Each year, nearly 6,000 children in the UK are admitted to paediatric intensive care units with life-threatening chest infections.[1] While these infections are often caused by viruses, most of these critically ill children will be treated with life-saving antibiotics, even when they may not need them. Professor Padmanabhan Ramnarayan of Imperial College London is aiming to develop a breath test that can rapidly diagnose bacterial infections and distinguish them from viral ones. An accurate, non-invasive new diagnostic tool would help transform the care of critically ill children, ensuring they receive the best possible treatment while reducing antibiotic use and unnecessary side effects.
How are children’s lives affected now?
Most critically ill children with life-threatening chest infections who require mechanical ventilation to support their breathing are treated with precautionary antibiotics for several days. However, doctors can’t be certain whether an infection is bacterial or viral, as routine tests are slow and often unreliable.
“Doctors must act quickly to avoid delays in potentially life-saving treatment,” says Professor Ramnarayan. “While antibiotics undoubtedly help to save many of these children’s lives, they can also cause unpleasant and sometimes serious side effects.”
Improving the diagnosis of chest infections could help reduce the use of antibiotics in critically ill children who are unlikely to benefit from them. The reliance on antibiotics is also a growing global health concern as it may help encourage the development of resistant strains of bacteria – or so-called ‘superbugs’.
“There’s an urgent need for a simple new test that can rapidly diagnose bacterial chest infections and distinguish them from viral ones,” says Professor Ramnarayan. “This would allow doctors to target antibiotics to children who need them.”
How could this research help?
Our ultimate goal is to develop a non-invasive breath test that can quickly and reliably diagnose bacterial chest infections in critically ill children, transforming their care.
Professor Ramnarayan will work with experts at Imperial College London, who specialise in using small molecules – called volatile organic compounds (VOCs) – in exhaled breath to diagnose infections in adults.
“By analysing breath samples from critically ill children receiving mechanical ventilation for chest infections, we aim to identify VOC signatures that can accurately diagnose bacterial infections – and also distinguish these infections from viral ones,” says Professor Ramnarayan.
The team will also form a parent advisory group, consulting with them regularly to ensure the project aligns with families’ needs.
“If successful, this new breath test will be quick, safe and painless for these vulnerable children,” says Professor Ramnarayan. “It could also be repeated regularly, allowing doctors to monitor their progress and adjust antibiotic treatment accordingly – either stopping it sooner or avoiding it altogether.”
Research table
Project details
| Project Leader | Dr Padmanabhan Ramnarayan (Ram) MD FRCPCH FFICM |
| Location | Department of Surgery and Cancer, Imperial College London |
| Project Team |
Dr Toranj Wadia MD LLM
Dr Piers Boshier PhD FRCS Dr Bhamini Vadhwana PhD MRCS Dr Jethro Herberg PhD MRCPCH Dr Myrsini Kaforou MEng PhD Professor Michael Levin PhD FRCP Professor George Hanna PhD FRCS |
| Other Locations | Department of Infectious Diseases, Imperial College London Paediatric Intensive Care Unit, Imperial College Healthcare NHS Trust |
| Grant Amount | £199,977 |
| Duration | 36 months |
| Grant Code (GN number) | GN3073 |
References
- Paediatric Intensive Care Audit Network, National Paediatric Critical Care Audit State of the Nation Report 2024: https://www.picanet.org.uk/wp-content/uploads/sites/25/2024/12/PICANet-NPCCA-State-of-the-Nation-Report-2024_v1.0-12Dec2024.pdf
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