Ventilator-associated pneumonia is a type of lung infection that occurs in people who are on mechanical ventilation breathing machines in hospitals. VAP is a major source of increased illness and death. The diagnosis of VAP varies among hospitals and providers but usually requires a new infiltrate on chest x-ray pneumonia in pediatrics pdf two or more other factors. People who are on mechanical ventilation are often sedated and are rarely able to communicate.
As such, many of the typical symptoms of pneumonia will either be absent or unable to be obtained. Patients who are in the ICU for head trauma or other severe neurologic illness, as well as patients who are in the ICU for blunt or penetrating trauma, are at especially high risk of developing VAP.
Further, patients hospitalized for blunt trauma are at a higher risk of developing VAP compared to patients with penetrating trauma. In particular, viruses and fungi are uncommon causes in people who do not have underlying immune deficiencies.
Though any microorganism that causes CAP can cause VAP, there are several bacteria which are particularly important causes of VAP because of their resistance to commonly used antibiotics. Pseudomonas aeruginosa is the most common MDR Gram-negative bacterium causing VAP. Pseudomonas has natural resistance to many antibiotics and has been known to acquire resistance to every antibiotic except for polymyxin B. Resistance is typically acquired through upregulation or mutation of a variety of efflux pumps which pump antbiotics out of the cell.