Hospital-Acquired and Ventilator-Associated Pneumonia

Patients with hospital-acquired pneumonia (HAP) are those who develop pneumonia 48 hours or more after hospital admission. Ventilator-associated pneumonia (VAP) is defined as pneumonia developed after 48 hours of endotracheal intubation,  and is believed to affect approximately 10% of patients who undergo mechanical ventilation for longer than 48 hours.  Together, these illnesses are the most frequent hospital-acquired infections and are associated with significant morbidity and mortality.  Diagnosis of HAP/VAP can be difficult because its symptoms, such as fever and increased white blood cell count, are associated with a variety of conditions in hospitalized patients; in addition, differentiating between airway colonization and infection can be challenging.  Although there is no gold standard for diagnosis, laboratory testing for HAP and VAP typically includes CBC, gram stain and culture, and arterial blood gas or oximetry.  Molecular tests such as multiplex polymerase chain reaction (PCR) panels and next generation sequencing (NGS) are rapidly developing technologies that may contribute to diagnosis and to identification of treatment-resistant pathogens.    Given the emergence of multidrug-resistant (MDR) organisms, accurate pathogen identification and treatment in HAP/VAP have become increasingly important. In addition, because pneumonia can be caused by bacteria, viruses, or fungi, pathogen determination will affect patient treatment and management.

Tabs Content
Content Review: 
March 2019

Last Update: June 2019