Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Diagnostic Role of C-reactive Protein, Procalcitonin and Lipopolysaccharide-Binding Protein in Discriminating Bacterial-Community Acquired Pneumonia from 2009 H1N1 Influenza A Infection

박테리아성 지역사회획득 폐렴과 2009 H1N1 바이러스성 감염의 감별에 있어 C-Reactive Protein, Procalcitonin, Lipopolysaccharide-Binding Protein의 역할

  • Han, Seon-Sook (Department of Internal Medicine, Kangwon National University School of Medicine) ;
  • Kim, Se-Hyun (Department of Internal Medicine, Kangwon National University School of Medicine) ;
  • Kim, Woo-Jin (Department of Internal Medicine, Kangwon National University School of Medicine) ;
  • Lee, Seung-Joon (Department of Internal Medicine, Kangwon National University School of Medicine) ;
  • Ryu, Sook-Won (Department of Laboratory Medicine, Kangwon National University School of Medicine) ;
  • Cheon, Myeong-Ju (Clinical Research Institute of Kangwon National University Hospital, Kangwon National University School of Medicine)
  • 한선숙 (강원대학교 의학전문대학원 내과학교실) ;
  • 김세현 (강원대학교 의학전문대학원 내과학교실) ;
  • 김우진 (강원대학교 의학전문대학원 내과학교실) ;
  • 이승준 (강원대학교 의학전문대학원 내과학교실) ;
  • 유숙원 (강원대학교 의학전문대학원 진단검사의학교실) ;
  • 천명주 (강원대학교 의학전문대학원 강원대학교병원 임상의학연구소)
  • Received : 2011.03.07
  • Accepted : 2011.04.29
  • Published : 2011.06.30
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Abstract

Background: It is difficult but important to differentiate between bacterial and viral infections, especially for respiratory infections. Hence, there is an ongoing need for sensitive and specific markers of bacterial infections. We investigated novel biomarkers for discriminating community acquired bacterial pneumonia from 2009 H1N1 influenza A infections. Methods: This was a prospective, observational study of patients with community acquired bacterial pneumonia, 2009 H1N1 Influenza A infection, and healthy controls. Serum samples were obtained on the initial visit to the hospital and stored at $-80^{\circ}C$. We evaluated CRP (C-reactive protein), PCT (procalcitonin), LBP (lipopolysaccharide-binding protein) and copeptin. These analytes were all evaluated retrospectively except CRP. Receiver operating characteristic curve (ROC) analyses were performed on the resulting data. Results: Enrolled patients included 27 with community acquired bacterial pneumonia, 20 with 2009 H1N1 Influenza A infection, and 26 who were healthy controls. In an ROC analysis for discriminating community acquired bacterial pneumonia from 2009 H1N1 influenza A infection, areas under the curve (AUCs) were 0.799 for CRP (95% Confidence interval [CI], 0.664~0.934), 0.753 for PCT (95% CI, 0.613~0.892) and 0.684 for LBP (95% CI, 0.531~0.837). Copeptin was not different among the three groups. Conclusion: These findings suggest that serum CRP, PCT and LBP can assist physicians in discriminating community acquired bacterial pneumonia from 2009 H1N1 influenza A infection.

Keywords

References

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