Biomarkers: Are They Useful in Severe Community-Acquired Pneumonia?

Abstract

Community acquired pneumonia (CAP) is a prevalent infectious disease often requiring hospitalization, although its diagnosis remains challenging as there is no gold standard test. In severe CAP, clinical and radiologic criteria have poor sensitivity and specificity, and microbiologic documentation is usually delayed and obtained in less than half of sCAP patients. Biomarkers could be an alternative for diagnosis, treatment monitoring and establish resolution. Beyond the existing evidence about biomarkers as an adjunct diagnostic tool, most evidence comes from studies including CAP patients in primary care or emergency departments, and not only sCAP patients. Ideally, biomarkers used in combination with signs, symptoms, and radiological findings can improve clinical judgment to confirm or rule out CAP diagnosis, and may be valuable adjunctive tools for risk stratification, differentiate viral pneumonia and monitoring the course of CAP. While no single biomarker has emerged as an ideal one, CRP and PCT have gathered the most evidence. Overall, biomarkers offer valuable information and can enhance clinical decision-making in the management of CAP, but further research and validation are needed to establish their optimal use and clinical utility.

Biomarkers in pulmonary infections: a clinical approach

“…Therefore, strategies have been proposed to help guide the duration of antimicrobial therapy by ensuring both its appropriate use to achieve clinical cure and avoid excessive drug exposure, thus mitigating the above-mentioned problems and the impact on microbiota [ 10 ]. In this scenario, protein-based biomarkers, both pathogen-specific and host-response biomarkers have been evaluated [ 11 – 13 ] to help clinicians optimize antimicrobial stewardship at a patient level [ 12 ]. In this review, the potential role of omics as well as molecular diagnostic tests in severe respiratory infections will not be addressed.…”