Abstract
The rapid and accurate detection of causative pathogens, infective foci, and the severity of illness are specifically important for diagnostic strategies for infection in critical care settings. Difficulties in obtaining appropriate samples and/or the time required for traditional microbiological culture methods have been undesirable. Procalcitonin (PCT) or soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) have a relatively higher diagnostic ability compared with traditional biomarkers for infection, such as CRP or neutrophil counts. A meta-analysis, however, revealed that no single biomarker can be used for the definite diagnosis of infection. A PCT-guided treatment algorithm could become an option for curtailing excess antimicrobial use without affecting mortality. No other new biomarkers that have been developed experimentally or clinically have been established for clinical utilization. Intensivists should recognize that a comprehensive pathogen-directed diagnostic approach remains central but should be supplemented with currently available microbiological diagnosis in combination with an appropriate assessment of current biomarkers and the severity of each patient's illness.
