Ventilator-associated pneumonia: pathobiological heterogeneity and diagnostic challenges
Fiona Howroyd, Cyril Chacko, Andrew MacDuff, Nandan Gautam, Brian Pouchet, Bill Tunnicliffe, Jonathan Weblin, Fang Gao Smith, Zubair Ahmed, Niharika A. Duggal, Tonny Veenith
Abstract
Ventilator-associated pneumonia (VAP) affects up to 20% of critically ill patients and induces significant antibiotic prescription pressure, accounting for half of all antibiotic use in the ICU. VAP significantly increases hospital length of stay and healthcare costs yet is also associated with long-term morbidity and mortality. The diagnosis of VAP continues to present challenges and pitfalls for the currently available clinical, radiological and microbiological diagnostic armamentarium. Biomarkers and artificial intelligence offer an innovative potential direction for ongoing future research. In this Review, we summarise the pathobiological heterogeneity and diagnostic challenges associated with VAP. Ventilator-associated pneumonia (VAP) is a nosocomial infection that significantly affects critically ill patients undergoing mechanical ventilation in the Intensive Care Unit (ICU). This review presents the diagnostic challenges associated with VAP in ICU.