Circulating metabolome as key biomarkers for ventilator-associated pneumonia: Case–Control study in a tertiary care hospital of North India
Abstract
Introduction: Ventilator-associated pneumonia (VAP) is a microbial infection that develops in the lungs when a patient has been intubated for mechanical ventilation for more than 48 h. Diagnosis of VAP remains a challenge despite clinical advances. NMR-based metabolomics might play a pivotal role in overcoming the diagnostic complexity of VAP by investigating biomarkers. Materials and Methods: This case–control study was conducted in 2024–2025 at Sir Sunder Lal Hospital, Varanasi. The participated patients had an intubation period of more than 48 h; a total of 44 patients were recruited, of which 20 patients developed VAP and 24 were non-VAP patients. NMR spectra of serum were recorded, and statistical analysis was done. Results: The 2D scatter plot of PC1 versus PC2 scores clearly shows a distinction between the groups, with the principal component analysis explaining 18.9% of the variance. Partial least-squares discriminant analysis demonstrated R2 and Q2 values of 0.328 and 0.0552, respectively, indicating a probability to model fit. A total of 27 distinct metabolites were identified. Univariate receiver operating characteristic curve analysis identified phenylalanine (area under the curve [AUC] = 0.720), acetoacetate (AUC = 0.706), and glutamate (AUC = 0.690) as significant metabolites. With AUC values within the fair accuracy range, these three metabolites are considered acceptable biomarkers for the diagnosis of VAP. Conclusion: The elevated metabolites indicate lung…
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