Suppression of microbial burden to reduce pneumonia in critical illness: the SMURF feasibility pilot study
Authors' conclusion
Implementation of nasal aPDT in the ICU was feasible and safe, with high sampling adherence and successful blinded adjudication.
Study context
- Population
- Adults ≥ 19 years with expected ICU stay > 48 h, mixed medical-surgical ICUs, tertiary academic hospitalanalysed
- Participants
- 227 adults
- Comparison
- Intervention vs Control
- Interventionn = 101
- Controln = 126reference
- Primary endpoint
- Feasibility: recruitment rate, protocol adherence, safety, data completeness, and ability to adjudicate pneumonia events (blinded, rule-based, CDC/NHSN definitions)
Methodological detailssingle-centre, sequential control and intervention phases
- Single-centre
- Sequential control and intervention phases
Primary result
As reported in the abstract
Feasibility
Adherence to scheduled nasal swab collection
97.7%
Scheduled antimicrobial photodynamic therapy (aPDT) treatments delivered in full (intervention phase)
57.8%
Scheduled aPDT treatments partially delivered (intervention phase)
12.0%
Further findings
| Outcome | Intervention | Control | IRR (95% CI) | |
|---|---|---|---|---|
| Adjudicated VAP/HAP incidence (exploratory)Exploratory analysis | 9.0 per 1,000 ICU patient-days | 14.9 per 1,000 ICU patient-days | 0.61 (0.31–1.17) | |
| 0.20.5125Incidence rate ratio (log scale) |
| Outcome | P value |
|---|---|
| Early cumulative nasal pathogen burden (exploratory)Significantly lower in the intervention group · exploratory analysis | P < 0.01 |
Hierarchical composite endpoint (pneumonia, microbiologic clearance, cumulative pathogen burden)
- Win ratio favoring treatment
- 1.29 (95% CI 0.74-2.31)
- Exploratory analysis
Safety
- Intervention-related serious adverse events
- 0 · events
Original publication
Suppression of microbial burden to reduce pneumonia in critical illness: the SMURF feasibility pilot study. Crit Care. Published 7 April 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →