TY - JOUR
T1 - Biomarkers in pulmonary infections
T2 - a clinical approach
AU - Póvoa, Pedro
AU - Coelho, Luís
AU - Cidade, José Pedro
AU - Ceccato, Adrian
AU - Morris, Andrew Conway
AU - Salluh, Jorge
AU - Nobre, Vandack
AU - Nseir, Saad
AU - Martin-Loeches, Ignacio
AU - Lisboa, Thiago
AU - Ramirez, Paula
AU - Rouzé, Anahita
AU - Sweeney, Daniel A.
AU - Kalil, Andre C.
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/7
Y1 - 2024/7
N2 - Severe acute respiratory infections, such as community-acquired pneumonia, hospital-acquired pneumonia, and ventilator-associated pneumonia, constitute frequent and lethal pulmonary infections in the intensive care unit (ICU). Despite optimal management with early appropriate empiric antimicrobial therapy and adequate supportive care, mortality remains high, in part attributable to the aging, growing number of comorbidities, and rising rates of multidrug resistance pathogens. Biomarkers have the potential to offer additional information that may further improve the management and outcome of pulmonary infections. Available pathogen-specific biomarkers, for example, Streptococcus pneumoniae urinary antigen test and galactomannan, can be helpful in the microbiologic diagnosis of pulmonary infection in ICU patients, improving the timing and appropriateness of empiric antimicrobial therapy since these tests have a short turnaround time in comparison to classic microbiology. On the other hand, host-response biomarkers, for example, C-reactive protein and procalcitonin, used in conjunction with the clinical data, may be useful in the diagnosis and prediction of pulmonary infections, monitoring the response to treatment, and guiding duration of antimicrobial therapy. The assessment of serial measurements overtime, kinetics of biomarkers, is more informative than a single value. The appropriate utilization of accurate pathogen-specific and host-response biomarkers may benefit clinical decision-making at the bedside and optimize antimicrobial stewardship.
AB - Severe acute respiratory infections, such as community-acquired pneumonia, hospital-acquired pneumonia, and ventilator-associated pneumonia, constitute frequent and lethal pulmonary infections in the intensive care unit (ICU). Despite optimal management with early appropriate empiric antimicrobial therapy and adequate supportive care, mortality remains high, in part attributable to the aging, growing number of comorbidities, and rising rates of multidrug resistance pathogens. Biomarkers have the potential to offer additional information that may further improve the management and outcome of pulmonary infections. Available pathogen-specific biomarkers, for example, Streptococcus pneumoniae urinary antigen test and galactomannan, can be helpful in the microbiologic diagnosis of pulmonary infection in ICU patients, improving the timing and appropriateness of empiric antimicrobial therapy since these tests have a short turnaround time in comparison to classic microbiology. On the other hand, host-response biomarkers, for example, C-reactive protein and procalcitonin, used in conjunction with the clinical data, may be useful in the diagnosis and prediction of pulmonary infections, monitoring the response to treatment, and guiding duration of antimicrobial therapy. The assessment of serial measurements overtime, kinetics of biomarkers, is more informative than a single value. The appropriate utilization of accurate pathogen-specific and host-response biomarkers may benefit clinical decision-making at the bedside and optimize antimicrobial stewardship.
KW - C-reactive protein
KW - Host-response biomarkers
KW - Pathogen-specific biomarkers
KW - Procalcitonin
KW - Pulmonary infections
UR - http://www.scopus.com/inward/record.url?scp=85198841727&partnerID=8YFLogxK
U2 - 10.1186/s13613-024-01323-0
DO - 10.1186/s13613-024-01323-0
M3 - Review article
AN - SCOPUS:85198841727
SN - 2110-5820
VL - 14
JO - Annals of Intensive Care
JF - Annals of Intensive Care
IS - 1
M1 - 113
ER -