Review Article

Biomarkers of Community-Acquired Pneumonia: A Key to Disease Diagnosis and Management

Table 1

Acute-phase proteins and signaling molecules in the estimation of CAP aetiologies.

Study [Ref.]Study designPatientsCAP aetiologiesTarget biomarkers

Ingram et al., 2009
[25]
retrospective observational study in small cohort25
adults
viral infection: 2009 H1N1 influenza (n = 16)
bacterial/mixed infection (n = 9)
PCT,
CRP

Wu et al.,
2013
[26]
systematic reviews and meta-analyses518
adults
viral infection: 2009 H1N1 influenza (n = 381)
bacterial/mixed infection (n = 137)
PCT

Pfister et al., 2014
[27]
prospective cohort study
systematic review
and individual patient data meta-analysis
161
adults
viral infection: 2009 H1N1 influenza (n = 84)
bacterial/mixed infection (n = 77)
PCT,
CRP

Kruger et al., 2009
[28]
multicenter prospective cohort study CAPNETZ1337 adultsunknown
(n = 865)
typical bacterial infection: (n = 185)
atypical bacterial infection (n = 190)
viral infection: Adenovirus, Influenza A,
RS Virus, and Enterovirus
(n = 39)
mixed infections with two or more pathogens (n = 58)
PCT,
CRP,
WBC

Self et al., 2017
[29]
multicenter prospective active surveillance study1735 adultsunknown
(n = 1075)
typical bacterial infection: (n = 169)
atypical bacterial infection (n = 67)
Mycobacteria/
Fungus (n = 15)
viral infection:
(n = 409), the most common pathogen were rhinovirus (n = 114)
PCT

Kim et al., 2011
[31]
prospective cohort study in small cohort75 childreninfluenza H1N1 2009 virus infection -pneumonia
(n = 57)
pneumonia but without H1N1 infection
(n = 18)
IFN-α, IFN-γ, IL-1β, IL-4, IL-6, IL-10, IL-17, IP-10, MIP-1α, TNF-α

Zobel et al., 2012
[32]
multicenter prospective cohort study CAPNETZ1000 adultsunknown
(n = 679)
typical bacterial infections (n = 98)
atypical bacterial infections (n = 155)
viral infections:
Adenovirus,
Influenza A,
Influenza B,
RSV,
and Enterovirus
(n = 23)
mixed infections (n = 45)
IL-6,
IL-10,
LBP

Menendez et al., 2012
[33]
prospective cohort study685 adultsunknown
(n = 390)
causal diagnosis (n = 295):
gram-positive cocci (n = 134), gram-negative bacilli (n = 69),
atypical pathogens (n = 24),
viral infections (n = 12)
PCT,
CRP,
IL-1 β,
IL-6,
IL-8,
IL-10,
TNF- α

Siljan et al., 2018
[34]
prospective cohort study267 adultsunknown (n = 90)
bacterial infection (n = 70)
viral infection (n = 39)
viral-bacterial infection (n = 48)
27 cytokines:
IL-1β, IL-1ra, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8/CXCL8, IL-9, IL-10, IL-12 (p70), IL-13, IL-15, IL-17A, bFGF, eotaxin/CCL11, G-CSF, GM-CSF, IFN-γ, IP-10/ CXCL10, MCP-1/CCL2, MIP-1α/CCL3, MIP-1β/CCL4, RANTES/CCL5, TNF-α, PDGF-BB and VEGF

Strehlitz et al, 2018
[35]
animal studymice with S. aureus or S. pneumoniae respiratory infectionexperimental murine models of bacterial pneumoniamRNA levels of IFN-β, IFN-γ, CXCL9, CXCL10
IFN-β,
IFN-γ,
CXCL9/MIG,
CXCL10/IP-10
Signature CXCL9+CXCL10 serum concentrations