Tuberc Respir Dis.  2011 Jun;70(6):490-497.

Diagnostic Role of C-reactive Protein, Procalcitonin and Lipopolysaccharide-Binding Protein in Discriminating Bacterial-Community Acquired Pneumonia from 2009 H1N1 Influenza A Infection

• Han SS
• Kim SH
• Kim WJ
• Lee SJ
• Ryu SW
• Cheon MJ

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.

Keyword

C-Reactive Protein; procalcitonin; lipopolysaccharide-binding protein; Bacteria; Influenza A Virus

MeSH Terms

Acute-Phase Proteins
Bacteria
Bacterial Infections
Biomarkers
C-Reactive Protein
Calcitonin
Carrier Proteins
Humans
Influenza A virus
Influenza, Human
Membrane Glycoproteins
Pneumonia
Pneumonia, Bacterial
Prospective Studies
Protein Precursors
Respiratory Tract Infections
Retrospective Studies
ROC Curve
Acute-Phase Proteins
C-Reactive Protein
Calcitonin
Carrier Proteins
Membrane Glycoproteins
Protein Precursors

Figure

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  Figure 1 Receiver operating characteristic curves comparing CRP, PCT, LBP and WBC for differentiating between bacterial pneumonia and 2009 Influenza A H1N1 infection. CRP: C-reactive protein; PCT: procalcitonin; LBP: lipopolysaccharide-binding protein; WBC: white blood cell count.

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