Diagnosis of Hospital-Acquired Pneumonia

Relevance. Hospital-acquired pneumonia (HAP), particularly ventilator-associated pneumonia (VAP), remains one of the leading infectious complications in intensive care units in the context of increasing antimicrobial resistance and is associated with high mortality rates. The aim of the study was to present current approaches to the diagnosis of HAP with emphasis on clinical, laboratory, radiological, and ultrasound methods, as well as integrated scoring systems and rapid diagnostic tests.

Methods. The study analyzes Russian and international clinical guidelines, original studies, and systematic reviews published between 1991 and 2025, focusing on the epidemiology, diagnosis, and differential diagnosis of HAP. Special attention was given to imaging methods (chest X-ray, computed tomography, lung ultrasound), biomarkers, and molecular technologies for rapid pathogen identification.

Results. HAP diagnosis is based on a combination of clinical and laboratory findings and imaging methods, but their sensitivity and specificity remain limited. The CPIS score is still the most widely used, yet it lacks sufficient accuracy. New integrated scores (CEPPIS, VPLUS) and ultrasound-based protocols improve diagnostic reliability, while molecular rapid tests enable early detection of pathogens, their resistance mechanisms, and timely initiation of adequate etiotropic antibiotic therapy.

Conclusion. Improving diagnostic accuracy of HAP is possible through integration of clinical data, instrumental methods, and modern rapid tests. Lung ultrasound combined with biomarkers and molecular techniques represents a promising direction for a personalized approach to disease management.

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