Host-Response Proteomic Biomarkers for Bacterial Respiratory Infections: Procalcitonin Leads the Field
This review evaluated the diagnostic performance of host-response proteomic biomarkers for distinguishing bacterial from non-bacterial respiratory tract infections. Procalcitonin demonstrated the strongest diagnostic accuracy, outperforming CRP and newer candidates including proadrenomedullin, soluble TREM-1, neopterin, and pentraxin-3. The authors noted that syndecan-4 and lipocalin-2 lack sufficient evidence and called for larger, adequately powered studies with standardized patient populations to validate emerging biomarkers.
The original study
Host-response biomarkers for the diagnosis of bacterial respiratory tract infections.
- Authors
- Saleh MAA, van de Garde EMW, van Hasselt JGC
- Journal
- Clinical chemistry and laboratory medicine
- Type
- Journal Article, Review
- PMID
- 30183665
Original abstract
Appropriate antibiotic treatment for respiratory tract infections (RTIs) necessitates rapid and accurate diagnosis of microbial etiology, which remains challenging despite recent innovations. Several host response-based biomarkers due to infection have been suggested to allow discrimination of bacterial and non-bacterial microbial RTI etiology. This review provides an overview of clinical studies that investigated the diagnostic performance of host-response proteomic biomarkers to identify RTI microbial etiology. Procalcitonin and C-reactive protein have been studied most extensively; whereof procalcitonin has demonstrated the strongest diagnostic performance compared to other biomarkers. Proadrenomedullin, soluble triggering receptor expressed on myeloid cells-1, neopterin and pentraxin-3 need more studies to confirm their diagnostic value. For syndecan-4 and lipocalin-2 currently insufficient evidence exists. Common limitations in several of the studies were the relatively small scale setting, heterogeneous patient population and the absence of statistical power calculation.