AIMS
This study aims to improve our understanding of hospital-acquired pneumonia. This is a serious chest infection that develops while someone is in hospital. Researchers will use hospital records to find out who is most at risk, who is more likely to become seriously unwell, and how antibiotics are used to treat the infection. They will also compare people whose chest X-rays show signs of pneumonia with people who are treated for suspected pneumonia, but whose chest X-rays do not show clear signs of it.
BACKGROUND
Hospital-acquired pneumonia is the most common infection picked up in healthcare settings. It is estimated to affect between one and two people in every 100 hospital admissions. People who develop it are more likely to need intensive care, stay in hospital for longer, or die than people who do not develop the infection.
We still do not fully understand who is most likely to become seriously unwell with this infection. It can also be difficult to tell from hospital records whether someone has pneumonia. Some people may be treated for it when they do not have it, while others who do have it may not be identified.
Another concern is antibiotic resistance, which means bacteria no longer respond to antibiotics used to treat them. Many people with suspected hospital-acquired pneumonia receive antibiotics that treat a wide range of bacteria. However, we need to know more about which germs are causing these infections and whether the antibiotics used are the best choice. This could help improve care and avoid unnecessary antibiotic treatment.
RESEARCH
Researchers will study existing hospital records of people who develop pneumonia, or are treated for suspected pneumonia, during a hospital stay. They will use routinely collected hospital data alongside information from clinical notes and chest X-ray reports. A computer tool called natural language processing will help find relevant information in the written records.
The study will compare two groups: people who meet internationally agreed standards for diagnosing hospital-acquired pneumonia, and people treated for suspected pneumonia whose chest X-rays do not show clear signs of it. Researchers will look at what happens to people in each group, including how well they recover. This could help show whether the way hospital-acquired pneumonia is identified can be improved.
PATIENT AND PUBLIC INVOLVEMENT
Patients and members of the public have helped shape this research from an early stage. At public workshops run through the Birmingham Biomedical Research Centre, people highlighted infections picked up in hospital as an important concern. They also wanted better ways to identify people at risk of becoming seriously unwell with an infection.
Members of the Birmingham and Solihull Breathe Easy support group, who live with long-term lung conditions, have also discussed the study. They reviewed the plans and the information needed for the research. They agreed that it is important to understand who is most at risk from hospital-acquired pneumonia and how care can be improved. Members have agreed to support the study and help write summaries of the findings for the public.
SUPPORT AND RESEARCH TEAM
All members of the PIONEER Data Trust Committee supported this project.
The study is led by Dr Samuel Quarton, a Clinical Research Fellow at the University of Birmingham’s Institute of Inflammation and Ageing. It is part of the National Institute for Health and Care Research Birmingham Biomedical Research Centre programme. The research team includes colleagues from the University of Birmingham, University Hospitals Birmingham and PIONEER.
