title: Ventilator-associated pneumonia.
abstract: Ventilator-associated pneumonia (VAP) is an iatrogenic pulmonary infection that develops in tracheally intubated patients on mechanical ventilation for at least 48 hours. VAP is the nosocomial infection with the greatest impact on patient outcomes and health care costs. Endogenous colonization by aerobic gram-negative pathogens, that is, Pseudomonas aeruginosa, and methicillin-resistant Staphylococcus aureus play a pivotal role in the pathogenesis of VAP. Several preventive strategies have shown efficacy in decreasing VAP incidence and are often implemented altogether as a prevention bundle. In patients with clinical suspicion of VAP, respiratory samples should be promptly collected. The empiric treatment should be based on the local prevalence of pathogens, duration of hospital stay, and prior antimicrobial therapy. The antibiotics can be stopped or adjusted to more narrow-spectrum once cultures and susceptibilities are available.
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Thorax Institute, Hospital Clinic, Barcelona, Spain.
authors.forename: Gianluigi Li
authors.initials: GL
authors.lastname: Bassi
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Thorax Institute, Hospital Clinic, Barcelona, Spain.
authors.forename: Miquel
authors.initials: M
authors.lastname: Ferrer
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Thorax Institute, Hospital Clinic, Barcelona, Spain.
authors.forename: Joan Daniel
authors.initials: JD
authors.lastname: Marti
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Thorax Institute, Hospital Clinic, Barcelona, Spain.
authors.forename: Talitha
authors.initials: T
authors.lastname: Comaru
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Thorax Institute, Hospital Clinic, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Torres
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D007442:Intubation, Intratracheal; D007902:Length of Stay; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D053717:Pneumonia, Ventilator-Associated / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012121:Respiration, Artificial / Q000009:adverse effects; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents