Semin Respir Crit Care Med 2019; 40(04): 465-475
DOI: 10.1055/s-0039-1696689
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Biomarkers of Infection: Are They Useful in the ICU?

Eva Heilmann
1  Medical University Department of Internal Medicine, Kantonsspital Aarau, Aarau, Switzerland
,
Claudia Gregoriano
1  Medical University Department of Internal Medicine, Kantonsspital Aarau, Aarau, Switzerland
,
Philipp Schuetz
1  Medical University Department of Internal Medicine, Kantonsspital Aarau, Aarau, Switzerland
2  Faculty of Medicine, University of Basel, Switzerland
› Author Affiliations
Further Information

Publication History

Publication Date:
04 October 2019 (online)

Abstract

Biomarkers are increasingly used in patients with serious infections in the critical care setting to complement clinical judgment and interpretation of other diagnostic and prognostic tests. The main purposes of such blood markers are (1) to improve infection diagnosis (i.e., differentiation between bacterial vs. viral vs. fungal vs. noninfectious), (2) to help in the early risk stratification and thus provide prognostic information regarding the risk for mortality and other adverse outcomes, and (3) to optimize antibiotic tailoring to individual needs of patients (“antibiotic stewardship”).

Especially in critically ill patients, in whom sepsis is a major cause of morbidity and mortality, rapid diagnosis is desirable to start timely and specific treatment.

Besides some biomarkers, such as procalcitonin, which is well established and has shown positive effects in regard to utilization of antimicrobials and clinical outcomes, there is a growing number of novel markers from different pathophysiological pathways, where the final proof of an added value to clinical judgment and ultimately clinical benefit to patients is still lacking.

Without a doubt, the addition of blood biomarkers to clinical medicine has had a strong impact on the way we care for patients today. Recent trials show that as an adjunct to other clinical and laboratory parameters these markers provide important information about risks for bacterial infection and resolution of infection. Moreover, biomarkers can help to optimize management of patients with serious illness in the intensive care unit, thereby offering more individualized treatment courses with overall improvements in clinical outcomes.

Financial Disclosures

Prof. Schuetz reports receiving grants from bioMerieux, Thermo Fisher, and Roche Diagnostics (paid to the Institution).