. 2018 Feb;17(2):110–116.

Table 1.

VAP definition

VAP two-stage Definition
Clinical VAP Definition	Microbiological VAP Definition
Radiological changes: A chest x-ray or computed tomography scan suggestive of pneumonia (2 or more required for patients with underlying cardiac or pulmonary disease) and at least one of the following Systematic inflammation including white cell count of >10000/mm³ or <4000/mm³ Or Temperature >380C with no other cause and at least one of the following (Two required if microbiology is by qualitative endotracheal aspirate culture or if cultures are negative). Clinical pulmonary signs: New onset of purulent sputum or change in character (color, odor, consistency or quantity) Or a cough or dyspnea or tachypnea Or Auscultatory findings (rales, bronchial breathing, ronchi, wheeze) Or Worsening gas exchange (including desaturation, increasing FiO₂ or ventilator requirement.	Bacteriologic confirmation: Either Positive quantitative culture from minimally contaminated lower respiratory tract samples (including growth at>10⁴ CFU/ml from bronchoalveolar lavage (BAL) cultures) Or positive blood cultures without another source, positive pleural fluid culture, pleural or pulmonary abscess with culture-positive needle aspirate, histological evidence of pneumonia, non-culture methods of detection (legionella antigen, viral PCR) Or The positive qualitative culture of endotracheal aspirates or non-directed mini-BAL, negative cultures meeting clinical criteria above is recorded as “clinical VAP”.

VAP two-stage Definition

Clinical VAP Definition

Microbiological VAP Definition

Radiological changes: A chest x-ray or computed tomography scan suggestive of pneumonia (2 or more required for patients with underlying cardiac or pulmonary disease) and at least one of the following Systematic inflammation including white cell count of >10000/mm³ or <4000/mm³
Or
Temperature >380C with no other cause and at least one of the following (Two required if microbiology is by qualitative endotracheal aspirate culture or if cultures are negative). Clinical pulmonary signs: New onset of purulent sputum or change in character (color, odor, consistency or quantity)
Or
a cough or dyspnea or tachypnea
Or
Auscultatory findings (rales, bronchial breathing, ronchi, wheeze)
Or
Worsening gas exchange (including desaturation, increasing FiO₂ or ventilator requirement.

Bacteriologic confirmation:
Either
Positive quantitative culture from minimally contaminated lower respiratory tract samples (including growth at>10⁴ CFU/ml from bronchoalveolar lavage (BAL) cultures)
Or
positive blood cultures without another source, positive pleural fluid culture, pleural or pulmonary abscess with culture-positive needle aspirate, histological evidence of pneumonia, non-culture methods of detection (legionella antigen, viral PCR)
Or
The positive qualitative culture of endotracheal aspirates or non-directed mini-BAL, negative cultures meeting clinical criteria above is recorded as “clinical VAP”.