대한임상검사과학회지 (Korean Journal of Clinical Laboratory Science)

  • 제49권1호
  • /
  • Pages.15-21
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  • 2017
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  • 1738-3544(pISSN)
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  • 2288-1662(eISSN)
대한임상검사과학회 (Korean Society for Clinical Laboratory Science)
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호흡기 바이러스 감염과 C-Reactive Protein

C-Reactive Protein and Respiratory Viral Infection

  • 전재식 (단국대학교 의과대학 임상병리학과) ;
  • 임인수 (단국대학교 의과대학 임상병리학과) ;
  • 김재경 (단국대학교 보건과학대학 임상병리학과)
  • Jeon, Jae-Sik (Department of Laboratory Medicine, Dankook University College of Medicine) ;
  • Rheem, Insoo (Department of Laboratory Medicine, Dankook University College of Medicine) ;
  • Kim, Jae Kyung (Department of Biomedical Laboratory Science, Dankook University College of Health Sciences)
  • 투고 : 2017.01.01
  • 심사 : 2017.02.24
  • 발행 : 2017.03.31
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초록

C-reactive protein (CRP) levels are not generally associated with viral infections. This study investigated the changes in the CRP level caused by an infection from respiratory virus (RV). Nasopharyngeal samples from hospitalized patients with suspected RV infection were used to measure the CRP levels, virus load, virus-virus co-infection, age, sex, and length of hospital stay (LOS). Abnormal CRP levels were detected in 62.3% (3,608 out of 5,788) of all RV-positive samples. The percentage of patients with abnormal CRP levels tended to increase with age. Furthermore, LOS in patients with abnormal CRP levels was significantly longer than that in patients with normal CRP levels. The frequency of elevated CRP levels differed according to the causative virus and the frequency of abnormal levels increased with age. Moreover, LOS was longer in those with abnormal CRP levels. These data provide important insights into the role of CRP levels in RV infection.

키워드

참고문헌

  1. Kim JK, Jeon JS, Kim JW, Rheem I. Epidemiology of respiratory viral infection using multiplex RT-PCR in Cheonan, Korea (2006-2010). J Microbiol Biotechnol. 2013;23(2):267-273. https://doi.org/10.4014/jmb.1212.12050
  2. Makela MJ, Puhakka T, Ruuskanen O, Leinonen M, Saikku P, Kimpimaki M, et al. Viruses and bacteria in the etiology of the common cold. J Clin Microbiol. 1998;36(2):539-542.
  3. Kim SH, Huh JH, Bae SY, Kim JS, Yoon SY, Lim CS, et al. Epidemiology of respiratory viral infection in 2004-2006. Korean J Lab Med. 2006;26(5):351-357. https://doi.org/10.3343/kjlm.2006.26.5.351
  4. Nichols WG, Peck Campbell AJ, Boeckh M. Respiratory viruses other than influenza virus: impact and therapeutic advances. Clin Microbiol Rev. 2008;21(2):274-290. https://doi.org/10.1128/CMR.00045-07
  5. Cho KS. Characterization and outbreak pattern of influenzavirus isolated in Busan Area, 2000-2002 years. Korean J Clin Lab Sci. 2003;35(1):1-8.
  6. Choi EH, Lee HJ, Kim SJ, Eun BW, Kim NH, Lee JA, et al. The association of newly identified respiratory viruses with lower respiratory tract infections in Korean children, 2000-2005. Clin Infect Dis. 2006;43(5):585-592. https://doi.org/10.1086/506350
  7. Bilavsky E, Yarden-Bilavsky H, Shouval DS, Fisch N, Garty BZ, Ashkenazi S, et al. Respiratory syncytial virus-positive bronchiolitis in hospitalized infants is associated with thrombocytosis. Isr Med Assoc J. 2010;12(1):39-41.
  8. Park IH, Lee SH, You ST, Choi DY. Hematologic complication of respiratory virus infection. Korean J Pediatr Infect Dis. 2013;20(3):178-185. https://doi.org/10.14776/kjpid.2013.20.3.178
  9. Saijo M, Ishii T, Kokubo M, Murono K, Takimoto M, Fujita K. White blood cell count, C-reactive protein and erythrocyte sedimentation rate in respiratory syncytial virus infection of the lower respiratory tract. Acta Paediatr Jpn. 1996;38(6):596-600. https://doi.org/10.1111/j.1442-200X.1996.tb03714.x
  10. Hur M, Lee YK, Kang HJ, Lee KM. Distribution of high-sensitivity C-reactive protein in Korean healthy individuals. J Clin Pathol Qual Control. 2001;23(2):259-263.
  11. Lee CK, Ryu JR, Nam HC, Park JS, Whang SJ, Jung SK, et al. ROC analysis of CRP assay among some acute chest pain patients. Korean J Clin Lab Sci. 2000;32(3):162-168.
  12. Woodhead M, Blasi F, Ewig S, Garau J, Huchon G, Ieven M, et al. Guidelines for the management of adult lower respiratory tract infections - full version. Clin Microbiol Infect. 2011;17(6):E1-59.
  13. van der Meer V, Neven AK, van den Broek PJ, Assendelft WJ. Diagnostic value of C reactive protein in infections of the lower respiratory tract: systematic review. BMJ. 2005;331:26. doi: 10.1136/bmj.38483.478183.EB.
  14. Appenzeller C, Ammann RA, Duppenthaler A, Gorgievski-Hrisoho M, Aebi C. Serum C-reactive protein in children with adenovirus infection. Swiss Med Wkly. 2002;132(25-26):345-350.
  15. Oved K, Cohen A, Boico O, Navon R, Friedman T, Etshtein L, et al. A novel host-proteome signature for distinguishing between acute bacterial and viral infections. PLoS One. 2015;10(3):e0120012. https://doi.org/10.1371/journal.pone.0120012
  16. Graffelman AW, Knuistingh NA, le CS, Kroes AC, Springer MP, van den Broek PJ. A diagnostic rule for the aetiology of lower respiratory tract infections as guidance for antimicrobial treatment. Br J Gen Pract. 2004;54:20-24.
  17. Holm A, Pedersen SS, Nexoe J, Obel N, Nielsen LP, Koldkjaer O, et al. Procalcitonin versus C-reactive protein for predicting pneumonia in adults with lower respiratory tract infection in primary care. Br J Gen Pract. 2007;57(540):555-560.
  18. Wang Y, Chen Z, Yan YD, Guo H, Chu C, Liu J, et al. Seasonal distribution and epidemiological characteristics of human metapneumovirus infections in pediatric inpatients in Southeast China. Arch Virol. 2013;158:417-424. https://doi.org/10.1007/s00705-012-1492-7
  19. Peter E. Leukopenia. In: Kliegman RM, Stanton BF, editors. Nelson textbook of pediatrics. 19th ed. Philadelphia: Elsevier Saunders; 2011. p746-752.
  20. Korppi M, Heiskanen-Kosma T, Leinonen M. White blood cells, C-reactive protein and erythrocyte sedimentation rate in pneumococcal pneumonia in children. Eur Respir J. 1997;10(5):1125-1129. https://doi.org/10.1183/09031936.97.10051125
  21. Melbye H, Hvidsten D, Holm A, Nordbo SA, Brox J. The course of C-reactive protein response in untreated upper respiratory tract infection. Br J Gen Pract. 2004;54(506):653-658.
  22. Nunes MC, Kuschner Z, Rabede Z, Madimabe R, Niekerk NV, Moloi J, et al. Clinical epidemiology of bocavirus, rhinovirus, two polyomaviruses and four coronaviruses in HIV-infected and HIV-uninfected South African children. PLoS One. 2014;9(2):e86448. https://doi.org/10.1371/journal.pone.0086448
  23. Kim HK, Ham SC, Nam SY, Koh YJ, Ahn KM, Lee SI. A clinical study of adenoviral respiratory infection in children. Korean J Pediatr. 2000;43(2):195-202.
  24. Lee HJ, Jang SH. Clinical and epidemiologic features of respiratory syncytial virus infection. Korean J Pediatr. 1992;35(10):1389-1401.
  25. Aberle JH, Aberle SW, Pracher E, Hutter HP, Kundi M, Popow-Kraupp T. Single versus dual respiratory virus infections in hospitalized infants: impact on clinical course of disease and interferon-gamma response. Pediatr Infect Dis J. 2005;24(7):605-610. https://doi.org/10.1097/01.inf.0000168741.59747.2d
  26. Papadopoulos NG, Moustaki M, Tsolia M, Bossios A, Astra E, Prezerakou A, et al. Association of rhinovirus infection with increased disease severity in acute bronchiolitis. Am J Respir Crit Care Med. 2002;165(9):1285-1289. https://doi.org/10.1164/rccm.200112-118BC
  27. Semple MG, Cowell A, Dove W, Greensill J, McNamara PS, Halfhide C, et al. Dual infection of infants by human metapneumovirus and human respiratory syncytial virus is strongly associated with severe bronchiolitis. J Infect Dis. 2005;191(3):382-386. https://doi.org/10.1086/426457
  28. Bicer S, Giray T, Col D, Erdag GC, Vitrinel A, Gurol Y, et al. Virological and clinical characterizations of respiratory infections in hospitalized children. Ital J Pediatr. 2013;39:22. doi: 10.1186/1824-7288-39-22.
  29. Pierangeli A, Gentile M, Di Marco P, Pagnotti P, Scagnolari C, Trombetti S, et al. Detection and typing by molecular techniques of respiratory viruses in children hospitalized for acute respiratory infection in Rome. Italy J Med Virol. 2007;79(4):463-468. https://doi.org/10.1002/jmv.20832
  30. van Woensel JB, Bos AP, Lutter R, Rossen JW, Schuurman R. Absence of human metapneumovirus co-infection in cases of severe respiratory syncytial virus infection. Pediatr Pulmonol. 2006;41(9):872-874. https://doi.org/10.1002/ppul.20459
  31. Guo WL, Wang J, Zhu LY, Hao CL. Differentiation between mycoplasma and viral community-acquired pneumonia in children with lobe or multi foci infiltration: a retrospective case study. BMJ Open. 2015;5(1):e006766. https://doi.org/10.1136/bmjopen-2014-006766
  32. Kim JK, Jeon JS, Kim JW, Kim GY. Correlation between abnormal platelet count and respiratory viral infection in patients from Cheonan, Korea. J Clin Lab Anal. 2016;30(3):185-189. https://doi.org/10.1002/jcla.21822
  33. Zimmerman O, Rogowski O, Aviram G, Mizrahi M, Zeltser D, Justo D, et al. C-reactive protein serum levels as an early predictor of outcome in patients with pandemic H1N1 influenza A virus infection. BMC Infect Dis. 2010;10:288. doi: 10.1186/1471-2334-10-288.
  34. Putto A, Ruuskanen O, Meurman O, Ekblad H, Korvenranta H, Mertsola J, et al. C reactive protein in the evaluation of febrile illness. Arch Dis Child. 1986;61(1):24-29. https://doi.org/10.1136/adc.61.1.24

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