Study Background

Patients in the neurosurgical intensive care unit (ICU) who require artificial airways after surgery frequently experience disruption of the pulmonary microbiome. Surgical trauma, antibiotic exposure, and airway management disturb the normal bacterial composition, creating an environment conducive to the overgrowth of pathogenic organisms.

Study Design

This observational study will enroll 220 postoperative ICU patients from three hospitals in Beijing between August 2025 and August 2026. Eligible participants are those who have undergone surgery for brain tumors, intracerebral hemorrhage, or traumatic brain injury. Tracheal aspirates will be collected immediately after surgery and at multiple subsequent time points for microbial composition analysis. The study follows a multicenter, prospective cohort design, with longitudinal tracking of individual patient data and microbiome dynamics.

Clinical Significance

Disruption of the pulmonary microbiome increases the risk of ventilator‑associated pneumonia (VAP) in patients using artificial airways. Reduced microbial diversity and the rise of pathogenic strains make it difficult to predict infection onset, and delayed treatment worsens patient prognosis. Early detection of microbiome shifts could therefore inform infection‑prevention and early‑intervention strategies.

Expected Impact

The findings may enable the development of biomarkers based on pulmonary microbiome alterations. Commercialization of early‑detection technologies could optimize antibiotic use in the ICU, reduce unnecessary broad‑spectrum therapy, lower costs, and help curb the spread of resistant organisms. Additionally, the data could stimulate investment in personalized microbiome‑modulating therapeutics.

Industry Implications

These data provide a foundation for biotech companies to build pulmonary microbiome analysis platforms or develop microbe‑based therapeutics (e.g., probiotics, bacteriophages). The ICU infection‑management market is currently valued at several billions of dollars annually, with rapidly growing demand for precise diagnostic and preventive solutions. Consequently, the study outcomes will offer critical insights for corporate R&D roadmaps and investment strategies.