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Publications

Journal Article Review Epublish

PubMed: 42888246 DOI: 10.1038/s41467-026-78901-2

ICU-acquired pneumonia beyond pathogen detection.

Nat Commun 17(1)

Authors: Ignacio Martin-Loeches, Antoni Torres

Affiliations

  • Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St James' Hospital, Dublin, Ireland.
  • School of Medicine, Trinity College Dublin, Dublin, Ireland.
  • Trinity Centre for Biomedical Engineering, Trinity College Dublin, Dublin, Ireland.
  • Applied Research in Respiratory Diseases, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain. School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain. Respiratory Institute, Hospital Clínic de Barcelona, Barcelona, Spain.

Abstract

Intensive care unit-acquired pneumonia is often treated as a binary diagnosis, although clinical deterioration, imaging and microbial detection describe different aspects of disease. This Perspective proposes an explicit, graded and revisable assessment of whether a detected organism plausibly causes the current lung injury. The framework encompasses pneumonia arising during ventilation, pneumonia that precedes intubation and pneumonia in non-ventilated ICU patients. It places molecular results within clinical, anatomical, microbiological and host context and uses formal reassessment at 48-72 hours to guide treatment continuation, narrowing or discontinuation.

MeSH

Pneumonia, Intensive Care Units