2009 H1N1 인플루엔자 폐렴에서 Procalcitonin의 유용성: 세균성 폐렴과의 감별 역할

• Published in: Tuberculosis and respiratory diseases Vol. 68; no. 4; pp. 205 - 211
• Main Authors: 안신, Shin Ahn, 김원영, Won Young Kim, 윤지영, Ji Young Yoon, 손창환, Chang Hwan Sohn, 서동우, Dong Woo Seo, 김성한, Sung Han Kim, 홍상범, Sang Bum Hong, 임채만, Chae Man Lim, 고윤석, Youn Suck Koh, 김원, Won Kim
• Format: Journal Article
• Language: Korean
• Published: 대한결핵 및 호흡기학회 30.04.2010; 대한결핵및호흡기학회
• Subjects: H1N1 Subtype; Influenza A Virus; Pneumonia; Procalcitonin; 내과학; Influenza A Virus, H1N1 Subtype; Pneumonia; Procalcitonin
• ISSN: 1738-3536; 2005-6184

Background: Procalcitonin is a well known marker in infection that plays a role in distinguishing between bacterial and viral infections in screening. The aim of the present study was to evaluate the role of procalcitonin in differentiating between 2009 H1N1 influenza pneumonia and community acquired pneumonia of bacterial origin, or mixed bacterial origin and 2009 H1N1 influenza infection. Methods: A retrospective observational study was performed over the 6-month winter period during the 2009 H1N1 influenza pandemic. Ninety-six patient-subjects were enrolled, all of whom had been diagnosed with community acquired pneumonia in emergency department during the study period. On admission, laboratory studies were performed, which included 2009 H1N1 influenza real-time polymerase chain reaction of nasal secretions and procalcitonin on serum; the laboratory values were compared between the study groups. Receiver operating characteristic curve analyses were performed on the resulting data. Results: Compared to those with bacterial or mixed infections (n=62) and bacterial pneumonia with confirmed organisms (n=30), patients with 2009 H1N1 pneumonia (n=34) were significantly more likely to have low procalcitonin levels (p=0.008, 0.001). Using cutoff of value ＞0.3 ng/mL, the sensitivity and specificity of procalcitonin for detection of patients with confirmed bacterial pneumonia were 76.2% and 60.6%, respectively. A significant difference in procalcitonin was found between 2009 H1N1 pneumonia and pneumonia caused by mixed influenza viral and bacterial infections (0.15 [0.05∼0.84] vs. 10.3 [0.05∼22.87] ng/mL, p=0.045). Conclusion: Serum procalcitonin measurement may assist in the discrimination between pneumonia of bacterial and of 2009 H1N1 influenza origin. High values of procalcitonin suggest that bacterial infection or mixed infection of bacteria and 2009 H1N1 influenza is more likely.