ABSTRACT
Mechanically ventilated patients are 6-21 times more likely to develop nosocomial
pneumonia. It is estimated that between 6% and 52% of ventilated patients develop
ventilator-associated pneumonia (VAP) with attributable mortality of 27-51%. Certain
high risk organisms carry higher mortality (e.g., Pseudomonas aeruginosa and Acinetobacter spp.). Aspiration of colonized orodigestive secretions is the commonly recognized
route of infection, whereas inhalation of contaminated aerosol hematogenous spread
and direct infection are less common. Gram-negative pathogens are responsible for
40-60% of VAP, whereas gram-positive pathogens cause 15-20%, and it is commonly polymicrobial.
Diagnosis remains difficult, and studies showed that early appropriate treatment can
improve patient outcome. Better understanding of the pathogenesis and risk factors
is important for implementing more effective infection control measures. Clinical
trials evaluating outcome will help in assessing current and future preventive and
therapeutic measures.
KEYWORD
Intensive care unit - mechanical ventilation - ventilator-associated pneumonia
