ABSTRACT
Ventilator-associated pneumonia (VAP) is the most common lethal infection in patients who require intensive care unit (ICU) stay.1 The clinical definition of VAP includes the presence of a new or persistent infiltrate in chest x-rays and two or more of the following criteria: purulent tracheal secretions, blood leukocytosis or leukopenia, and fever.2,3
Regarding time of occurrence, VAP is an infection in the lung parenchyma occurring more than 48 hours after hospital admission in a patient requiring mechanical ventilation.4 It also could be considered a type of hospitalacquired pneumonia (HAP), and HAP is defined as a lung infection occurring more than two days after hospital admission. It is important to notice that some patients might evolve from HAP to VAP; their management should be similar to those patients with VAP. In general terms, the closer from admission that a patient develops HAP, the more likely the pathogens will not be multidrug resistant (MDR). For the purposes of this chapter, we will be covering VAP in immune-competent patients.
