Tuberc Respir Dis > Volume 70(6); 2011 > Article
Tuberculosis and Respiratory Diseases 2011;70(6):490-497.
DOI: https://doi.org/10.4046/trd.2011.70.6.490    Published online June 1, 2011.
Diagnostic Role of C-reactive Protein, Procalcitonin and Lipopolysaccharide-Binding Protein in Discriminating Bacterial-Community Acquired Pneumonia from 2009 H1N1 Influenza A Infection.
Seon Sook Han, Se Hyun Kim, Woo Jin Kim, Seung Joon Lee, Sook Won Ryu, Myeong Ju Cheon
1Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea. ssunimd@kangwon.ac.kr
2Department of Laboratory Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.
3Clinical Research Institute of Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea.
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 -80degrees 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.
Key Words: C-Reactive Protein, procalcitonin, lipopolysaccharide-binding protein, Bacteria, Influenza A Virus
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