Integrating host response and unbiased microbe detection for lower respiratory tract infection diagnosis in critically ill adults

pnas.org July 4, 2019

Lower respiratory tract infections (LRTIs) are the leading cause of infectious disease-related deaths worldwide yet remain challenging to diagnose because of limitations in existing microbiologic tests. In critically ill patients, noninfectious respiratory syndromes that resemble LRTIs further complicate diagnosis and confound targeted treatment. This prospective observational study evaluated adults with acute respiratory failure requiring mechanical ventilation who were admitted to the University of California, San Francisco (UCSF) Moffitt–Long Hospital ICUs. Subjects were enrolled sequentially between July 25, 2013, and October 17, 2017, within the first 72 h of intubation for respiratory failure. We prospectively enrolled 92 adults admitted to the ICU with acute respiratory failure and collected tracheal aspirate (TA) samples within 72 h of intubation.