Biomarker-based exclusion of ventilator-associated pneumonia: a multicentre validation study

Ventilator-associated pneumonia (VAP) remains a leading cause of nosocomial infection in the ICU [1]. VAP is confirmed by positive microbiology in approximately one-third of patients with suspected VAP [2], implying that there is scope to improve antibiotic stewardship. In a single-centre study, bronchoalveolar lavage fluid (BALF) inflammatory mediators (in particular interleukin-1 beta (IL-1β)) [3] and neutrophil proteases [4] demonstrated potential as biomarkers to exclude VAP. We aimed to validate these findings in a multicentre study.