• aD'Or Institute for Research and Education bPrograma de Pós-Graduação de Clinica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil cPolyvalent Intensive Care Unit, São Francisco Xavier Hospital, CHLO dNOVA Medical School, CEDOC, New University of Lisbon, Lisbon, Portugal.
• Curr Opin Crit Care. 2017 Oct 1; 23 (5): 391-397.

Purpose Of ReviewNosocomial pneumonia is a frequent and severe nosocomial infection divided in two distinct groups: hospital-acquired pneumonia and ventilator-associated pneumonia (VAP). In this context, the VAP is notoriously difficult to diagnose clinically, resulting from the lack of a 'gold standard' method of diagnosis.Recent FindingsThe use of biomarkers may potentially improve the early diagnosis of infections allowing earlier and better identification and treatment. An exhausting list of biomarkers has been studied and although far from perfect, procalcitonin (PCT) and C-reactive protein (CRP) are the most studied biomarkers used in clinical practice. Data coming from literature suggests the use of PCT for VAP prognosis and as a based algorithm tool for the reduction of duration of pneumonia therapy, as well as, the use of the CRP dynamics to the early prediction of VAP and the response to the antibiotics.SummaryThe evidence for the use of biomarkers to diagnose nosocomial pneumonia as a stand-alone tool is low to moderate. Improved performance for both PCT and CRP can be obtained by using them in association with clinical features or scoring systems but prospective studies are still needed to validate this hypothesis.

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