Biomarkers in pulmonary infections: a clinical approach.

Fecha de publicación: 17/07/2024 Fecha Ahead of Print: 17/07/2024

Autores de IIS La Fe

• Ignacio Martin Loheches

  Autor

• Paula Ramírez Galleymore

  Autor

Participantes ajenos a IIS La Fe

• Povoa, Pedro
• Coelho, Luis
• Cidade, Jose Pedro
• Ceccato, Adrian
• Morris, Andrew Conway
• Salluh, Jorge
• Nobre, Vandack
• Nseir, Saad
• Lisboa, Thiago
• Rouze, Anahita
• Sweeney, Daniel A
• Kalil, Andre C

Grupos

• Infecciones Respiratorias

  Investigador Principal

  Raúl Méndez Ocaña

• Medicina Intensiva

  Leader

  Álvaro Castellanos Ortega

Abstract

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.

© 2024. The Author(s).

Keywords

• Pulmonary infections; Pathogen-specific biomarkers; Host-response biomarkers; C-reactive protein; Procalcitonin