PandemieGrippaleV1, Main, Merge, bibRecord, 002F97

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

Identifieur interne : 002F97 ( Main/Merge ); précédent : 002F96; suivant : 002F98

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 : (Print) [ 0342-4642 ] ; 2011.

RBID : Pascal:11-0224659

Descripteurs français

Pascal (Inist)
- Bactériose, Pneumonie, Procalcitonine, Homme, Grippe A, Réanimation, Soin intensif.
Wicri :
- topic : Homme.

English descriptors

KwdEn :
- Bacteriosis, Human, Influenza A, Intensive care, Pneumonia, Procalcitonin, Resuscitation.

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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Le document en format XML

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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Can procalcitonin help identify associated bacterial infection in patients with severe influenza pneumonia? A multicentre study</title>
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<s3>FRA</s3>
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<country>France</country>
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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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<author><name sortKey="Villers, D" sort="Villers, D" uniqKey="Villers D" first="D." last="Villers">D. Villers</name>
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<region nuts="2" type="region">Catalogne</region>
</placeName>
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<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"><inist:fA14 i1="05"><s1>Medical Intensive Care Unit, Centre Hospitalo-Universitaire A. Michallon</s1>
<s2>Grenoble</s2>
<s3>FRA</s3>
<sZ>5 aut.</sZ>
</inist:fA14>
<country>France</country>
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<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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<s2>Paris</s2>
<s3>FRA</s3>
<sZ>6 aut.</sZ>
</inist:fA14>
<country>France</country>
<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"><inist:fA14 i1="07"><s1>Medical Intensive Care Unit, Centre Hospitalo-Universitaire</s1>
<s2>Angers</s2>
<s3>FRA</s3>
<sZ>7 aut.</sZ>
</inist:fA14>
<country>France</country>
<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"><inist:fA14 i1="08"><s1>Medical Intensive Care Unit, APHP, Centre Hospitalo-Universitaire Bichat-Claude Bernard, AP-HP</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>8 aut.</sZ>
</inist:fA14>
<country>France</country>
<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"><inist:fA14 i1="09"><s1>Medical Intensive Care Unit, Centre Hospitalo-Universitaire Archet 1</s1>
<s2>Nice</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
</inist:fA14>
<country>France</country>
<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"><inist:fA14 i1="10"><s1>Polyvalent Intensive Care Unit, Centre Hospitalier F. Mitterand</s1>
<s2>Pau</s2>
<s3>FRA</s3>
<sZ>10 aut.</sZ>
</inist:fA14>
<country>France</country>
<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"><inist:fA14 i1="11"><s1>Medical Intensive Care Unit, APHP, Centre Hospitalo-Universitaire Pitié-Salpétrière, Paris, AP-HP</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>11 aut.</sZ>
</inist:fA14>
<country>France</country>
<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"><inist:fA14 i1="12"><s1>Medical ICU, Centre Hospitalier Regional</s1>
<s2>Orleans</s2>
<s3>FRA</s3>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>France</country>
<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"><inist:fA14 i1="01"><s1>Service de Reanimation médicale, Medical Intensive Care Unit, GH Henri Mondor, AP-HP, Universite Paris-Est Creteil</s1>
<s2>Créteil</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Créteil</settlement>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">Intensive care medicine : (Print)</title>
<title level="j" type="abbreviated">Intensive care med. : (Print)</title>
<idno type="ISSN">0342-4642</idno>
<imprint><date when="2011">2011</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">Intensive care medicine : (Print)</title>
<title level="j" type="abbreviated">Intensive care med. : (Print)</title>
<idno type="ISSN">0342-4642</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Bacteriosis</term>
<term>Human</term>
<term>Influenza A</term>
<term>Intensive care</term>
<term>Pneumonia</term>
<term>Procalcitonin</term>
<term>Resuscitation</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Bactériose</term>
<term>Pneumonie</term>
<term>Procalcitonine</term>
<term>Homme</term>
<term>Grippe A</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">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="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>

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	Serveur d'exploration sur les pandémies grippales
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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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