rouen, France</json:string></affiliations></json:item><json:item><name>D. Villers</name><affiliations><json:string>Medical Intensive Care Unit, Centre Hospitalo-Universitaire Hotel-Dieu, Nantes, France</json:string></affiliations></json:item><json:item><name>F. Roche-Campo</name><affiliations><json:string>Polyvalent Intensive Care Unit, Hospital Santa Creu I Sant Pau, Barcelona, Spain</json:string></affiliations></json:item><json:item><name>C. Ara Somohano</name><affiliations><json:string>Medical Intensive Care Unit, Centre Hospitalo-Universitaire A. Michallon, Grenoble, France</json:string></affiliations></json:item><json:item><name>M. Fartoukh</name><affiliations><json:string>Medical Intensive Care Unit, APHP, Centre Hospitalo-Universitaire Tenon, AP-HP, Paris, France</json:string></affiliations></json:item><json:item><name>A. Kouatchet</name><affiliations><json:string>Medical Intensive Care Unit, Centre Hospitalo-Universitaire, Angers, France</json:string></affiliations></json:item><json:item><name>B. Mourvillier</name><affiliations><json:string>Medical Intensive Care Unit, APHP, Centre Hospitalo-Universitaire Bichat-Claude Bernard, AP-HP, Paris, France</json:string></affiliations></json:item><json:item><name>J. Dellamonica</name><affiliations><json:string>Medical Intensive Care Unit, Centre Hospitalo-Universitaire Archet 1, Nice, France</json:string></affiliations></json:item><json:item><name>W. Picard</name><affiliations><json:string>Polyvalent Intensive Care Unit, Centre Hospitalier F. Mitterand, Pau, France</json:string></affiliations></json:item><json:item><name>M. Schmidt</name><affiliations><json:string>Medical Intensive Care Unit, APHP, Centre Hospitalo-Universitaire Pitié-Salpétrière, Paris, AP-HP, Paris, France</json:string></affiliations></json:item><json:item><name>T. Boulain</name><affiliations><json:string>Medical ICU, Centre Hospitalier Régional, Orléans, France</json:string></affiliations></json:item><json:item><name>C. Brun-Buisson</name><affiliations><json:string>Service de Réanimation médicale, Medical Intensive Care Unit, GH Henri Mondor, AP-HP, Université Paris-Est Créteil, Créteil, France</json:string><json:string>E-mail: christian.brun-buisson@hmn.aphp.fr</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Procalcitonin</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Pneumonia</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>A/H1N1v influenza</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Bacterial infection</value></json:item></subject><articleId><json:string>2189</json:string><json:string>s00134-011-2189-1</json:string></articleId><arkIstex>ark:/67375/VQC-P7CR3SK6-2</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>OriginalPaper</json:string></originalGenre><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.</abstract><qualityIndicators><score>5.55</score><pdfWordCount>2874</pdfWordCount><pdfCharCount>19537</pdfCharCount><pdfVersion>1.3</pdfVersion><pdfPageCount>5</pdfPageCount><pdfPageSize>595.276 x 790.866 pts</pdfPageSize><refBibsNative>false</refBibsNative><abstractWordCount>223</abstractWordCount><abstractCharCount>1537</abstractCharCount><keywordCount>4</keywordCount><pdfWordsPerPage>575</pdfWordsPerPage><pdfText>true</pdfText></qualityIndicators><title>Can procalcitonin help identify associated bacterial infection in patients with severe influenza pneumonia? 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A multicentre study</title><author><persName><forename type="first">E.</forename><surname>Cuquemelle</surname></persName><affiliation><orgName type="institution">A/H1N1 REVA-SRLF Study Group</orgName><orgName type="department">Service de Réanimation médicale, Medical Intensive Care Unit, GH Henri Mondor, AP-HP</orgName><orgName type="institution">Université Paris-Est Créteil</orgName><address><settlement>Créteil</settlement><country key="FR" xml:lang="en">FRANCE</country></address></affiliation></author><author><persName><forename type="first">F.</forename><surname>Soulis</surname></persName><affiliation><orgName type="institution">A/H1N1 REVA-SRLF Study Group</orgName><orgName type="department">Medical Intensive Care Unit</orgName><orgName type="institution">Centre Hospitalo-Universitaire Charles Nicolle</orgName><address><settlement>Rouen</settlement><country key="FR" xml:lang="en">FRANCE</country></address></affiliation></author><author><persName><forename type="first">D.</forename><surname>Villers</surname></persName><affiliation><orgName type="institution">A/H1N1 REVA-SRLF Study Group</orgName><orgName type="department">Medical Intensive Care Unit</orgName><orgName type="institution">Centre Hospitalo-Universitaire Hotel-Dieu</orgName><address><settlement>Nantes</settlement><country key="FR" xml:lang="en">FRANCE</country></address></affiliation></author><author><persName><forename type="first">F.</forename><surname>Roche-Campo</surname></persName><affiliation><orgName type="institution">A/H1N1 REVA-SRLF Study Group</orgName><orgName type="department">Polyvalent Intensive Care Unit</orgName><orgName type="institution">Hospital Santa Creu I Sant Pau</orgName><address><settlement>Barcelona</settlement><country key="ES" xml:lang="en">SPAIN</country></address></affiliation></author><author><persName><forename type="first">C.</forename><surname>Ara Somohano</surname></persName><affiliation><orgName type="institution">A/H1N1 REVA-SRLF Study Group</orgName><orgName type="department">Medical Intensive Care Unit</orgName><orgName type="institution">Centre Hospitalo-Universitaire A. Michallon</orgName><address><settlement>Grenoble</settlement><country key="FR" xml:lang="en">FRANCE</country></address></affiliation></author><author><persName><forename type="first">M.</forename><surname>Fartoukh</surname></persName><affiliation><orgName type="institution">A/H1N1 REVA-SRLF Study Group</orgName><orgName type="department">Medical Intensive Care Unit</orgName><orgName type="institution">APHP, Centre Hospitalo-Universitaire Tenon, AP-HP</orgName><address><settlement>Paris</settlement><country key="FR" xml:lang="en">FRANCE</country></address></affiliation></author><author><persName><forename type="first">A.</forename><surname>Kouatchet</surname></persName><affiliation><orgName type="institution">A/H1N1 REVA-SRLF Study Group</orgName><orgName type="department">Medical Intensive Care Unit</orgName><orgName type="institution">Centre Hospitalo-Universitaire</orgName><address><settlement>Angers</settlement><country key="FR" xml:lang="en">FRANCE</country></address></affiliation></author><author><persName><forename type="first">B.</forename><surname>Mourvillier</surname></persName><affiliation><orgName type="institution">A/H1N1 REVA-SRLF Study Group</orgName><orgName type="department">Medical Intensive Care Unit</orgName><orgName type="institution">APHP, Centre Hospitalo-Universitaire Bichat-Claude Bernard, AP-HP</orgName><address><settlement>Paris</settlement><country key="FR" xml:lang="en">FRANCE</country></address></affiliation></author><author><persName><forename type="first">J.</forename><surname>Dellamonica</surname></persName><affiliation><orgName type="institution">A/H1N1 REVA-SRLF Study Group</orgName><orgName type="department">Medical Intensive Care Unit</orgName><orgName type="institution">Centre Hospitalo-Universitaire Archet 1</orgName><address><settlement>Nice</settlement><country key="FR" xml:lang="en">FRANCE</country></address></affiliation></author><author><persName><forename type="first">W.</forename><surname>Picard</surname></persName><affiliation><orgName type="institution">A/H1N1 REVA-SRLF Study Group</orgName><orgName type="department">Polyvalent Intensive Care Unit</orgName><orgName type="institution">Centre Hospitalier F. Mitterand</orgName><address><settlement>Pau</settlement><country key="FR" xml:lang="en">FRANCE</country></address></affiliation></author><author><persName><forename type="first">M.</forename><surname>Schmidt</surname></persName><affiliation><orgName type="institution">A/H1N1 REVA-SRLF Study Group</orgName><orgName type="department">Medical Intensive Care Unit</orgName><orgName type="institution">APHP, Centre Hospitalo-Universitaire Pitié-Salpétrière, Paris, AP-HP</orgName><address><settlement>Paris</settlement><country key="FR" xml:lang="en">FRANCE</country></address></affiliation></author><author><persName><forename type="first">T.</forename><surname>Boulain</surname></persName><affiliation><orgName type="institution">A/H1N1 REVA-SRLF Study Group</orgName><orgName type="department">Medical ICU</orgName><orgName type="institution">Centre Hospitalier Régional</orgName><address><settlement>Orléans</settlement><country key="FR" xml:lang="en">FRANCE</country></address></affiliation></author><author role="corresp"><persName><forename type="first">C.</forename><surname>Brun-Buisson</surname></persName><email>christian.brun-buisson@hmn.aphp.fr</email><affiliation><orgName type="institution">A/H1N1 REVA-SRLF Study Group</orgName><orgName type="department">Service de Réanimation médicale, Medical Intensive Care Unit, GH Henri Mondor, AP-HP</orgName><orgName type="institution">Université Paris-Est Créteil</orgName><address><settlement>Créteil</settlement><country key="FR" xml:lang="en">FRANCE</country></address></affiliation></author><author><orgName type="institution">A/H1N1 REVA-SRLF Study Group</orgName><persName><surname>A/H1N1 REVA-SRLF Study Group</surname></persName></author><idno type="istex">AFE1C4D3A173615DDDB9DECF2E2EDF7694B27BAB</idno><idno type="ark">ark:/67375/VQC-P7CR3SK6-2</idno><idno type="publisher-id">s00134-011-2189-1</idno><idno type="DOI">10.1007/s00134-011-2189-1</idno><idno type="article-id">2189</idno></analytic><monogr><title level="j" type="main">Intensive Care Medicine</title><title level="j" type="abbrev">Intensive Care Med</title><idno type="journal-id">134</idno><idno type="pISSN">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></monogr></biblStruct></sourceDesc></fileDesc><encodingDesc><schemaRef type="ODD" url="https://xml-schema.delivery.istex.fr/tei-istex.odd"></schemaRef><appInfo><application ident="pub2tei" version="1.0.48" when="2020-05-28"><label>pub2TEI-ISTEX</label><desc>A set of style sheets for converting XML documents encoded in various scientific publisher formats into a common TEI format.
<ref target="http://www.tei-c.org/">We use TEI</ref></desc></application></appInfo></encodingDesc><profileDesc><abstract xml:lang="en"><head>Abstract</head><head>Purpose</head><p>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.</p><head>Methods</head><p>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.</p><head>Results</head><p>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 <hi rend="italic">Streptococcus pneumoniae</hi> (54%) or <hi rend="italic">Staphylococcus aureus</hi> (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 (<hi rend="italic">P</hi> < 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; <hi rend="italic">P</hi> < 0.001).</p><head>Conclusions</head><p>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.</p></abstract><textClass ana="subject"><keywords scheme="journal-subject"><list><item><term type="Primary">Medicine & Public Health</term></item><item><term type="Secondary">Pain Medicine</term></item><item><term type="Secondary">Anesthesiology</term></item><item><term type="Secondary">Pneumology/Respiratory System</term></item><item><term type="Secondary">Pediatrics</term></item><item><term type="Secondary">Emergency Medicine</term></item><item><term type="Secondary">Intensive / Critical Care Medicine</term></item></list></keywords></textClass><textClass ana="keyword"><keywords xml:lang="en"><term>Procalcitonin</term><term>Pneumonia</term><term>A/H1N1v influenza</term><term>Bacterial infection</term></keywords></textClass><langUsage><language ident="en"></language></langUsage></profileDesc><revisionDesc><change when="2020-05-28" who="#istex" xml:id="pub2tei">formatting</change><change when="2011-02-15">Registration</change><change when="2010-11-21">Received</change><change when="2010-11-27">Accepted</change><change when="2011-03-03">ePublished</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/VQC-P7CR3SK6-2/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus springer-journals not found" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//Springer-Verlag//DTD A++ V2.4//EN" URI="http://devel.springer.de/A++/V2.4/DTD/A++V2.4.dtd" name="istex:docType"></istex:docType><istex:document><Publisher><PublisherInfo><PublisherName>Springer-Verlag</PublisherName><PublisherLocation>Berlin/Heidelberg</PublisherLocation></PublisherInfo><Journal OutputMedium="All"><JournalInfo JournalProductType="NonStandardArchiveJournal" NumberingStyle="Unnumbered"><JournalID>134</JournalID><JournalPrintISSN>0342-4642</JournalPrintISSN><JournalElectronicISSN>1432-1238</JournalElectronicISSN><JournalTitle>Intensive Care Medicine</JournalTitle><JournalAbbreviatedTitle>Intensive Care Med</JournalAbbreviatedTitle><JournalSubjectGroup><JournalSubject Type="Primary">Medicine & Public Health</JournalSubject><JournalSubject Type="Secondary">Pain Medicine</JournalSubject><JournalSubject Type="Secondary">Anesthesiology</JournalSubject><JournalSubject Type="Secondary">Pneumology/Respiratory System</JournalSubject><JournalSubject Type="Secondary">Pediatrics</JournalSubject><JournalSubject Type="Secondary">Emergency Medicine</JournalSubject><JournalSubject Type="Secondary">Intensive / Critical Care Medicine</JournalSubject></JournalSubjectGroup></JournalInfo><Volume OutputMedium="All"><VolumeInfo TocLevels="0" VolumeType="Regular"><VolumeIDStart>37</VolumeIDStart><VolumeIDEnd>37</VolumeIDEnd><VolumeIssueCount>12</VolumeIssueCount></VolumeInfo><Issue IssueType="Regular" OutputMedium="All"><IssueInfo IssueType="Regular" TocLevels="0"><IssueIDStart>5</IssueIDStart><IssueIDEnd>5</IssueIDEnd><IssueArticleCount>30</IssueArticleCount><IssueHistory><OnlineDate><Year>2011</Year><Month>4</Month><Day>8</Day></OnlineDate><PrintDate><Year>2011</Year><Month>4</Month><Day>7</Day></PrintDate><CoverDate><Year>2011</Year><Month>5</Month></CoverDate><PricelistYear>2011</PricelistYear></IssueHistory><IssueCopyright><CopyrightHolderName>Copyright jointly held by Springer and ESICM</CopyrightHolderName><CopyrightYear>2011</CopyrightYear></IssueCopyright></IssueInfo><Article ID="s00134-011-2189-1" OutputMedium="All"><ArticleInfo ArticleType="OriginalPaper" ContainsESM="No" Language="En" NumberingStyle="Unnumbered" TocLevels="0"><ArticleID>2189</ArticleID><ArticleDOI>10.1007/s00134-011-2189-1</ArticleDOI><ArticleSequenceNumber>10</ArticleSequenceNumber><ArticleTitle Language="En" OutputMedium="All">Can procalcitonin help identify associated bacterial infection in patients with severe influenza pneumonia? A multicentre study</ArticleTitle><ArticleCategory>Original</ArticleCategory><ArticleFirstPage>796</ArticleFirstPage><ArticleLastPage>800</ArticleLastPage><ArticleHistory><RegistrationDate><Year>2011</Year><Month>2</Month><Day>15</Day></RegistrationDate><Received><Year>2010</Year><Month>11</Month><Day>21</Day></Received><Accepted><Year>2010</Year><Month>11</Month><Day>27</Day></Accepted><OnlineDate><Year>2011</Year><Month>3</Month><Day>3</Day></OnlineDate></ArticleHistory><ArticleCopyright><CopyrightHolderName>Copyright jointly held by Springer and ESICM</CopyrightHolderName><CopyrightYear>2011</CopyrightYear></ArticleCopyright><ArticleGrants Type="Regular"><MetadataGrant Grant="OpenAccess"></MetadataGrant><AbstractGrant Grant="OpenAccess"></AbstractGrant><BodyPDFGrant Grant="Restricted"></BodyPDFGrant><BodyHTMLGrant Grant="Restricted"></BodyHTMLGrant><BibliographyGrant Grant="Restricted"></BibliographyGrant><ESMGrant Grant="Restricted"></ESMGrant></ArticleGrants></ArticleInfo><ArticleHeader><AuthorGroup><Author AffiliationIDS="Aff1"><AuthorName DisplayOrder="Western"><GivenName>E.</GivenName><FamilyName>Cuquemelle</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff2"><AuthorName DisplayOrder="Western"><GivenName>F.</GivenName><FamilyName>Soulis</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff3"><AuthorName DisplayOrder="Western"><GivenName>D.</GivenName><FamilyName>Villers</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff4"><AuthorName DisplayOrder="Western"><GivenName>F.</GivenName><FamilyName>Roche-Campo</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff5"><AuthorName DisplayOrder="Western"><GivenName>C.</GivenName><FamilyName>Ara Somohano</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff6"><AuthorName DisplayOrder="Western"><GivenName>M.</GivenName><FamilyName>Fartoukh</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff7"><AuthorName DisplayOrder="Western"><GivenName>A.</GivenName><FamilyName>Kouatchet</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff8"><AuthorName DisplayOrder="Western"><GivenName>B.</GivenName><FamilyName>Mourvillier</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff9"><AuthorName DisplayOrder="Western"><GivenName>J.</GivenName><FamilyName>Dellamonica</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff10"><AuthorName DisplayOrder="Western"><GivenName>W.</GivenName><FamilyName>Picard</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff11"><AuthorName DisplayOrder="Western"><GivenName>M.</GivenName><FamilyName>Schmidt</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff12"><AuthorName DisplayOrder="Western"><GivenName>T.</GivenName><FamilyName>Boulain</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff1" CorrespondingAffiliationID="Aff1"><AuthorName DisplayOrder="Western"><GivenName>C.</GivenName><FamilyName>Brun-Buisson</FamilyName></AuthorName><Contact><Phone>+33-1-49812391</Phone><Fax>+33-1-42079943</Fax><Email>christian.brun-buisson@hmn.aphp.fr</Email></Contact></Author><InstitutionalAuthor><InstitutionalAuthorName>A/H1N1 REVA-SRLF Study Group</InstitutionalAuthorName></InstitutionalAuthor><Affiliation ID="Aff1"><OrgDivision>Service de Réanimation médicale, Medical Intensive Care Unit, GH Henri Mondor, AP-HP</OrgDivision><OrgName>Université Paris-Est Créteil</OrgName><OrgAddress><City>Créteil</City><Country Code="FR">France</Country></OrgAddress></Affiliation><Affiliation ID="Aff2"><OrgDivision>Medical Intensive Care Unit</OrgDivision><OrgName>Centre Hospitalo-Universitaire Charles Nicolle</OrgName><OrgAddress><City>Rouen</City><Country Code="FR">France</Country></OrgAddress></Affiliation><Affiliation ID="Aff3"><OrgDivision>Medical Intensive Care Unit</OrgDivision><OrgName>Centre Hospitalo-Universitaire Hotel-Dieu</OrgName><OrgAddress><City>Nantes</City><Country Code="FR">France</Country></OrgAddress></Affiliation><Affiliation ID="Aff4"><OrgDivision>Polyvalent Intensive Care Unit</OrgDivision><OrgName>Hospital Santa Creu I Sant Pau</OrgName><OrgAddress><City>Barcelona</City><Country Code="ES">Spain</Country></OrgAddress></Affiliation><Affiliation ID="Aff5"><OrgDivision>Medical Intensive Care Unit</OrgDivision><OrgName>Centre Hospitalo-Universitaire A. Michallon</OrgName><OrgAddress><City>Grenoble</City><Country Code="FR">France</Country></OrgAddress></Affiliation><Affiliation ID="Aff6"><OrgDivision>Medical Intensive Care Unit</OrgDivision><OrgName>APHP, Centre Hospitalo-Universitaire Tenon, AP-HP</OrgName><OrgAddress><City>Paris</City><Country Code="FR">France</Country></OrgAddress></Affiliation><Affiliation ID="Aff7"><OrgDivision>Medical Intensive Care Unit</OrgDivision><OrgName>Centre Hospitalo-Universitaire</OrgName><OrgAddress><City>Angers</City><Country Code="FR">France</Country></OrgAddress></Affiliation><Affiliation ID="Aff8"><OrgDivision>Medical Intensive Care Unit</OrgDivision><OrgName>APHP, Centre Hospitalo-Universitaire Bichat-Claude Bernard, AP-HP</OrgName><OrgAddress><City>Paris</City><Country Code="FR">France</Country></OrgAddress></Affiliation><Affiliation ID="Aff9"><OrgDivision>Medical Intensive Care Unit</OrgDivision><OrgName>Centre Hospitalo-Universitaire Archet 1</OrgName><OrgAddress><City>Nice</City><Country Code="FR">France</Country></OrgAddress></Affiliation><Affiliation ID="Aff10"><OrgDivision>Polyvalent Intensive Care Unit</OrgDivision><OrgName>Centre Hospitalier F. Mitterand</OrgName><OrgAddress><City>Pau</City><Country Code="FR">France</Country></OrgAddress></Affiliation><Affiliation ID="Aff11"><OrgDivision>Medical Intensive Care Unit</OrgDivision><OrgName>APHP, Centre Hospitalo-Universitaire Pitié-Salpétrière, Paris, AP-HP</OrgName><OrgAddress><City>Paris</City><Country Code="FR">France</Country></OrgAddress></Affiliation><Affiliation ID="Aff12"><OrgDivision>Medical ICU</OrgDivision><OrgName>Centre Hospitalier Régional</OrgName><OrgAddress><City>Orléans</City><Country Code="FR">France</Country></OrgAddress></Affiliation></AuthorGroup><Abstract ID="Abs1" Language="En" OutputMedium="All"><Heading>Abstract</Heading><AbstractSection ID="ASec1"><Heading>Purpose</Heading><Para>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.</Para></AbstractSection><AbstractSection ID="ASec2"><Heading>Methods</Heading><Para>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.</Para></AbstractSection><AbstractSection ID="ASec3"><Heading>Results</Heading><Para>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 <Emphasis Type="Italic">Streptococcus pneumoniae</Emphasis> (54%) or <Emphasis Type="Italic">Staphylococcus aureus</Emphasis> (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 (<Emphasis Type="Italic">P</Emphasis> < 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; <Emphasis Type="Italic">P</Emphasis> < 0.001).</Para></AbstractSection><AbstractSection ID="ASec4"><Heading>Conclusions</Heading><Para>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.</Para></AbstractSection></Abstract><KeywordGroup Language="En" OutputMedium="All"><Heading>Keywords</Heading><Keyword>Procalcitonin</Keyword><Keyword>Pneumonia</Keyword><Keyword>A/H1N1v influenza</Keyword><Keyword>Bacterial infection</Keyword></KeywordGroup><ArticleNote Type="Misc"><SimplePara>Members of the A/H1N1 REVA-SRLF Study Group are list in the Appendix.</SimplePara></ArticleNote></ArticleHeader><NoBody></NoBody></Article></Issue></Volume></Journal></Publisher></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Can procalcitonin help identify associated bacterial infection in patients with severe influenza pneumonia? A multicentre study</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Can procalcitonin help identify associated bacterial infection in patients with severe influenza pneumonia? A multicentre study</title></titleInfo><name type="corporate"><namePart>A/H1N1 REVA-SRLF Study Group</namePart></name><name type="personal"><namePart type="given">E.</namePart><namePart type="family">Cuquemelle</namePart><affiliation>Service de Réanimation médicale, Medical Intensive Care Unit, GH Henri Mondor, AP-HP, Université Paris-Est Créteil, Créteil, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">F.</namePart><namePart type="family">Soulis</namePart><affiliation>Medical Intensive Care Unit, Centre Hospitalo-Universitaire Charles Nicolle, Rouen, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">D.</namePart><namePart type="family">Villers</namePart><affiliation>Medical Intensive Care Unit, Centre Hospitalo-Universitaire Hotel-Dieu, Nantes, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">F.</namePart><namePart type="family">Roche-Campo</namePart><affiliation>Polyvalent Intensive Care Unit, Hospital Santa Creu I Sant Pau, Barcelona, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C.</namePart><namePart type="family">Ara Somohano</namePart><affiliation>Medical Intensive Care Unit, Centre Hospitalo-Universitaire A. Michallon, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M.</namePart><namePart type="family">Fartoukh</namePart><affiliation>Medical Intensive Care Unit, APHP, Centre Hospitalo-Universitaire Tenon, AP-HP, Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">A.</namePart><namePart type="family">Kouatchet</namePart><affiliation>Medical Intensive Care Unit, Centre Hospitalo-Universitaire, Angers, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">B.</namePart><namePart type="family">Mourvillier</namePart><affiliation>Medical Intensive Care Unit, APHP, Centre Hospitalo-Universitaire Bichat-Claude Bernard, AP-HP, Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J.</namePart><namePart type="family">Dellamonica</namePart><affiliation>Medical Intensive Care Unit, Centre Hospitalo-Universitaire Archet 1, Nice, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">W.</namePart><namePart type="family">Picard</namePart><affiliation>Polyvalent Intensive Care Unit, Centre Hospitalier F. Mitterand, Pau, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M.</namePart><namePart type="family">Schmidt</namePart><affiliation>Medical Intensive Care Unit, APHP, Centre Hospitalo-Universitaire Pitié-Salpétrière, Paris, AP-HP, Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">T.</namePart><namePart type="family">Boulain</namePart><affiliation>Medical ICU, Centre Hospitalier Régional, Orléans, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal" displayLabel="corresp"><namePart type="given">C.</namePart><namePart type="family">Brun-Buisson</namePart><affiliation>Service de Réanimation médicale, Medical Intensive Care Unit, GH Henri Mondor, AP-HP, Université Paris-Est Créteil, Créteil, France</affiliation><affiliation>E-mail: christian.brun-buisson@hmn.aphp.fr</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="OriginalPaper" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>Springer-Verlag</publisher><place><placeTerm type="text">Berlin/Heidelberg</placeTerm></place><dateCreated encoding="w3cdtf">2010-11-21</dateCreated><dateIssued encoding="w3cdtf">2011-05-01</dateIssued><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><abstract 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.</abstract><note>Original</note><subject lang="en"><genre>Keywords</genre><topic>Procalcitonin</topic><topic>Pneumonia</topic><topic>A/H1N1v influenza</topic><topic>Bacterial infection</topic></subject><relatedItem type="host"><titleInfo><title>Intensive Care Medicine</title></titleInfo><titleInfo type="abbreviated"><title>Intensive Care Med</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><originInfo><publisher>Springer</publisher><dateIssued encoding="w3cdtf">2011</dateIssued><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><subject><genre>Medicine & Public Health</genre><topic>Pain Medicine</topic><topic>Anesthesiology</topic><topic>Pneumology/Respiratory System</topic><topic>Pediatrics</topic><topic>Emergency Medicine</topic><topic>Intensive / Critical Care Medicine</topic></subject><identifier type="ISSN">0342-4642</identifier><identifier type="eISSN">1432-1238</identifier><identifier type="JournalID">134</identifier><identifier type="IssueArticleCount">30</identifier><identifier type="VolumeIssueCount">12</identifier><part><date>2011</date><detail type="volume"><number>37</number><caption>vol.</caption></detail><detail type="issue"><number>5</number><caption>no.</caption></detail><extent unit="pages"><start>796</start><end>800</end></extent></part><recordInfo><recordOrigin>Copyright jointly held by Springer and ESICM, 2011</recordOrigin></recordInfo></relatedItem><identifier type="istex">AFE1C4D3A173615DDDB9DECF2E2EDF7694B27BAB</identifier><identifier type="ark">ark:/67375/VQC-P7CR3SK6-2</identifier><identifier type="DOI">10.1007/s00134-011-2189-1</identifier><identifier type="ArticleID">2189</identifier><identifier type="ArticleID">s00134-011-2189-1</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright jointly held by Springer and ESICM, 2011</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-3XSW68JL-F">springer</recordContentSource><recordOrigin>Converted from (version 1.2.14) to MODS version 3.6.</recordOrigin><recordCreationDate encoding="w3cdtf">2020-05-28</recordCreationDate></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/ark:/67375/VQC-P7CR3SK6-2/record.json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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