Division of Pulmonary, Critical Care, and Sleep Medicine, Rush University Medical Center, Rush Medical College, 1725 West Harrison Street Suite 054, Chicago, IL 60612, USA.
Division of Pulmonary, Critical Care, and Sleep Medicine, Rush University Medical Center, Rush Medical College, 1725 West Harrison Street Suite 054, Chicago, IL 60612, USA.
Infect Dis Clin North Am. 2024 Mar;38(1):35-49. doi: 10.1016/j.idc.2023.12.005.
Biomarkers are used in the diagnosis, severity determination, and prognosis for patients with community-acquired pneumonia (CAP). Selected biomarkers may indicate a bacterial infection and need for antibiotic therapy (C-reactive protein, procalcitonin, soluble triggering receptor expressed on myeloid cells). Biomarkers can differentiate CAP patients who require hospital admission and severe CAP requiring intensive care unit admission. Biomarker-guided antibiotic therapy may limit antibiotic exposure without compromising outcome and thus improve antibiotic stewardship. The authors discuss the role of biomarkers in diagnosing, determining severity, defining the prognosis, and limiting antibiotic exposure in CAP and ventilator-associated pneumonia patients.
生物标志物用于社区获得性肺炎(CAP)患者的诊断、严重程度确定和预后判断。一些选定的生物标志物可能提示细菌感染和抗生素治疗的需要(C 反应蛋白、降钙素原、髓系细胞表达的可溶性触发受体)。生物标志物可区分需要住院治疗的 CAP 患者和需要入住重症监护病房的重症 CAP 患者。生物标志物指导的抗生素治疗可在不影响结果的情况下限制抗生素暴露,从而改善抗生素管理。作者讨论了生物标志物在 CAP 和呼吸机相关性肺炎患者的诊断、严重程度确定、预后判断和抗生素暴露限制中的作用。