2009 H1N1 인플루엔자 폐렴에서 Procalcitonin의 유용성: 세균성 폐렴과의 감별 역할

안신; 김원영; 윤지영; 손창환; 서동우; 김성한; 홍상범; 임채만; 고윤석; 김원

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자료유형: 학술저널

저자정보: 안신 (울산대학교 의과대학 서울아산병원 응급의학교실) 김원영 (울산대학교 의과대학 서울아산병원 응급의학교실) 윤지영 (울산대학교 의과대학 서울아산병원 응급의학교실) 손창환 (울산대학교 의과대학 서울아산병원 응급의학교실) 서동우 (울산대학교 의과대학 서울아산병원 응급의학교실) 김성한 (울산대학교 의과대학 서울아산병원 감염내과학교실) 홍상범 (울산대학교 의과대학 서울아산병원 호흡기내과학교실) 임채만 (울산대학교 의과대학 서울아산병원 호흡기내과학교실) 고윤석 (울산대학교 의과대학 서울아산병원 호흡기내과학교실) 김원 (울산대학교 의과대학 서울아산병원 응급의학교실)

저널정보: 대한결핵 및 호흡기학회 Tuberculosis and Respiratory Diseases 결핵 및 호흡기 질환 제68권 제4호

발행연도: 2010.1

수록면: 205 - 211 (7page)

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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.

#Influenza A Virus, H1N1 Subtype #Procalcitonin #Pneumonia

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