Table 1.

Published diagnostic criteria for VAP

VAP criteria	Inflammatory marks	Sputum	Chest radiography/LUS	Microbiologic or histopathology marks	PEEP/FiO2
CDC criteria [11]	Temperature >38 °C, or >36 °C, or WBC ≥12,000 or ≤4000 cells/mm3 and new antimicrobial agent is started for ≥4 days	Purulent respiratory secretions		Microbiologic quantitative-positive Endotracheal aspirate ≥105 CFU/mL Broncho-alveolar lavage ≥104 CFU/mL Protected specimen brush ≥103 CFU/mL or histological-positive Lung tissue ≥104 CFU/g or positive for Legionella, influenza virus, RSV, adenovirus, or parainfluenza	After a period of stability or improvement on the ventilator, Minimum daily FiO2 increase to 0.20 remain for 2 d or daily PEEP values increase to 3 cm H2O
CPIS (a score of 6 is suggestive of VAP) [12]	Temperature 38.5–38.9 °C = 1 point; ≥39 or <36.5 °C = 2 points WBC <4000 or >11,000/mm3 = 1 point	Non-purulent respiratory secretions = 1 point; purulent respiratory secretions = 2 points	Chest radiography Diffuse infiltrate = 1 point Localized infiltrate = 2 points Progressive infiltrate (without cardiac disease or ARDS) = 2 points	Moderate or heavy microbiologic quantitative or heavy microbiologic quantitative-positive = 1 point Microbiologic quantitative-positive and same pathogenic bacteria seen on Gram stain = 2 points	PaO2/FiO2 ≤ 240 without ARDS = 2 points
CEPPIS (a score of 5 is suggestive of VAP) [12]	Temperature 38.5–38.9 °C = 1 point; ≥39 or <36.5 °C = 2 points Procalcitonin (ng/mL) ≥0.5 and <1 = 1 point; ≥1 = 2 points	Non-purulent respiratory secretions = 1 point; purulent respiratory secretions = 2 points	LUS-positive (sub-pleural echo-poor region or more with tissue-like echo texture) = 2 points	Microbiologic culture-positive = 2 points	PaO2/FiO2 ≤ 240 without ARDS = 2 points
CHEST [13]	Temperature >38 °C WBC <4000/mc3 or >12,000/mm3	Purulent respiratory secretions	Chest radiography New or progressive consolidation
Johanson criteria [14]	Temperature >38 °C WBC <12,000/mc3	Purulent respiratory secretions	Chest radiography New or progressive radiographic infiltrate

ARDS acute respiratory distress syndrome, CDC Centers for Disease Control and Prevention, CEPPIS Chest Echography and Procalcitonin Pulmonary Infection Score, CHEST American College of Chest Physicians, CPIS Clinical Pulmonary Infection Score, FiO ₂ fraction of inspired oxygen, PaO₂, PEEP positive end expiratory pressure, RSV respiratory syncytial virus, WBC white blood cell