Florin Todd A, Ambroggio Lilliam
Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 2008, Cincinnati, OH, 45229, USA,
Curr Infect Dis Rep. 2014 Dec;16(12):451. doi: 10.1007/s11908-014-0451-8.
Community-acquired pneumonia is one of the most common reasons for emergency department (ED) visits in children and adults. Despite its prevalence, there are many challenges to proper diagnosis and management of pneumonia. There is no accurate and timely etiologic gold standard to differentiate bacterial from viral disease, and there are limitations with precise risk stratification of patients to ensure appropriate site-of-care decisions. Clinical factors obtained by history and physical examination have limited the ability to diagnose pneumonia etiology and severity. Biomarkers offer information about the host response to infection and pathogen activity within the host that can serve to augment clinical features in decision-making. As science and technology progress, novel biomarkers offer great potential in aiding critical decisions for patients with pneumonia. This review summarizes existing knowledge about biomarkers of host response and pathogen activity, in addition to briefly reviewing emerging biomarkers using novel technologies.
社区获得性肺炎是儿童和成人急诊就诊的最常见原因之一。尽管其发病率很高，但肺炎的正确诊断和管理仍面临许多挑战。目前尚无准确、及时的病因学金标准来区分细菌性疾病和病毒性疾病，并且在对患者进行精确的风险分层以确保做出合适的治疗地点决策方面存在局限性。通过病史和体格检查获得的临床因素对肺炎病因和严重程度的诊断能力有限。生物标志物可提供有关宿主对感染的反应以及宿主体内病原体活动的信息，有助于在决策过程中补充临床特征。随着科学技术的进步，新型生物标志物在辅助肺炎患者的关键决策方面具有巨大潜力。本综述总结了有关宿主反应和病原体活动生物标志物的现有知识，并简要回顾了使用新技术的新兴生物标志物。
