The “Point prevalence survey of healthcare associated infections and antimicrobial use in European acute care hospitals” protocol adopts the following definition of Lower Respiratory Tract Infection other than pneumonia (LRI):

LRI-BRON: bronchitis, tracheobronchitis, bronchiolitis, tracheitis, without evidence of pneumonia.

Tracheobronchial infections must meet the following criteria:

  • Patient has no clinical or radiographic evidence of pneumonia


patient has at least two of the following signs or symptoms with no other recognised cause: fever (> 38 °C), cough, new or increased sputum production, rhonchi, wheezing and at least one of the following:

    • positive culture obtained by deep tracheal aspirate or bronchoscopy;
    • positive antigen test on respiratory secretions.

A chronic bronchitis in a patient with chronic lung disease must not be reported as an healthcare associated infection , unless there is evidence of an acute secondary infection, manifested by change in organism.


LRI-LUNG: other infections of the lower respiratory tract.

Other infections of the lower respiratory tract must meet at least one of the following criteria:

  • patient has organisms seen on smear or cultured from lung tissue or fluid, including pleural fluid;
  • patient has a lung abscess or empyema seen during a surgical operation or histopathologic examination;
  • patient has an abscess cavity seen on radiographic examination of lung.


A lung abscess or empyema without pneumonia must be reported as LRI-LUNG.



Link to European IC/HH Core Competencies

Area 3. Surveillance and investigation of healthcare associated infection (HAI)