Chapters authored
Microbiology of Ventilator-Associated Pneumonia
Ventilator-associated pneumonia (VAP) is a pulmonary infection that appears after 2 days of endotracheal intubation and when invasive mechanical ventilation is used. VAP is considered the most common nosocomial infection in the intensive care unit (ICU) and presents high morbidity and mortality rates, principally when caused by multi-resistant bacteria. Several risk factors are associated with VAP, including the microbiota, advanced age, immunocompromising conditions, pulmonary illness, length of mechanical ventilation, the aspiration technique, tracheostomy, supine positioning, enteral feeding, previous antibiotic exposure, among other endogenous and exogenous factors. The main pathogens are Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacteriaceae members, which are considered potentially multidrug-resistant pathogens. Conventional microbiology methods continue to be used for laboratory diagnosis. However, it is necessary to validate rapid and accurate laboratory methods, such as molecular assays that detect multiple gene sequences of a wide range of bacterial species and resistance markers. Therefore, the objective of this chapter is to review and update several aspects related to VAP, including risk factors, etiology, laboratory diagnosis, bacterial virulence and VAP severity, and antibiotic susceptibility.
Part of the book: Contemporary Topics of Pneumonia