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Prognostic Value of Procalcitonin and C-Reactive Protein in 1608 Critically Ill Patients with Severe Influenza Pneumonia

  • Identification data

    Identifier: imarina:9202549
    Authors:
    Carbonell, RaquelMoreno, GerardMartin-Loeches, IgnacioGomez-Bertomeu, FredericSarvise, CarolinaGomez, JosepBodi, MariaDiaz, EmiliPapiol, ElisabethTrefler, SandraNieto, MercedesEstella, AngelJimenez Herrera, MariaVidal Cortes, PabloGuardiola, Juan JoseSole-Violan, JordiRodriguez, Alejandro
    Abstract:
    Background: Procalcitonin (PCT) and C-Reactive protein (CRP) are well-established sepsis biomarkers. The association of baseline PCT levels and mortality in pneumonia remains unclear, and we still do not know whether biomarkers levels could be related to the causative microorganism (GPC, GNB). The objective of this study is to address these issues. Methods: a retrospective observational cohort study was conducted in 184 Spanish ICUs (2009-2018). Results: 1608 patients with severe influenza pneumonia with PCT and CRP available levels on admission were included, 1186 with primary viral pneumonia (PVP) and 422 with bacterial Co-infection (BC). Those with BC presented higher PCT levels (4.25 [0.6-19.5] versus 0.6 [0.2-2.3]ng/mL) and CRP (36.7 [20.23-118] versus 28.05 [13.3-109]mg/dL) as compared to PVP (p < 0.001). Deceased patients had higher PCT (ng/mL) when compared with survivors, in PVP (0.82 [0.3-2.8]) versus 0.53 [0.19-2.1], p = 0.001) and BC (6.9 [0.93-28.5] versus 3.8 [0.5-17.37], p = 0.039). However, no significant association with mortality was observed in the multivariate analysis. The PCT levels (ng/mL) were significantly higher in polymicrobial infection (8.4) and GPC (6.9) when compared with GNB (1.2) and Aspergillus (1.7). The AUC-ROC of PCT for GPC was 0.67 and 0.32 for GNB. The AUROC of CRP was 0.56 for GPC and 0.39 for GNB. Conclusions: a single PCT/CRP value at ICU admission was not associated with mortality in severe influenza pneumonia. None of the biomarkers have enough discriminatory power to be used for predicting the causative microorganism of the co-infection.
  • Others:

    Author, as appears in the article.: Carbonell, Raquel; Moreno, Gerard; Martin-Loeches, Ignacio; Gomez-Bertomeu, Frederic; Sarvise, Carolina; Gomez, Josep; Bodi, Maria; Diaz, Emili; Papiol, Elisabeth; Trefler, Sandra; Nieto, Mercedes; Estella, Angel; Jimenez Herrera, Maria; Vidal Cortes, Pablo; Guardiola, Juan Jose; Sole-Violan, Jordi; Rodriguez, Alejandro;
    Department: Bioquímica i Biotecnologia Medicina i Cirurgia Infermeria
    URV's Author/s: Bodi Saera, Maria Amparo / Gómez Alvarez, Josep / Gomez Bertomeu, Frederic-Francesc / Jiménez Herrera, María Francisca / Rodríguez Oviedo, Alejandro Hugo / TREFLER CRESPO, SANDRA INES
    Keywords: Virus pneumonia Task performance Streptococcus pneumoniae Staphylococcus capitis Staphylococcus aureus Sequential organ failure assessment score Sensitivity and specificity Retrospective study Renal replacement therapy Red blood cell distribution width Receiver operating characteristic Procalcitonin Predictive value Pneumonia Observational study Obesity Mortality Middle aged Male Lung lavage Limit of detection Leukocyte count Legionella pneumophila Intensive care unit Influenza Human Heart failure Gram-positive cocci Gram negative bacilli Enzyme linked immunosorbent assay Critically ill patient Creatinine Continuous renal replacement therapy Cohort analysis C-reactive protein C reactive protein Body mass Biological marker Aspergillus Artificial ventilation Article Apache Adult Acute kidney failure
    Abstract: Background: Procalcitonin (PCT) and C-Reactive protein (CRP) are well-established sepsis biomarkers. The association of baseline PCT levels and mortality in pneumonia remains unclear, and we still do not know whether biomarkers levels could be related to the causative microorganism (GPC, GNB). The objective of this study is to address these issues. Methods: a retrospective observational cohort study was conducted in 184 Spanish ICUs (2009-2018). Results: 1608 patients with severe influenza pneumonia with PCT and CRP available levels on admission were included, 1186 with primary viral pneumonia (PVP) and 422 with bacterial Co-infection (BC). Those with BC presented higher PCT levels (4.25 [0.6-19.5] versus 0.6 [0.2-2.3]ng/mL) and CRP (36.7 [20.23-118] versus 28.05 [13.3-109]mg/dL) as compared to PVP (p < 0.001). Deceased patients had higher PCT (ng/mL) when compared with survivors, in PVP (0.82 [0.3-2.8]) versus 0.53 [0.19-2.1], p = 0.001) and BC (6.9 [0.93-28.5] versus 3.8 [0.5-17.37], p = 0.039). However, no significant association with mortality was observed in the multivariate analysis. The PCT levels (ng/mL) were significantly higher in polymicrobial infection (8.4) and GPC (6.9) when compared with GNB (1.2) and Aspergillus (1.7). The AUC-ROC of PCT for GPC was 0.67 and 0.32 for GNB. The AUROC of CRP was 0.56 for GPC and 0.39 for GNB. Conclusions: a single PCT/CRP value at ICU admission was not associated with mortality in severe influenza pneumonia. None of the biomarkers have enough discriminatory power to be used for predicting the causative microorganism of the co-infection.
    Thematic Areas: Pharmacology, toxicology and pharmaceutics (miscellaneous) Pharmacology, toxicology and pharmaceutics (all) Pharmacology (medical) Pharmacology & pharmacy Microbiology (medical) Microbiology Infectious diseases General pharmacology, toxicology and pharmaceutics Engenharias ii Biochemistry
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: josep.gomez@urv.cat alejandrohugo.rodriguez@urv.cat frederic-francesc.gomez@urv.cat maria.jimenez@urv.cat mariaamparo.bodi@urv.cat mariaamparo.bodi@urv.cat
    Author identifier: 0000-0002-0573-7621 0000-0001-8828-5984 0000-0002-8039-2889 0000-0003-2599-3742 0000-0001-7652-8379 0000-0001-7652-8379
    Record's date: 2024-07-27
    Papper version: info:eu-repo/semantics/publishedVersion
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: Antibiotics. 10 (4):
    APA: Carbonell, Raquel; Moreno, Gerard; Martin-Loeches, Ignacio; Gomez-Bertomeu, Frederic; Sarvise, Carolina; Gomez, Josep; Bodi, Maria; Diaz, Emili; Papio (2021). Prognostic Value of Procalcitonin and C-Reactive Protein in 1608 Critically Ill Patients with Severe Influenza Pneumonia. Antibiotics, 10(4), -. DOI: 10.3390/antibiotics10040350
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2021
    Publication Type: Journal Publications
  • Keywords:

    Biochemistry,Infectious Diseases,Microbiology,Microbiology (Medical),Pharmacology & Pharmacy,Pharmacology (Medical),Pharmacology, Toxicology and Pharmaceutics (Miscellaneous)
    Virus pneumonia
    Task performance
    Streptococcus pneumoniae
    Staphylococcus capitis
    Staphylococcus aureus
    Sequential organ failure assessment score
    Sensitivity and specificity
    Retrospective study
    Renal replacement therapy
    Red blood cell distribution width
    Receiver operating characteristic
    Procalcitonin
    Predictive value
    Pneumonia
    Observational study
    Obesity
    Mortality
    Middle aged
    Male
    Lung lavage
    Limit of detection
    Leukocyte count
    Legionella pneumophila
    Intensive care unit
    Influenza
    Human
    Heart failure
    Gram-positive cocci
    Gram negative bacilli
    Enzyme linked immunosorbent assay
    Critically ill patient
    Creatinine
    Continuous renal replacement therapy
    Cohort analysis
    C-reactive protein
    C reactive protein
    Body mass
    Biological marker
    Aspergillus
    Artificial ventilation
    Article
    Apache
    Adult
    Acute kidney failure
    Pharmacology, toxicology and pharmaceutics (miscellaneous)
    Pharmacology, toxicology and pharmaceutics (all)
    Pharmacology (medical)
    Pharmacology & pharmacy
    Microbiology (medical)
    Microbiology
    Infectious diseases
    General pharmacology, toxicology and pharmaceutics
    Engenharias ii
    Biochemistry
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