Accuracy of Biomarkers for the Diagnosis of Adult Community-acquired Pneumonia: A Meta-analysis.

  title={Accuracy of Biomarkers for the Diagnosis of Adult Community-acquired Pneumonia: A Meta-analysis.},
  author={Mark H. Ebell and Michelle Bentivegna and Xinyan Cai and Cassie Hulme and Maggie Kearney},
  journal={Academic emergency medicine : official journal of the Society for Academic Emergency Medicine},
  • M. EbellM. Bentivegna M. Kearney
  • Published 26 February 2020
  • Medicine
  • Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
BACKGROUND Biomarkers such as C-reactive protein (CRP) and procalcitonin may help distinguish community-acquired pneumonia (CAP) from other causes of lower respiratory tract infection. METHODS We performed a systematic review of the literature to identify prospective studies evaluating the accuracy of a biomarker in patients with acute cough or suspected CAP. We performed parallel abstraction of data regarding study inclusion, characteristics, quality, and test accuracy. Study quality was… 

Systematic Review and Meta-Analysis of Diagnostic Biomarkers for Pediatric Pneumonia.

CRP and PCT performed better than WBC and ESR but had suboptimal sensitivity, and some less well-studied novel biomarkers appear to have promise particularly in combination.

Use of infection biomarkers in the emergency department

There are insufficient data to recommend the widespread use of CRP and procalcitonin for the diagnosis and prognosis of infection in the emergency department, but these biomarkers can be used for appropriate antibiotic use in selected infection groups, such as community-acquired pneumonia, especially to reduce unnecessary antibiotic prescribing.

Refractory Mycoplasma Pneumonia in Children: A Systematic Review and Meta-analysis of Laboratory Features and Predictors

The available evidence indicates that CRP, LDH, neutrophils (%), D-dimer, and lung consolidation are predictive factors for RMPP.

Diagnostic value of soluble biomarkers for parapneumonic pleural effusion.

It is found that none of the available biomarkers has adequate performance for diagnosing and stratifying PPE and further work is needed to identify and validate novel biomarkers, and their combinations, for the management of PPE.

Federal guidelines on diagnosis and treatment of community-acquired pneumonia

The presented clinical guidelines cover current information about the etiology, clinical manifestations, diagnosis and treatment tactics for community-acquired pneumonia and have been approved by the Scientific and Practical Council of the Ministry of Health of the Russian Federation in 2021.

Evaluation of the relationships between procalcitonin and neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in patients with pneumonia.

In this study, white blood cell, neutrophil, neutphil/lymphocyte ratio, and C-reactive protein values were found to be significantly higher in patients with elevated procalcitonin.

Clinical characteristics and predictors of pneumonia in patients presenting fever or respiratory symptoms with normal or low leukocyte counts: a retrospective study

Temperature higher than 37.8 °C were a potential predictor of pneumonia in patients with normal or low leukocyte counts in the early stage, however, a hsCRP level less than 1.64 mg/L could rule out most cases of pneumonia.

Association of SP-A and SP-D Surfactant Proteins with the Severity of CommunityAcquired Pneumonia

According to the results of this study, the SP-A and SP-D proteins are associated with clinical and laboratory signs that reflect the severity of CAP, and are new laboratory markers of CAP severity.

The Role of CRP POC Testing in the Fight against Antibiotic Overuse in European Primary Care: Recommendations from a European Expert Panel

An expert panel conducted an extensive report on C-reactive protein point-of-care (CRP POC) testing in the evaluation of LRTIs and its usefulness to limit antibiotic prescriptions and found it to be a potentially useful tool to limit antibiotics’ overuse in a community setting.

The effect of C‐reactive protein on chest X‐ray interpretation: A decision‐making experiment among pediatricians

It is sought to test if pediatricians over‐rely on C‐reactive protein (CRP) results when managing a child with suspected pneumonia.



C-reactive protein and community-acquired pneumonia in ambulatory care: systematic review of diagnostic accuracy studies.

CRP may be of value in ruling out a diagnosis of CAP in situations where the probability of CAP >10%, typically accident and emergency departments, and in primary care, additional diagnostic testing with CRP is unlikely to change subsequent management decisions.

Diagnostic and prognostic accuracy of clinical and laboratory parameters in community-acquired pneumonia

PCT, and to a lesser degree hsCRP, improve the accuracy of currently recommended approaches for the diagnosis of CAP, thereby complementing clinical signs and symptoms and laboratory biomarkers for CAP.

C-reactive protein in diagnosis of community-acquired pneumonia in adult patients in primary care

It is concluded that the examined inflammatory parameters did not contribute notably in the routine diagnosis of CAP established by clinical measures.

Diagnostic value of C reactive protein in infections of the lower respiratory tract: systematic review

Testing for C reactive protein is neither sufficiently sensitive to rule out nor sufficiently specific to rule in an infiltrate on chest radiograph and bacterial aetiology of lower respiratory tract infection.

Use of serum C reactive protein and procalcitonin concentrations in addition to symptoms and signs to predict pneumonia in patients presenting to primary care with acute cough: diagnostic study

A clinical rule based on symptoms and signs to predict pneumonia in patients presenting to primary care with acute cough performed best in patients with mild or severe clinical presentation.

[Prediction of the presence of pneumonia in adults with fever].

Clinical judgment prior to observation of radiography has a low sensitivity in the improvement in clinical judgment in the presence of pneumonia in febrile patients.

Contributions of symptoms, signs, erythrocyte sedimentation rate, and C-reactive protein to a diagnosis of pneumonia in acute lower respiratory tract infection.

Most symptoms and signs traditionally associated with pneumonia are not predictive of pneumonia in general practice, but a prediction rule for low-risk patients, including a CRP of < 20, can considerably reduce unjustified antibiotic prescribing.

The role of procalcitonin in adult patients with community-acquired pneumonia--a systematic review.

PCT should only be an adjunct to the clinical examination and should be regarded a prognostic rather than diagnostic factor, and may help to safely reduce anti-biotic use.

Aetiology and prediction of pneumonia in lower respiratory tract infection in primary care.

  • A. HolmJ. Nexoe C. Pedersen
  • Medicine, Biology
    The British journal of general practice : the journal of the Royal College of General Practitioners
  • 2007
CRP should not be introduced for diagnosis of radiographic pneumonia in general practice before its use has been investigated in prospective, controlled intervention trials using CRP-guided treatment algorithms.

Laboratory tests for pneumonia in general practice: the diagnostic values depend on the duration of illness.

The usefulness in the diagnosis of pneumonia of temperature and the laboratory tests: erythrocyte sedimentation rate (ESR), leucocyte count, and C-reactive protein (CRP) was evaluated against a