PandemieGrippaleV1, Main, Merge, bibRecord, 002997

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

Identifieur interne : 002997 ( Main/Merge ); précédent : 002996; suivant : 002998

Can 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.

RBID : ISTEX:AFE1C4D3A173615DDDB9DECF2E2EDF7694B27BAB

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.

English descriptors

KwdEn :
- Adult, Bacterial Infections (blood), Bacterial Infections (diagnosis), Bacterial Infections (physiopathology), Biomarkers, Calcitonin (blood), Calcitonin Gene-Related Peptide, Female, France, Humans, Influenza A Virus, H1N1 Subtype, Influenza, Human (diagnosis), Influenza, Human (physiopathology), Influenza, Human (virology), Male, Middle Aged, Pneumonia (diagnosis), Pneumonia (physiopathology), Pneumonia (virology), Protein Precursors (blood), 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:

DOI: 10.1007/s00134-011-2189-1

Links to Exploration step

ISTEX:AFE1C4D3A173615DDDB9DECF2E2EDF7694B27BAB

Le document en format XML

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<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>Biomarkers</term>
<term>Calcitonin (blood)</term>
<term>Calcitonin Gene-Related Peptide</term>
<term>Female</term>
<term>France</term>
<term>Humans</term>
<term>Influenza A Virus, H1N1 Subtype</term>
<term>Influenza, Human (diagnosis)</term>
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<term>Influenza, Human (virology)</term>
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<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>
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<term>Infections bactériennes (physiopathologie)</term>
<term>Infections bactériennes (sang)</term>
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<term>Pneumopathie infectieuse (physiopathologie)</term>
<term>Pneumopathie infectieuse (virologie)</term>
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<term>Sous-type H1N1 du virus de la grippe A</term>
<term>Études rétrospectives</term>
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<keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Calcitonin</term>
<term>Protein Precursors</term>
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<keywords scheme="MESH" type="chemical" xml:lang="en"><term>Biomarkers</term>
<term>Calcitonin Gene-Related Peptide</term>
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<keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>Bacterial Infections</term>
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<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Bacterial Infections</term>
<term>Influenza, Human</term>
<term>Pneumonia</term>
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<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>
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<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>
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<author><name sortKey="Dellamonica, J" sort="Dellamonica, J" uniqKey="Dellamonica J" first="J." last="Dellamonica">J. Dellamonica</name>
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<author><name sortKey="Picard, W" sort="Picard, W" uniqKey="Picard W" first="W." last="Picard">W. Picard</name>
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<author><name sortKey="Schmidt, M" sort="Schmidt, M" uniqKey="Schmidt M" first="M." last="Schmidt">M. Schmidt</name>
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<author><name sortKey="Boulain, T" sort="Boulain, T" uniqKey="Boulain T" first="T." last="Boulain">T. Boulain</name>
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<author><name sortKey="Brun Buisson, C" sort="Brun Buisson, C" uniqKey="Brun Buisson C" first="C." last="Brun-Buisson">C. Brun-Buisson</name>
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<sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Can procalcitonin help identify associated bacterial infection in patients with severe influenza pneumonia? A multicentre study</title>
<author><name sortKey="Cuquemelle, E" sort="Cuquemelle, E" uniqKey="Cuquemelle E" first="E." last="Cuquemelle">E. Cuquemelle</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>
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</affiliation>
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<author><name sortKey="Soulis, F" sort="Soulis, F" uniqKey="Soulis F" first="F." last="Soulis">F. Soulis</name>
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<wicri:regionArea>Medical Intensive Care Unit, Centre Hospitalo-Universitaire Charles Nicolle, Rouen</wicri:regionArea>
<placeName><region type="region">Région Normandie</region>
<region type="old region">Haute-Normandie</region>
<settlement type="city">Rouen</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Villers, D" sort="Villers, D" uniqKey="Villers D" first="D." last="Villers">D. Villers</name>
<affiliation wicri:level="3"><country xml:lang="fr">France</country>
<wicri:regionArea>Medical Intensive Care Unit, Centre Hospitalo-Universitaire Hotel-Dieu, Nantes</wicri:regionArea>
<placeName><region type="region">Pays de la Loire</region>
<region type="old region">Pays de la Loire</region>
<settlement type="city">Nantes</settlement>
</placeName>
</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 wicri:level="3"><country xml:lang="fr">Espagne</country>
<wicri:regionArea>Polyvalent Intensive Care Unit, Hospital Santa Creu I Sant Pau, Barcelona</wicri:regionArea>
<placeName><settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
</placeName>
</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 wicri:level="3"><country xml:lang="fr">France</country>
<wicri:regionArea>Medical Intensive Care Unit, Centre Hospitalo-Universitaire A. Michallon, Grenoble</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Rhône-Alpes</region>
<settlement type="city">Grenoble</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Fartoukh, M" sort="Fartoukh, M" uniqKey="Fartoukh M" first="M." last="Fartoukh">M. Fartoukh</name>
<affiliation wicri:level="3"><country xml:lang="fr">France</country>
<wicri:regionArea>Medical Intensive Care Unit, APHP, Centre Hospitalo-Universitaire Tenon, 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="Kouatchet, A" sort="Kouatchet, A" uniqKey="Kouatchet A" first="A." last="Kouatchet">A. Kouatchet</name>
<affiliation wicri:level="3"><country xml:lang="fr">France</country>
<wicri:regionArea>Medical Intensive Care Unit, Centre Hospitalo-Universitaire, Angers</wicri:regionArea>
<placeName><region type="region">Pays de la Loire</region>
<region type="old region">Pays de la Loire</region>
<settlement type="city">Angers</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mourvillier, B" sort="Mourvillier, B" uniqKey="Mourvillier B" first="B." last="Mourvillier">B. Mourvillier</name>
<affiliation wicri:level="3"><country xml:lang="fr">France</country>
<wicri:regionArea>Medical Intensive Care Unit, APHP, Centre Hospitalo-Universitaire Bichat-Claude Bernard, 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="Dellamonica, J" sort="Dellamonica, J" uniqKey="Dellamonica J" first="J." last="Dellamonica">J. 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>
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<biblScope unit="page" to="800">800</biblScope>
</imprint>
<idno type="ISSN">0342-4642</idno>
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<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>
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<PMC><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Can procalcitonin help identify associated bacterial infection in patients with severe influenza pneumonia? A multicentre study</title>
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<institution>Service de Réanimation médicale, Medical Intensive Care Unit, GH Henri Mondor, AP-HP,</institution>
<institution>Université Paris-Est Créteil,</institution>
</institution-wrap>
Créteil, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Créteil</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Soulis, F" sort="Soulis, F" uniqKey="Soulis F" first="F." last="Soulis">F. Soulis</name>
<affiliation wicri:level="3"><nlm:aff id="Aff2">Medical Intensive Care Unit, Centre Hospitalo-Universitaire Charles Nicolle, Rouen, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Medical Intensive Care Unit, Centre Hospitalo-Universitaire Charles Nicolle, Rouen</wicri:regionArea>
<placeName><region type="region">Région Normandie</region>
<region type="old region">Haute-Normandie</region>
<settlement type="city">Rouen</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Villers, D" sort="Villers, D" uniqKey="Villers D" first="D." last="Villers">D. Villers</name>
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<institution>Medical Intensive Care Unit,</institution>
<institution>Centre Hospitalo-Universitaire Hotel-Dieu,</institution>
</institution-wrap>
Nantes, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Nantes</wicri:regionArea>
</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>
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<institution>Polyvalent Intensive Care Unit,</institution>
<institution>Hospital Santa Creu I Sant Pau,</institution>
</institution-wrap>
Barcelona, Spain</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Barcelona</wicri:regionArea>
</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 wicri:level="3"><nlm:aff id="Aff5">Medical Intensive Care Unit, Centre Hospitalo-Universitaire A. Michallon, Grenoble, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Medical Intensive Care Unit, Centre Hospitalo-Universitaire A. Michallon, Grenoble</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Rhône-Alpes</region>
<settlement type="city">Grenoble</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Fartoukh, M" sort="Fartoukh, M" uniqKey="Fartoukh M" first="M." last="Fartoukh">M. Fartoukh</name>
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<institution>Medical Intensive Care Unit,</institution>
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</institution-wrap>
Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Paris</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Kouatchet, A" sort="Kouatchet, A" uniqKey="Kouatchet A" first="A." last="Kouatchet">A. Kouatchet</name>
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<institution>Medical Intensive Care Unit,</institution>
<institution>Centre Hospitalo-Universitaire,</institution>
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Angers, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Angers</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Mourvillier, B" sort="Mourvillier, B" uniqKey="Mourvillier B" first="B." last="Mourvillier">B. Mourvillier</name>
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<institution>APHP, Centre Hospitalo-Universitaire Bichat-Claude Bernard, AP-HP,</institution>
</institution-wrap>
Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Paris</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Dellamonica, J" sort="Dellamonica, J" uniqKey="Dellamonica J" first="J." last="Dellamonica">J. Dellamonica</name>
<affiliation wicri:level="3"><nlm:aff id="Aff9">Medical Intensive Care Unit, Centre Hospitalo-Universitaire Archet 1, Nice, France</nlm:aff>
<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"><nlm:aff id="Aff10">Polyvalent Intensive Care Unit, Centre Hospitalier F. Mitterand, Pau, France</nlm:aff>
<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>
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Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Paris</wicri:regionArea>
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<author><name sortKey="Boulain, T" sort="Boulain, T" uniqKey="Boulain T" first="T." last="Boulain">T. Boulain</name>
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Orléans, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Orléans</wicri:regionArea>
</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>
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Créteil, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Créteil</wicri:regionArea>
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<idno type="wicri:Area/Ncbi/Checkpoint">000F85</idno>
<idno type="wicri:doubleKey">0342-4642:2011:Cuquemelle E:can:procalcitonin:help</idno>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Can procalcitonin help identify associated bacterial infection in patients with severe influenza pneumonia? A multicentre study</title>
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<institution-id institution-id-type="ISNI">0000000121497878</institution-id>
<institution>Service de Réanimation médicale, Medical Intensive Care Unit, GH Henri Mondor, AP-HP,</institution>
<institution>Université Paris-Est Créteil,</institution>
</institution-wrap>
Créteil, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Créteil</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Soulis, F" sort="Soulis, F" uniqKey="Soulis F" first="F." last="Soulis">F. Soulis</name>
<affiliation wicri:level="3"><nlm:aff id="Aff2">Medical Intensive Care Unit, Centre Hospitalo-Universitaire Charles Nicolle, Rouen, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Medical Intensive Care Unit, Centre Hospitalo-Universitaire Charles Nicolle, Rouen</wicri:regionArea>
<placeName><region type="region">Région Normandie</region>
<region type="old region">Haute-Normandie</region>
<settlement type="city">Rouen</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Villers, D" sort="Villers, D" uniqKey="Villers D" first="D." last="Villers">D. Villers</name>
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<institution-id institution-id-type="ISNI">0000000404720371</institution-id>
<institution>Medical Intensive Care Unit,</institution>
<institution>Centre Hospitalo-Universitaire Hotel-Dieu,</institution>
</institution-wrap>
Nantes, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Nantes</wicri:regionArea>
</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 wicri:level="1"><nlm:aff id="Aff4"><institution-wrap><institution-id institution-id-type="GRID">grid.413396.a</institution-id>
<institution-id institution-id-type="ISNI">0000000417688905</institution-id>
<institution>Polyvalent Intensive Care Unit,</institution>
<institution>Hospital Santa Creu I Sant Pau,</institution>
</institution-wrap>
Barcelona, Spain</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Barcelona</wicri:regionArea>
</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 wicri:level="3"><nlm:aff id="Aff5">Medical Intensive Care Unit, Centre Hospitalo-Universitaire A. Michallon, Grenoble, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Medical Intensive Care Unit, Centre Hospitalo-Universitaire A. Michallon, Grenoble</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Rhône-Alpes</region>
<settlement type="city">Grenoble</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Fartoukh, M" sort="Fartoukh, M" uniqKey="Fartoukh M" first="M." last="Fartoukh">M. Fartoukh</name>
<affiliation wicri:level="1"><nlm:aff id="Aff6"><institution-wrap><institution-id institution-id-type="GRID">grid.50550.35</institution-id>
<institution-id institution-id-type="ISNI">0000000121754109</institution-id>
<institution>Medical Intensive Care Unit,</institution>
<institution>APHP, Centre Hospitalo-Universitaire Tenon, AP-HP,</institution>
</institution-wrap>
Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Paris</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Kouatchet, A" sort="Kouatchet, A" uniqKey="Kouatchet A" first="A." last="Kouatchet">A. Kouatchet</name>
<affiliation wicri:level="1"><nlm:aff id="Aff7"><institution-wrap><institution-id institution-id-type="GRID">grid.411147.6</institution-id>
<institution-id institution-id-type="ISNI">0000000404720283</institution-id>
<institution>Medical Intensive Care Unit,</institution>
<institution>Centre Hospitalo-Universitaire,</institution>
</institution-wrap>
Angers, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Angers</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Mourvillier, B" sort="Mourvillier, B" uniqKey="Mourvillier B" first="B." last="Mourvillier">B. Mourvillier</name>
<affiliation wicri:level="1"><nlm:aff id="Aff8"><institution-wrap><institution-id institution-id-type="GRID">grid.50550.35</institution-id>
<institution-id institution-id-type="ISNI">0000000121754109</institution-id>
<institution>Medical Intensive Care Unit,</institution>
<institution>APHP, Centre Hospitalo-Universitaire Bichat-Claude Bernard, AP-HP,</institution>
</institution-wrap>
Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Paris</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Dellamonica, J" sort="Dellamonica, J" uniqKey="Dellamonica J" first="J." last="Dellamonica">J. Dellamonica</name>
<affiliation wicri:level="3"><nlm:aff id="Aff9">Medical Intensive Care Unit, Centre Hospitalo-Universitaire Archet 1, Nice, France</nlm:aff>
<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"><nlm:aff id="Aff10">Polyvalent Intensive Care Unit, Centre Hospitalier F. Mitterand, Pau, France</nlm:aff>
<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="1"><nlm:aff id="Aff11"><institution-wrap><institution-id institution-id-type="GRID">grid.411439.a</institution-id>
<institution-id institution-id-type="ISNI">0000000121509058</institution-id>
<institution>Medical Intensive Care Unit,</institution>
<institution>APHP, Centre Hospitalo-Universitaire Pitié-Salpétrière, Paris, AP-HP,</institution>
</institution-wrap>
Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Paris</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Boulain, T" sort="Boulain, T" uniqKey="Boulain T" first="T." last="Boulain">T. Boulain</name>
<affiliation wicri:level="1"><nlm:aff id="Aff12"><institution-wrap><institution-id institution-id-type="GRID">grid.413932.e</institution-id>
<institution-id institution-id-type="ISNI">0000 0004 1792 201X</institution-id>
<institution>Medical ICU,</institution>
<institution>Centre Hospitalier Régional,</institution>
</institution-wrap>
Orléans, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Orléans</wicri:regionArea>
</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="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.410511.0</institution-id>
<institution-id institution-id-type="ISNI">0000000121497878</institution-id>
<institution>Service de Réanimation médicale, Medical Intensive Care Unit, GH Henri Mondor, AP-HP,</institution>
<institution>Université Paris-Est Créteil,</institution>
</institution-wrap>
Créteil, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Créteil</wicri:regionArea>
</affiliation>
</author>
</analytic>
<series><title level="j">Intensive Care Medicine</title>
<idno type="ISSN">0342-4642</idno>
<idno type="eISSN">1432-1238</idno>
<imprint><date when="2011">2011</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</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>Biomarkers</term>
<term>Calcitonin (blood)</term>
<term>Calcitonin Gene-Related Peptide</term>
<term>Female</term>
<term>France</term>
<term>Humans</term>
<term>Influenza A Virus, H1N1 Subtype</term>
<term>Influenza, Human (diagnosis)</term>
<term>Influenza, Human (physiopathology)</term>
<term>Influenza, Human (virology)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Pneumonia (diagnosis)</term>
<term>Pneumonia (physiopathology)</term>
<term>Pneumonia (virology)</term>
<term>Protein Precursors (blood)</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>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>Purpose</title>
<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>
</sec>
<sec><title>Methods</title>
<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>
</sec>
<sec><title>Results</title>
<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 <italic>Streptococcus pneumoniae</italic>
 (54%) or <italic>Staphylococcus aureus</italic>
 (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 (<italic>P</italic>
 < 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; <italic>P</italic>
 < 0.001).</p>
</sec>
<sec><title>Conclusions</title>
<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>
</sec>
</div>
</front>
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   |wiki=    Sante
   |area=    PandemieGrippaleV1
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   |clé=     ISTEX:AFE1C4D3A173615DDDB9DECF2E2EDF7694B27BAB
   |texte=   Can procalcitonin help identify associated bacterial infection in patients with severe influenza pneumonia? A multicentre study
}}

This area was generated with Dilib version V0.6.34.
Data generation: Wed Jun 10 11:04:28 2020. Site generation: Sun Mar 28 09:10:28 2021

Serveur d'exploration sur les pandémies grippales

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

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

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	Serveur d'exploration sur les pandémies grippales
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