Clinical Validation of Optical Molecular Alveoscopy for the Immediate Bed-Side Diagnosis of Pneumonia in the Intensive Care Unit

The proposal aims to provide clinical evidence of the performance and safety in the Intensive Care Unit of a disruptive optical imaging platform to image bacteria in the alveolar space and provide bedside, real-time, in vivo diagnostic information. Molecular alveoscopy will be achieved by passing an optical fibre through the working channel of a bronchoscope into the segmental airways and extended through serial transbronchial passes into the alveolar sacs. This will be coupled with the intra-alveolar administration of microdoses (<5 mcg) of exquisitely sensitive and highly selective bacteria-specific chemical “SmartProbes”. The resulting images will be optimised and processed with image analysis algorithms to provide objective determination of bacterial presence and their Gram-status. This chest x-ray-guided regional pulmonary imaging approach will be validated through comparison with established and constructed reference standards in a staged multi-site clinical trial. Key Goals A) Validate optical endomicroscopy and SmartProbes for immediate detection of alveolar bacteria (and their Gram-status), thereby confirming or excluding bacterial pneumonia. B) Model the potential impact of this novel technology on antibiotic use in the ICU. C) Perform a care-pathway analysis to model the health economic impact and explore work flow and perceived barriers to adoption.