Blood biomarkers differentiating viral versus bacterial pneumonia aetiology: a literature review
Thomas, Jithin |
Recenzentas / Reviewer | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member |
Aim & Objectives: The goal of this literature review is to compare current studies regarding the accuracy of different serum markers in differentiating viral from bacterial pneumonia in the pediatric population with what is employed in the medical setting at present.
Methods: Literature search conducted on Medline using a combination of the following term "Community-acquired pneumonia" OR "CAP" OR "viral pneumonia" OR "virus-induced pneumonia" OR "bacterial pneumonia" AND "biomarker" OR "marker" OR "protein" OR "interleukin" OR "chemokine." Articles that were in English and within ten years of the search date were manually sorted according to inclusion and exclusion criteria. Results: Initial search returned n=13405. After activating filters, n=137 were identified of which n=10 included for literature review. Markers that were investigated were C-reactive protein (CRP), Procalcitonin (PCT), White blood cell (WBC), Neutrophils, Myxoma resistance protein (MxA1), Lipocalin-2 (Lcn2), High mobility group box 1 protein (HMGB1) Syndecan4 (SYN4), Midregional Proadrenomedullin and Midregional proatrial natriuretic peptide.
Conclusion: Rise or drop in the concentration of a single marker is not accurate enough for predicting viral/bacterial CAP. This is because there is overlapping to a varying extent depending on the cut-off values, detection methods, analyses, the desired specificity, and sensitivity. Furthermore, the presence of mixed infection and makes almost all makers suboptimal to be used universally. New makers such as MxA1 and HMGB1 gave promising results. However, to replicate a similar testing condition in a clinical environment may not be practical. Another approach is to make use of more than one marker and combine with clinical signs and symptoms. This may not be cost-effective in many clinical settings; nevertheless, in many studies, using more than indicator greatly improved the predictive power.
Literatūroje apžvelgiami galimi serumo žymenys, kurie gali būti panaudojami diferencijuojant virusinę pneumoniją nuo visuomenėje įgytos bakterinės pneumonijos vaikų populiacijoje.Informacijos paieška atlikta naudojantis Medline. Išanalizuota 10 literatūros šaltinių. Prieita prie išvados, jog geriausias sprendimas yra serumo žymenų derinimas kartu tarpusavyje.