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Combination of procalcitonin and C‐reactive protein levels in the early diagnosis of bacterial co‐infections in children with H1N1 influenza

OBJECTIVE: This study evaluated the diagnostic value of measuring the levels of procalcitonin (PCT) and C‐reactive protein (CRP) to differentiate children co‐infected with H1N1 influenza and bacteria from children infected with H1N1 influenza alone. METHODS: Consecutive patients (children aged < ...

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Autores principales: Li, Zhihao, He, Liya, Li, Shuhua, He, Waner, Zha, Caihui, Ou, Wanxing, Hou, Qiaozhen, Wang, Weiying, Sun, Xin, Liang, Huiying
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379630/
https://www.ncbi.nlm.nih.gov/pubmed/30443990
http://dx.doi.org/10.1111/irv.12621
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author Li, Zhihao
He, Liya
Li, Shuhua
He, Waner
Zha, Caihui
Ou, Wanxing
Hou, Qiaozhen
Wang, Weiying
Sun, Xin
Liang, Huiying
author_facet Li, Zhihao
He, Liya
Li, Shuhua
He, Waner
Zha, Caihui
Ou, Wanxing
Hou, Qiaozhen
Wang, Weiying
Sun, Xin
Liang, Huiying
author_sort Li, Zhihao
collection PubMed
description OBJECTIVE: This study evaluated the diagnostic value of measuring the levels of procalcitonin (PCT) and C‐reactive protein (CRP) to differentiate children co‐infected with H1N1 influenza and bacteria from children infected with H1N1 influenza alone. METHODS: Consecutive patients (children aged < 5 years) with laboratory‐confirmed H1N1 influenza who were hospitalized or received outpatient care from a tertiary‐care hospital in Canton, China, between January 1, 2012, and September 1, 2017, were included in the present study. Laboratory results, including serum PCT and CRP levels, white blood cell (WBC) counts, and bacterial cultures, were analyzed. The predictive value of the combination of biomarkers versus any of the biomarkers alone for diagnosing bacterial co‐infections was evaluated using logistic regression analyses. RESULTS: Significantly higher PCT (1.46 vs 0.21 ng/mL, P < 0.001) and CRP (19.20 vs 5.10 mg/dL, P < 0.001) levels were detected in the bacterial co‐infection group than in the H1N1 infection‐alone group. Using PCT or CRP levels alone, the areas under the curves (AUCs) for predicting bacterial co‐infections were 0.801 (95% CI, 0.772‐0.855) and 0.762 (95% CI, 0.722‐0.803), respectively. Using a combination of PCT and CRP, the logistic regression‐based model, Logit(P) = −1.912 + 0.546 PCT + 0.087 CRP, showed significantly greater accuracy (AUC: 0.893, 95% CI: 0.842‐0.934) than did the other three biomarkers. CONCLUSIONS: The combination of PCT and CRP levels could provide a useful method of distinguishing bacterial co‐infections from an H1N1 influenza infection alone in children during the early disease phase. After further validation, the flexible model derived here could assist clinicians in decision‐making processes.
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spelling pubmed-63796302019-03-01 Combination of procalcitonin and C‐reactive protein levels in the early diagnosis of bacterial co‐infections in children with H1N1 influenza Li, Zhihao He, Liya Li, Shuhua He, Waner Zha, Caihui Ou, Wanxing Hou, Qiaozhen Wang, Weiying Sun, Xin Liang, Huiying Influenza Other Respir Viruses Original Articles OBJECTIVE: This study evaluated the diagnostic value of measuring the levels of procalcitonin (PCT) and C‐reactive protein (CRP) to differentiate children co‐infected with H1N1 influenza and bacteria from children infected with H1N1 influenza alone. METHODS: Consecutive patients (children aged < 5 years) with laboratory‐confirmed H1N1 influenza who were hospitalized or received outpatient care from a tertiary‐care hospital in Canton, China, between January 1, 2012, and September 1, 2017, were included in the present study. Laboratory results, including serum PCT and CRP levels, white blood cell (WBC) counts, and bacterial cultures, were analyzed. The predictive value of the combination of biomarkers versus any of the biomarkers alone for diagnosing bacterial co‐infections was evaluated using logistic regression analyses. RESULTS: Significantly higher PCT (1.46 vs 0.21 ng/mL, P < 0.001) and CRP (19.20 vs 5.10 mg/dL, P < 0.001) levels were detected in the bacterial co‐infection group than in the H1N1 infection‐alone group. Using PCT or CRP levels alone, the areas under the curves (AUCs) for predicting bacterial co‐infections were 0.801 (95% CI, 0.772‐0.855) and 0.762 (95% CI, 0.722‐0.803), respectively. Using a combination of PCT and CRP, the logistic regression‐based model, Logit(P) = −1.912 + 0.546 PCT + 0.087 CRP, showed significantly greater accuracy (AUC: 0.893, 95% CI: 0.842‐0.934) than did the other three biomarkers. CONCLUSIONS: The combination of PCT and CRP levels could provide a useful method of distinguishing bacterial co‐infections from an H1N1 influenza infection alone in children during the early disease phase. After further validation, the flexible model derived here could assist clinicians in decision‐making processes. John Wiley and Sons Inc. 2018-12-01 2019-03 /pmc/articles/PMC6379630/ /pubmed/30443990 http://dx.doi.org/10.1111/irv.12621 Text en © 2018 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Li, Zhihao
He, Liya
Li, Shuhua
He, Waner
Zha, Caihui
Ou, Wanxing
Hou, Qiaozhen
Wang, Weiying
Sun, Xin
Liang, Huiying
Combination of procalcitonin and C‐reactive protein levels in the early diagnosis of bacterial co‐infections in children with H1N1 influenza
title Combination of procalcitonin and C‐reactive protein levels in the early diagnosis of bacterial co‐infections in children with H1N1 influenza
title_full Combination of procalcitonin and C‐reactive protein levels in the early diagnosis of bacterial co‐infections in children with H1N1 influenza
title_fullStr Combination of procalcitonin and C‐reactive protein levels in the early diagnosis of bacterial co‐infections in children with H1N1 influenza
title_full_unstemmed Combination of procalcitonin and C‐reactive protein levels in the early diagnosis of bacterial co‐infections in children with H1N1 influenza
title_short Combination of procalcitonin and C‐reactive protein levels in the early diagnosis of bacterial co‐infections in children with H1N1 influenza
title_sort combination of procalcitonin and c‐reactive protein levels in the early diagnosis of bacterial co‐infections in children with h1n1 influenza
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379630/
https://www.ncbi.nlm.nih.gov/pubmed/30443990
http://dx.doi.org/10.1111/irv.12621
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