소아청소년에 있어 마이코플라스마 폐렴과 바이러스 폐렴을 구분하는 프로칼시토닌의 임상적 유용성: 다기관 단면연구
Clinical usefulness of serum procalcitonin to distinguish between viral pneumonia and Mycoplasma pneumonia in children: A multicenter, cross-sectional study
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: The aim of this study was to compare the clinical usefulness of serum procalcitonin (PCT) levels in Mycoplasma pneumoniae pneumonia (M. pneumonia) and viral pneumonia in children. Methods: We retrospectively analyzed the medical records of 348 patients admitted between June 2015 and December of 2015. There were 162 patients with M. pneumonia without virus coinfection (group 1) and 186 patients with viral pneumonia (group 2). All subjects had radiographic evidence of pneumonia with available specimens for both M. pneumonia and viral testing, and levels of serum PCT, white blood cell counts (WBC), neutrophil portion, and C-reactive protein (CRP). Fifty-eight children who performed follow-up sampling at the time of no fever for more than 48 hours were subdivided into group 3 (M. pneumonia with follow-up sampling, n=41) and group 4 (viral pneumonia with follow-up sampling, n=17). Results: No difference was noted in the levels of serum PCT (P=0.168), CRP (P=0.296), WBC (P=0.732), and neutrophil proportion (P=0.069) between groups 1 and 2, after adjusting for age. Serial changes in serum PCT levels between the first and second samples were significant in group 3 (P=0.046). Serial changes in serum CRP levels between the first and second samples were significant in group 4 (P=0.008). Conclusion: Serum PCT and CRP levels may change differently after infection according to the etiology of pneumonia.
Abstract
Purpose: The aim of this study was to compare the clinical usefulness of serum procalcitonin (PCT) levels in Mycoplasma pneumoniae pneumonia (M. pneumonia) and viral pneumonia in children. Methods: We retrospectively analyzed the medical records of 348 patients admitted between June 2015 and December of 2015. There were 162 patients with M. pneumonia without virus coinfection (group 1) and 186 patients with viral pneumonia (group 2). All subjects had radiographic evidence of pneumonia with available specimens for both M. pneumonia and viral testing, and levels of serum PCT, white blood cell counts (WBC), neutrophil portion, and C-reactive protein (CRP). Fifty-eight children who performed follow-up sampling at the time of no fever for more than 48 hours were subdivided into group 3 (M. pneumonia with follow-up sampling, n=41) and group 4 (viral pneumonia with follow-up sampling, n=17). Results: No difference was noted in the levels of serum PCT (P=0.168), CRP (P=0.296), WBC (P=0.732), and neutrophil proportion (P=0.069) between groups 1 and 2, after adjusting for age. Serial changes in serum PCT levels between the first and second samples were significant in group 3 (P=0.046). Serial changes in serum CRP levels between the first and second samples were significant in group 4 (P=0.008). Conclusion: Serum PCT and CRP levels may change differently after infection according to the etiology of pneumonia.
참고문헌 (26)
- Lee GE, "National hospitalization trends for pediatric pneumonia and associated complications", Pediatrics, 126, pp.204~213 (2010)
- Ferwerda A, "Respiratory tract infections by Mycoplasma pneumoniae in children: a review of diagnostic and therapeutic measures", Eur J Pediatr, 160, pp.483~491 (2001)
- Eun BW, "Mycoplasma pneumoniae in Korean children: the epidemiology of pneumonia over an 18-year period", J Infect, 56, pp.326~331 (2008)
- Ahn HS, "Hong Chang Eui pediatrics", pp.697~ (2016), MiraeN
- Nohynek H, "Erythrocyte sedimentation rate, white blood cell count and serum C-reactive protein in assessing etiologic diagnosis of acute lower respiratory infections in children", Pediatr Infect Dis J, 14, pp.484~490 (1995)
- Müller B, "Calcitonin precursors are reliable markers of sepsis in a medical intensive care unit", Crit Care Med, 28, pp.977~983 (2000)
- Stockmann C, "Procalcitonin accurately identifies hospitalized children with low risk of bacterial community-acquired pneumonia", J Pediatric Infect Dis Soc, 7, pp.46~53 (2018)
- Bouadma L, "Use of procalcitonin to reduce patients' exposure to antibiotics in intensive care units (PRORATA trial): a multicentre randomised controlled trial", Lancet, 375, pp.463~474 (2010)
- Sensini A, "Serological diagnosis of Mycoplasma pneumoniae infection: a complicated puzzle", Microbiol Med, 27, pp.171~176 (2012)
- Becker KL, "Clinical review 167: Procalcitonin and the calcitonin gene family of peptides in inflammation, infection, and sepsis: a journey from calcitonin back to its precursors", J Clin Endocrinol Metab, 89, pp.1512~1525 (2004)
- Harbarth S, "Diagnostic value of procalcitonin, interleukin-6, and interleukin-8 in critically ill patients admitted with suspected sepsis", Am J Respir Crit Care Med, 164, pp.396~402 (2001)
- Baer G, "Procalcitonin guidance to reduce antibiotic treatment of lower respiratory tract infection in children and adolescents (ProPAED): a randomized controlled trial", PLoS One, 8, pp.e68419~ (2013)
- Esposito S, "Procalcitonin measurements for guiding antibiotic treatment in pediatric pneumonia", Respir Med, 105, pp.1939~1945 (2011)
- Moulin F, "Procalcitonin in children admitted to hospital with community acquired pneumonia", Arch Dis Child, 84, pp.332~336 (2001)
- Toikka P, "Serum procalcitonin, C-reactive protein and interleukin-6 for distinguishing bacterial and viral pneumonia in children", Pediatr Infect Dis J, 19, pp.598~602 (2000)
- Menéndez R, "Cytokine activation patterns and biomarkers are influenced by microorganisms in community-acquired pneumonia", Chest, 141, pp.1537~1545 (2012)
- Nascimento-Carvalho CM, "Procalcitonin is useful in identifying bacteraemia among children with pneumonia", Scand J Infect Dis, 42, pp.644~649 (2010)
- Resch B, "Procalcitonin, interleukin-6, C-reactive protein and leukocyte counts in infants with bronchiolitis", Pediatr Infect Dis J, 22, pp.475~476 (2003)
- Christ-Crain M, "Biomarkers in respiratory tract infections: diagnostic guides to antibiotic prescription, prognostic markers and mediators", Eur Respir J, 30, pp.556~573 (2007)
- Jaye DL, "Clinical applications of C-reactive protein in pediatrics", Pediatr Infect Dis J, 16, pp.735~746 (1997)
- Squire EN Jr, "Criteria for the discontinuation of antibiotic therapy during presumptive treatment of suspected neonatal infection", Pediatr Infect Dis, 1, pp.85~90 (1982)
- Emmerson AJ, "C-reactive protein and the newborn infant", Arch Dis Child Educ Pract Ed, 96, pp.e1~ (2011)
- Peltola H, "-reactive protein in early detection of bacteremic versus viral infections in immunocompetent and compromised children", J Pediatr, 113, pp.641~646 (1988)
- Bahagon Y, "Prevalence and predictive features of bacteremic urinary tract infection in emergency department patients", Eur J Clin Microbiol Infect Dis, 26, pp.349~352 (2007)
- Aminzadeh Z, "Relationship between age and peripheral white blood cell count in patients with sepsis", Int J Prev Med, 2, pp.238~242 (2011)