Cited by 109Sepsis Diagnosis and TreatmentInfluenza Virus Research StudiesPneumonia and Respiratory Infections

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

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Cuquemelle, E., Soulis, F., Villers, D., Roche-Campo, F., Ara Somohano, C., Fartoukh, M., Kouatchet, A., Mourvillier, B., Dellamonica, J., Picard, W., Schmidt, M., Boulain, T., Brun-Buisson, C., A/H1N1 REVA-SRLF Study Group·2011·Intensive Care Medicine

DOI 10.1007/s00134-011-2189-1PMC PMC7080069

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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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Authors: Cuquemelle, E., Soulis, F., Villers, D., Roche-Campo, F., Ara Somohano, C., Fartoukh, M., Kouatchet, A., Mourvillier, B., Dellamonica, J., Picard, W., Schmidt, M., Boulain, T., Brun-Buisson, C., & A/H1N1 REVA-SRLF Study Group
Affiliations: Hôpital Charles-Nicolle (FR)
Centre Hospitalier Universitaire de Nantes (FR)
Assistance Publique – Hôpitaux de Paris (FR)
Centre Hospitalier Universitaire d'Angers (FR)
Centre Hospitalier Universitaire de Nice (FR)
Centre Hospitalier De Pau (FR)
Centre hospitalier universitaire d'Orléans (FR)
ORCID: Fartoukh, M.
Mourvillier, B.
Dellamonica, J.
Schmidt, M.
Boulain, T.
Venue: Intensive Care Medicine
Publisher: Springer Science and Business Media LLC
Published: 2011-03-03
Volume: 37
Issue: 5
Pages: 796-800
ISSN: 0342-4642 (ISSN-L)
1432-1238
DOI: 10.1007/s00134-011-2189-1
PMC: PMC7080069
OpenAlex: W1997205563
Cited by: 109
References: 15
Citations by year: 2026: 2 · 2025: 2 · 2024: 4 · 2023: 9 · 2022: 6 · 2021: 10 · 2020: 9 · 2019: 7 · 2018: 4 · 2017: 6 · 2016: 5 · 2015: 11 · 2014: 8 · 2013: 6 · 2012: 17
FWCI: 8.19
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
Locations: Intensive Care Medicine (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Société de Réanimation de Langue Française
Topics: Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
Keywords: procalcitonin, bacterial co-infection, influenza pneumonia, H1N1 influenza, Streptococcus pneumoniae, Staphylococcus aureus, intensive care unit patients, diagnostic biomarkers, 2009 H1N1 pandemic
MeSH terms: Adult, Bacterial Infections, Calcitonin, Female, France, Humans, Influenza, Human, Male, Middle Aged, Pneumonia, Protein Precursors, Retrospective Studies, Sensitivity and Specificity, Severity of Illness Index, Biomarkers, Calcitonin Gene-Related Peptide, Influenza A Virus, H1N1 Subtype

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

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