Ventilator-associated pneumonia: pathobiological heterogeneity and diagnostic challenges

Fiona Howroyd; Cyril Chacko; Andrew MacDuff; Nandan Gautam; Brian Pouchet; Bill Tunnicliffe; Jonathan Weblin; Fang Gao-Smith; Zubair Ahmed; Niharika A Duggal; Tonny Veenith

doi:10.1038/s41467-024-50805-z

Ventilator-associated pneumonia: pathobiological heterogeneity and diagnostic challenges

Nat Commun. 2024 Jul 31;15(1):6447. doi: 10.1038/s41467-024-50805-z.

Authors

Fiona Howroyd^{1

2}, Cyril Chacko^{3

4}, Andrew MacDuff^{3

4}, Nandan Gautam⁵, Brian Pouchet⁵, Bill Tunnicliffe⁵, Jonathan Weblin⁶, Fang Gao-Smith⁷, Zubair Ahmed⁸, Niharika A Duggal⁹, Tonny Veenith^{10

11}

Affiliations

¹ Therapy Services, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, UK. [email protected].
² Institute of Inflammation and Ageing, The University of Birmingham, Edgbaston, Birmingham, UK. [email protected].
³ Department of Critical Care Medicine and Anaesthesia, The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
⁴ Institute of Acute Care, Royal Wolverhampton Hospital and University of Wolverhampton, Wolverhampton, UK.
⁵ Critical Care Department, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, UK.
⁶ Therapy Services, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, UK.
⁷ Institute of Inflammation and Ageing, The University of Birmingham, Edgbaston, Birmingham, UK.
⁸ Institute of Inflammation and Ageing, The University of Birmingham, Edgbaston, Birmingham, UK. [email protected].
⁹ Institute of Inflammation and Ageing, The University of Birmingham, Edgbaston, Birmingham, UK. [email protected].
¹⁰ Department of Critical Care Medicine and Anaesthesia, The Royal Wolverhampton NHS Trust, Wolverhampton, UK. [email protected].
¹¹ Institute of Acute Care, Royal Wolverhampton Hospital and University of Wolverhampton, Wolverhampton, UK. [email protected].

Abstract

Ventilator-associated pneumonia (VAP) affects up to 20% of critically ill patients and induces significant antibiotic prescription pressure, accounting for half of all antibiotic use in the ICU. VAP significantly increases hospital length of stay and healthcare costs yet is also associated with long-term morbidity and mortality. The diagnosis of VAP continues to present challenges and pitfalls for the currently available clinical, radiological and microbiological diagnostic armamentarium. Biomarkers and artificial intelligence offer an innovative potential direction for ongoing future research. In this Review, we summarise the pathobiological heterogeneity and diagnostic challenges associated with VAP.

Publication types

Review

MeSH terms

Anti-Bacterial Agents / therapeutic use
Biomarkers
Critical Illness
Humans
Intensive Care Units
Length of Stay
Pneumonia, Ventilator-Associated* / diagnosis
Pneumonia, Ventilator-Associated* / microbiology

Substances

Anti-Bacterial Agents
Biomarkers