Circulatory biomarkers for microbial infections

Area of Science:

• Infectious disease diagnostics
• Host-response profiling
• Antimicrobial stewardship

Background:

• Traditional markers like C-reactive protein (CRP) and procalcitonin (PCT) lack specificity for precision antimicrobial stewardship.
• Current diagnostics often fail to differentiate between bacterial and viral infections, complicating treatment.
• Empiric therapy for infections has critical blind spots, particularly for fungal and protozoal pathogens.

Purpose of the Study:

• To explore the paradigm shift in infectious disease diagnostics from pathogen detection to host-response profiling.
• To highlight novel biomarkers and technologies for improved infection diagnosis and management.
• To discuss the integration of advanced diagnostics with AI for precision antimicrobial stewardship.

Main Methods:

• Review of traditional diagnostic markers (CRP, PCT) and their limitations.
• Exploration of novel biomarkers: presepsin for bacterial infections, mRNA signatures for viral/bacterial differentiation.
• Inclusion of pan-microbial surveillance markers (BDG, Galactomannan, HRP2/pLDH) for broader pathogen detection.

Main Results:

• Presepsin emerges as a superior early-phase bacterial biomarker.
• Multi-parametric mRNA signatures demonstrate high sensitivity in differentiating viral from bacterial infections.
• Expanded surveillance markers address limitations in empiric therapy for fungal and protozoal infections.

Conclusions:

• Circulatory biomarkers and AI-driven decision support are transforming infectious disease diagnostics.
• This shift enables precision antimicrobial stewardship, moving away from broad empiric treatments.
• Timely and accurate infection etiology determination within the "golden hour" can improve patient outcomes and combat antibiotic resistance.