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Intensive Care Med Exp2026;14(1):10.February 3, 2026Journal Article

Microbial lung-to-blood translocation associates with systemic inflammation in severe pneumonia: evidence from paired plasma and lower respiratory tract metagenomics.

Haopu Yang1,2, Matthew K Hensley1, Vi D-B Nguyen3, Nameer S Al-Yousif4, Noel Britton5, Ghady Haidar6, Libing Yang7, Faraaz Shah1,8,9, William Bain1,8,9, Xiaohong Wang1, Shulin Qin1, Asim A Ahmed10, Tim Blauwkamp10, Sivan Bercovici10, Brett A Kaufman11, Kevin M Redding11, Adam Fitch1,12, Barbara Methé1,12, Panayiotis V Benos13, Bryan J McVerry8,9,14, Alison Morris15, Georgios D Kitsios16,17
1Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Pittsburgh Medical Center, 3459 Fifth Avenue, Pittsburgh, PA, 15213, USA.
2Québec Heart and Lung Institute Research Centre, Québec City, QC, G1V 4G5, Canada.
3Department of Medicine, Olive View-UCLA Medical Center, Sylmar, CA, 91342, USA.
4Department of Medicine, University of Pittsburgh Medical Center Mercy, Pittsburgh, PA, 15219, USA.
5Center for Shock, Trauma and Anesthesiology Research, Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.
6Department of Medicine, Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA.
7Department of Thoracic Surgery, Peking Union Medical College Hospital, Beijing, 100730, China.
8Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, 15240, USA.
9Acute Lung Injury and Infection Center for Excellence, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA.
10Karius Inc, Redwood City, CA, 94065, USA.
11Heart, Lung, and Blood Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
12Center for Medicine and the Microbiome, University of Pittsburgh, Pittsburgh, PA, 15213, USA.
13Department of Epidemiology, University of Florida, Gainesville, FL, 32603, USA.
14Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
15Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, 07103, USA.
16Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Pittsburgh Medical Center, 3459 Fifth Avenue, Pittsburgh, PA, 15213, USA. kitsiosg@upmc.edu.
17Acute Lung Injury and Infection Center for Excellence, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA. kitsiosg@upmc.edu.
PubMed PMC DOI PDF

Abstract

BACKGROUND: Biological heterogeneity in host inflammatory responses to severe pneumonia predicts clinical outcomes and may influence the effectiveness of immunomodulatory therapy. The upstream drivers of this heterogeneity remain poorly defined. We hypothesized that microbial translocation from the lungs to the bloodstream, detectable via multi-compartment metagenomic analysis, contributes to dive…

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