Role of procalcitonin and C-reactive protein in differentiation of mixed bacterial infection from 2009 H1N1 viral pneumonia: Mixed bacterial infection in 2009 H1N1 influenza

Ahn, Shin; Kim, Won Young; Kim, Sung-Han; Hong, SangBum; Lim, Chae-Man; Koh, YounSuck; Lim, Kyung Soo; Kim, Won

doi:10.1111/j.1750-2659.2011.00244.x

Cited by 64Influenza Virus Research StudiesSepsis Diagnosis and TreatmentPneumonia and Respiratory Infections

Role of procalcitonin and C-reactive protein in differentiation of mixed bacterial infection from 2009 H1N1 viral pneumonia: Mixed bacterial infection in 2009 H1N1 influenza

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Ahn, Shin, Kim, Won Young, Kim, Sung-Han, Hong, SangBum, Lim, Chae-Man, Koh, YounSuck, Lim, Kyung Soo, Kim, Won·2011·Influenza and Other Respiratory Viruses

DOI 10.1111/j.1750-2659.2011.00244.xPMC PMC5780656

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Abstract

BACKGROUND: Mixed bacterial infection is an important contributor to morbidity and mortality during influenza pandemics. We evaluated procalcitonin (PCT) and C-reactive protein (CRP) in differentiating pneumonia caused by mixed bacterial and 2009 H1N1 influenza infection from 2009 H1N1 influenza infection alone. METHODS: Data were collected retrospectively over a 7-month period during the 2009 H1N1 influenza pandemic. Patients visiting emergency department and diagnosed as community-acquired pneumonia caused by 2009 H1N1 infection were included (n = 60). RESULTS: Mixed bacterial and viral infection pneumonia (n = 16) had significantly higher PCT and CRP levels than pneumonia caused by 2009 H1N1 influenza alone (n = 44, P = 0·019, 0·022 respectively). The sensitivity and specificity for detection of mixed bacterial infection pneumonia was 56% and 84% for PCT > 1·5 ng/ml, and 69% and 63% for CRP > 10 mg/dl. Using PCT and CRP in combination, the sensitivity and specificity were 50% and 93%, respectively. CONCLUSION: Procalcitonin and CRP alone and their combination had a moderate ability to detect pneumonia of mixed bacterial infection during the 2009 H1N1 pandemic. Considering high specificity, combination of low CRP and PCT result may suggest that pneumonia is unlikely to be caused by mixed bacterial infection.

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Only three studies excluded participants based on antibiotic use and reported coinfection rates of 12.2%, 26.7%, and 46.6%.
“Only three studies excluded participants based on antibiotic use and reported coinfection rates of 12·2%, 26·7%, and 46·6%.28, 34, 36”
From The frequency of influenza and bacterial coinfection: a systematic review and meta-analysis. (2016) · cites this paper as [28]

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Self-citation
Can procalcitonin help identify associated bacterial infection in patients with severe influenza pneumonia? A multicentre study
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Combination of procalcitonin and C‐reactive protein levels in the early diagnosis of bacterial co‐infections in children with H1N1 influenza
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Authors: Ahn, S., Kim, W. Y., Kim, S.-H., Hong, S., Lim, C.-M., Koh, Y., Lim, K. S., & Kim, W.
Affiliations: Asan Medical Center (KR)
Corresponding author: Kim, Won Young
Kim, Won
ORCID: Ahn, Shin
Kim, Won Young
Kim, Sung-Han
Lim, Chae-Man
Koh, YounSuck
Kim, Won
Venue: Influenza and Other Respiratory Viruses
Publisher: Wiley
Published: 2011-03-30
Volume: 5
Issue: 6
Pages: 398-403
ISSN: 1750-2640 (ISSN-L)
DOI: 10.1111/j.1750-2659.2011.00244.x
PMC: PMC5780656
OpenAlex: W1482277261
Cited by: 64
References: 27
Citations by year: 2026: 1 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 8 · 2021: 7 · 2020: 10 · 2019: 5 · 2018: 7 · 2017: 5 · 2016: 3 · 2015: 2 · 2014: 3 · 2013: 1 · 2012: 8
FWCI: 2.88
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 1616 d)
Locations: Influenza and Other Respiratory Viruses (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
Keywords: procalcitonin, C-reactive protein, mixed bacterial infection, 2009 H1N1 influenza, influenza-associated pneumonia, community-acquired pneumonia, sensitivity and specificity, bacterial co-infection, 2009 H1N1 pandemic
MeSH terms: Adult, Aged, Bacteria, C-Reactive Protein, Calcitonin, Female, Humans, Male, Middle Aged, Pneumonia, Viral, Protein Precursors, Retrospective Studies, Calcitonin Gene-Related Peptide, Pneumonia, Bacterial, Influenza A Virus, H1N1 Subtype, Young Adult, Coinfection

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Role of procalcitonin and C-reactive protein in differentiation of mixed bacterial infection from 2009 H1N1 viral pneumonia: Mixed bacterial infection in 2009 H1N1 influenza

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