PandemieGrippaleV1, PascalFrancis, Curation, bibRecord, 001176

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

Identifieur interne : 001176 ( PascalFrancis/Curation ); précédent : 001175; suivant : 001177

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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C01	`01`		`ENG`	@0 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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<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="Brun Buisson, C" sort="Brun Buisson, C" uniqKey="Brun Buisson C" first="C." last="Brun-Buisson">C. Brun-Buisson</name>
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<s2>Créteil</s2>
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<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>
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<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>
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<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>
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<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>
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<fA08 i1="01" i2="1" l="ENG"><s1>Can procalcitonin help identify associated bacterial infection in patients with severe influenza pneumonia? A multicentre study</s1>
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<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>
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<fA14 i1="02"><s1>Medical Intensive Care Unit, Centre Hospitalo-Universitaire Charles Nicolle</s1>
<s2>Rouen</s2>
<s3>FRA</s3>
<sZ>2 aut.</sZ>
</fA14>
<fA14 i1="03"><s1>Medical Intensive Care Unit, Centre Hospitalo-Universitaire Hotel-Dieu</s1>
<s2>Nantes</s2>
<s3>FRA</s3>
<sZ>3 aut.</sZ>
</fA14>
<fA14 i1="04"><s1>Polyvalent Intensive Care Unit, Hospital Santa Creu I Sant Pau</s1>
<s2>Barcelona</s2>
<s3>ESP</s3>
<sZ>4 aut.</sZ>
</fA14>
<fA14 i1="05"><s1>Medical Intensive Care Unit, Centre Hospitalo-Universitaire A. Michallon</s1>
<s2>Grenoble</s2>
<s3>FRA</s3>
<sZ>5 aut.</sZ>
</fA14>
<fA14 i1="06"><s1>Medical Intensive Care Unit, APHP, Centre Hospitalo-Universitaire Tenon, AP-HP</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>6 aut.</sZ>
</fA14>
<fA14 i1="07"><s1>Medical Intensive Care Unit, Centre Hospitalo-Universitaire</s1>
<s2>Angers</s2>
<s3>FRA</s3>
<sZ>7 aut.</sZ>
</fA14>
<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>
</fA14>
<fA14 i1="09"><s1>Medical Intensive Care Unit, Centre Hospitalo-Universitaire Archet 1</s1>
<s2>Nice</s2>
<s3>FRA</s3>
<sZ>9 aut.</sZ>
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<fA14 i1="10"><s1>Polyvalent Intensive Care Unit, Centre Hospitalier F. Mitterand</s1>
<s2>Pau</s2>
<s3>FRA</s3>
<sZ>10 aut.</sZ>
</fA14>
<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>
</fA14>
<fA14 i1="12"><s1>Medical ICU, Centre Hospitalier Regional</s1>
<s2>Orleans</s2>
<s3>FRA</s3>
<sZ>12 aut.</sZ>
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<fA20><s1>796-800</s1>
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<fA21><s1>2011</s1>
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<s1>© 2011 INIST-CNRS. All rights reserved.</s1>
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<fC01 i1="01" l="ENG"><s0>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.</s0>
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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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