Every year, over 18,000 children are admitted to paediatric intensive care units across the UK.[1] Ventilator-associated pneumonia (VAP), a life-threatening lung infection, affects up to one in five of these critically ill patients.[2] However, diagnosing VAP is very difficult, making it hard for doctors to decide on the most appropriate treatment. Dr Nazima Pathan of the University of Cambridge is aiming to improve the early detection and treatment of VAP by deepening the understanding of how these infections develop. Ultimately, this could lead to new diagnostic tools for VAP – which could save lives, shorten hospital stays and provide better care for critically ill children.
How are children’s lives affected now?
VAP is a lung infection that can develop in critically ill children who need help with breathing with a machine called a ventilator for more than two days, posing a major threat to their recovery.
“These vulnerable children are at risk of dying not only from their critical illness but also from this hospital-acquired infection, which is caused by harmful bacteria entering their weakened lungs,” says Dr Pathan. “VAP can lead to longer hospital stays and reduce their chances of survival.”
Diagnosing VAP is challenging because current tests don’t provide clear results, making it difficult for doctors to choose the best treatment. Consequently, most children with suspected VAP are treated with antibiotics, even when they may not need them. This unnecessary use of antibiotics is a growing concern as it may fuel the development of drug-resistant strains of bacteria.
There’s an urgent need for new diagnostic tools that can identify VAP earlier, more accurately and predict which children are most at risk of developing the infection. This would enable doctors to provide more targeted and effective treatment.
How could this research help?
“We’re aiming to identify early signs of VAP in critically ill children that could help improve detection and treatment of this infection,” says Dr Pathan.
The researchers plan to monitor changes in critically ill children receiving mechanical ventilation, specifically to their lung microbiota* and their body’s immune response. They will also study the impact of antibiotic resistance on their lung bacteria during the infection.
“We will compare blood and lung fluid samples from critically ill children admitted to intensive care to identify differences between those who develop VAP and those who do not,” says Dr Pathan.
Using advanced computational techniques, the researchers will then analyse these changes to uncover potential markers in the body and lungs that signal the early stages of VAP.
“We hope this will lead to the development of new diagnostic tools, enabling doctors to start treatment sooner, potentially preventing the infection from becoming severe or causing lung damage,” says Dr Pathan.
Improving the accuracy of diagnosing VAP could also help reduce unnecessary antibiotic use, ensuring they are prescribed only when needed and helping to combat antibiotic resistance.
*The lung microbiota is the community of microorganisms that live in the lungs, including bacteria, viruses and fungi.
Research table
Project details
| Project Leader | Dr Nazima Pathan, MB BS MRCP FRCPCH PhD |
| Location | Department of Paediatrics, University of Cambridge |
| Project Team |
Professor Clare E Bryant, PhD
Dr Namshik Han, PhD Professor Mark Peters, MBChB PhD FRCPCH Professor Katherine Brown, MA MB BChir MRCPCH Dr Vicky Enne, PhD Dr John Pappachan, MA MBBChir FRCA FFICM Dr Lucy Van Dorp, PhD Dr Benjamin Crulli, MSc MD |
| Other Locations |
Heart Lung Research Institute, University of Cambridge
Centre for Computational Biology and AI in Medicine, University of Cambridge Paediatric Intensive Care, Insitute of Child Health, Great Ormond Street Hospital Department of Microbiology, Guys and St Thomas’s NHS Foundation Trust |
| Grant Amount | £199,999 |
| Duration | 24 months |
| Grant Code (GN number) | GN3065 |
References
- Paediatric Intensive Care Audit Network, Annual Report 2024 Tables and Figures: https://www.picanet.org.uk/wp-content/uploads/sites/25/2024/12/PICANet-NPCCA-State-of-the-Nation-Report-2024_v1.0-12Dec2024.pdf
- Howroyd, F., Chacko, C., MacDuff, A. et al. Ventilator-associated pneumonia: pathobiological heterogeneity and diagnostic challenges. Nat Commun 2024; 15: 6447
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