ABSTRACT
Ventilator-associated pneumonia (VAP) is defined as pneumonia arising >48–72 hours following intubation. It is the most common infection in intubated patients requiring mechanical ventilation and the leading cause of death by nosocomial infections in the intensive care unit. Quantitative or semiquantitative culture should help rule out false positive diagnoses of VAP, though a false negative culture may occur in the setting of partially treated VAP. Cultures may also be positive with ventilator-associated tracheobronchitis; if this occurs in the setting of non-infectious pulmonary infiltrates, an erroneous diagnosis of VAP may delay diagnosis and treatment. Efforts at prevention and improving diagnosis and treatment have resulted in the development of VAP bundles. VAP is a cause of morbidity and mortality in mechanically ventilated patients. A 2002 single center trial of 107 ventilated patients treated for VAP demonstrated delayed initial appropriate antibiotic therapy had an adjusted odds ratio for death of 7.68.
