Sub-Theme Leaders: Najib Rahman
Key Researchers: Nikolaos Kanellakis
While the clinical entity of pneumonia is well established and easy to diagnose, the underlying cause is rarely established. Microbiological proof from blood culture or bronchoalveolar lavage is available in as few as 10% of cases and treatment is, in most cases, empirical. We want to better characterise the inflammatory and microbiological process associated with pneumonia.
In patients with pneumonia, fluid accumulates around the infected lung in 40% of cases (uninfected exudate), and in around 10% frankly infected pleural fluid develops (empyema). This requires chest tube drainage or surgery and is associated with a high morbidity and mortality. We aim to investigate the mechanisms and pathways responsible for progression from uninfected exudate to frank empyema.
This subtheme aims to investigate the mechanisms of lung parenchymal and pleural infection and to identify new targets for treatment by:
- Using repeated bedside thoracic ultrasound, transthoracic needle aspiration of consolidated lung and molecular microbiological techniques to better characterise the inflammatory and microbiological process associated with pneumonia.
- Establishing a highly characterised cohort of patients in whom we will define the true microbiological burden of this disease.
- Investigating the pathway from uninfected exudate to frank empyema by comparing the genetic and protein profile, carrying out a full molecular microbiological assessment, evaluating anatomical factors using CT and ultrasound and determining inflammatory and genetic factors associated with the host response.