Bacterial coinfection is associated with severity of avian influenza A (H7N9), and procalcitonin is a useful marker for early diagnosis

• Published in: Diagnostic microbiology and infectious disease Vol. 84; no. 2; pp. 165 - 169
• Main Authors: Yang, Meifang, Gao, Hainv, Chen, Jiajia, Xu, Xiaowei, Tang, Lingling, Yang, Yida, Liang, Weifeng, Yu, Liang, Sheng, Jifang, Li, Lanjuan
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2016
• Subjects: Adult; Aged; Aged, 80 and over; Animals; Bacterial co-infection; Bacterial Infections - complications; Bacterial Infections - diagnosis; Bacterial Infections - pathology; Calcitonin - blood; Calcitonin Gene-Related Peptide; Coinfection - diagnosis; Coinfection - pathology; Early Diagnosis; Female; H7N9; Humans; Infectious Disease; Influenza A; Influenza A Virus, H7N9 Subtype - isolation & purification; Influenza, Human - complications; Influenza, Human - pathology; Influenza, Human - virology; Internal Medicine; Male; Middle Aged; Mortality; Procalcitonin; Protein Precursors - blood; Retrospective Studies; Severity of Illness Index; Staphylococcus aureus; Young Adult; Influenza A; H7N9; Mortality; Procalcitonin; Bacterial co-infection
• ISSN: 0732-8893; 1879-0070
• DOI: 10.1016/j.diagmicrobio.2015.10.018

Abstract Patients contracting avian influenza A (H7N9) often develop severe disease. However, information on the contribution of bacterial coinfection to the severity of H7N9 is limited. We retrospectively studied 83 patients with confirmed H7N9 infection from April 2013 to February 2014. The severity of patients with bacterial coinfection and markers for early diagnosis of bacterial coinfection in H7N9 were analyzed. We found Staphylococcus aureus was the most prevalent pathogen. Higher Acute Physiology and Chronic Health Evaluation II score, shock, renal replacement treatment, mechanical ventilation, and extracorporeal membrane oxygenation treatment were more frequently observed in patients with bacterial coinfection. Procalcitonin is more sensitive than C-reactive protein in determining bacterial coinfection in H7N9 patients. In conclusion, H7N9 infection patients with bacterial coinfection had a more severe condition. Elevated procalcitonin is an accurate marker for diagnosing bacterial coinfection in H7N9 patients, thus enabling earlier antibiotic therapy.