Ventilator-associated pneumonia

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Definition

  • Pneumonia that develops at least 48 hours after starting invasive ventilation

Etiology

  • Early (within 4 days)
    • Streptococcus pneumoniae
    • Haemophilus influenzae
    • Methicillin-sensitive Staphylococcus aureus
    • Enteric Gram-negative bacilli
    • Escherichia coli
    • Klebsiella pneumiae
    • Enterobacter spp.
    • Proteus spp.
    • Serratia marcescens
  • Late (after 4 days)
    • Methicillin-resistant Staphylococcus aureus
    • Acinetobacter
    • Pseudomonas aeruginosa
    • ESBL bacteria

Clinical Presentation

  • Intubation
  • Fever, leukocytosis, purulent secretions

Investigations

  • CXR
  • Sputum culture
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