Evaluation Of IL-8 As A Diagnostic Marker In The Diagnosis Of Bacterial Pneumonia
Keywords:
Interleukin-6, Cholecystitis, Sensitivity, SpecificityAbstract
Background
Bacterial pneumonia remains a leading cause of morbidity and mortality worldwide, particularly in developing countries. Early and accurate diagnosis is essential for improving patient outcomes and reducing inappropriate antibiotic use. Interleukin-8 (IL-8), a pro-inflammatory chemokine, has been implicated in the host immune response to bacterial infections and may serve as a diagnostic biomarker.
Method
This case–control study included 82 patients (aged 18–65 years) with clinically and radiologically confirmed bacterial pneumonia admitted to Al-Saahb Hospital, Iraq, between April 2024 and January 2025. A total of 68 healthy individuals without respiratory disease served as controls. Patients with recent antimicrobial therapy, chronic respiratory illness, autoimmune disorders, pregnancy, or lactation were excluded. Serum IL-8 levels were measured using ELISA according to standardized protocols.
Results
Mean serum IL-8 levels were significantly higher in pneumonia patients (92.4 ± 20.6 pg/ml) compared to controls (35.7 ± 11.8 pg/ml) (p < 0.001). IL-8 levels also varied according to bacterial etiology, with the highest concentrations observed in patients infected with Klebsiella pneumoniae and Pseudomonas aeruginosa. Receiver operating characteristic (ROC) curve analysis demonstrated strong diagnostic accuracy of IL-8, with an area under the curve (AUC) of 0.902. At a cut-off value of 60.0 pg/ml, IL-8 achieved a sensitivity of 87.8% and specificity of 81.5% in distinguishing pneumonia patients from controls (p < 0.001).
Conclusion
Serum IL-8 is markedly elevated in bacterial pneumonia and shows strong potential as a diagnostic biomarker. Its high sensitivity and specificity suggest that IL-8 measurement could complement conventional diagnostic methods, supporting early detection and improved management of pneumonia in clinical setting.
References
Abakar, M. A. A., Hamad, D. H. A., Faisal, E., Omer, H. M. F., Faki, M. T. M., Idris, A. E. M., Omer, R., Osman, Z., Elhassan, E. A. G., Abrahim-Holie, M. A., Hakami, M. A., Alghamdi, A., Alfahed, A., Aloraini, G. S., Alharthi, N. S., & Waggiallah, H. A. (2023). Comparative analysis of immunological biomarkers in COVID-19 and bacterial pneumonia. Journal of medicine and life, 16(12), 1844–1851. https://doi.org/10.25122/jml-2023-0273
Cesta, M. C. (2022). The role of interleukin-8 in lung inflammation and injury. Frontiers in Pharmacology, 13, 808797. https://doi.org/10.3389/fphar.2022.808797
Chandna, A., Lubell, Y., Mwandigha, L., Tanunchai, P., Vinitsorn, A., Richard-Greenblatt, M., Koshiaris, C., Limmathurotsakul, D., Nosten, F., Abdad, M. Y., Perera-Salazar, R., Turner, C., & Turner, P. (2023). Defining the role of host biomarkers in the diagnosis and prognosis of the severity of childhood pneumonia: A prospective cohort study. Scientific Reports, 13, Article 12024. https://doi.org/10.1038/s41598-023-38731-4.
Cilloniz, C., Rodríguez-Hurtado, D., & Torres, A. (2021). Characteristics and management of community-acquired pneumonia in the era of global aging. Medical Clinics of North America, 105(4), 663–676. https://doi.org/10.1016/j.mcna.2021.03.001
Hellyer, T. P., McAuley, D. F., Walsh, T. S., Anderson, N., Conway Morris, A., Singh, S., Dark, P., Roy, A. I., Perkins, G. D., McMullan, R., Emerson, L. M., Blackwood, B., Wright, S. E., Kefala, K., O'Kane, C. M., Baudouin, S. V., Paterson, R. L., Rostron, A. J., Agus, A., Bannard-Smith, J., … Simpson, A. J. (2020). Biomarker-guided antibiotic stewardship in suspected ventilator-associated pneumonia (VAPrapid2): a randomised controlled trial and process evaluation. The Lancet. Respiratory medicine, 8(2), 182–191. https://doi.org/10.1016/S2213-2600(19)30367-4.
Ito, A. (2020). Diagnostic markers for community-acquired pneumonia. Annals of Translational Medicine, 8(9), 611. https://doi.org/10.21037/atm.2020.01.39
Jain, S., Self, W. H., Wunderink, R. G., & Team, CDC EPIC Study. (2022). Cytokine profiles and outcomes in pneumonia. Clinical Infectious Diseases, 75(2), 214–223. https://doi.org/10.1093/cid/ciab112
Li, Z., Zhou, H., & Huang, X. (2021). Cytokine expression in patients with bacterial pneumonia. Frontiers in Immunology, 12, 643215. https://doi.org/10.3389/fimmu.2021.643215
Ljungcrantz, E. G., Askman, S., Sjövall, F., & Paulsson, M. Metlay, J. P., Waterer, G. W., Long, A. C., Anzueto, A., Brozek, J., Crothers, K., ... Whitney, C. G. (2019). Diagnosis and treatment of adults with community-acquired pneumonia: An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. American Journal of Respiratory and Critical Care Medicine, 200(7), e45–e67. https://doi.org/10.1164/rccm.201908-1581ST
Metlay, J. P., Waterer, G. W., Long, A. C., Anzueto, A., Brozek, J., Crothers, K., ... Whitney, C. G. (2019). Diagnosis and treatment of adults with community-acquired pneumonia: An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. American Journal of Respiratory and Critical Care Medicine, 200(7), e45–e67. https://doi.org/10.1164/rccm.201908-1581ST
Pierrakos, C., & Vincent, J.-L. (2020). Biomarkers of sepsis: time for a reappraisal. Journal (review)
Póvoa, P., Martin-Loeches, I., & Torres, A. (2024). Biomarkers in pulmonary infections: A clinical approach. Annals of Intensive Care, 14, 38. https://doi.org/10.1186/s13613-024-01234-9
Ruuskanen, O., Lahti, E., Jennings, L. C., & Murdoch, D. R. (2020). Viral pneumonia. The Lancet, 396(10255), 1077–1089. https://doi.org/10.1016/S0140-6736(20)32082-3
Troeger, C., Blacker, B., Khalil, I. A., Rao, P. C., Cao, S., Zimsen, S. R. M., ... Reiner, R. C. (2020). Estimates of the global burden of pneumonia in children under five years. The Lancet Global Health, 8(4), e443–e453. https://doi.org/10.1016/S2214-109X(19)30467-