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editorial
. 2011 Mar 17;30(4):361–374. doi: 10.1016/j.healun.2011.01.701

Table 2.

Infections Associated With Ventilation or Endobronchial Stents

Infection Signs/symptoms Radiology Microbiology Histopathologic evidence
Ventilator-associated pneumonia (non-invasive or invasive ventilation); patient on ventilator for at least 48 hours continuously

  • At least one of the following:

  •  • Fever >38oC or hypothermia <36.5oC with no other recognized cause

  •  • Leukopenia (<4,000 WBC/mm3) or leukocytosis (≥11,000 WBC/mm3)

  • And at least two of the following:

  •  • New-onset purulent sputum OR change in character/quantity of sputum OR increased respiratory secretions suctioned

  •  • New-onset or worsening pleural rub, rales OR bronchial breath sounds

  •  • Worsening gas exchange (O2 desaturations, PaO2/FIO2 ≤240, increased O2 requirements, increased ventilation demands)

  • Two or more serial chest radiographs showing new/progressive infiltrate or consolidation OR one CT scan with at least one of the following:

  •  • New/progressive and persistent infiltrate

  •  • Consolidation

  •  • Cavitation

  • At least one of the following:

  •  • Positive respiratory culture (sputum, bronchial secretions, BAL, bronchial protected sterile brushing).

  •  • ≥5% BAL-obtained cells containing intracellular bacteria on direct microscopic exam.

  • Histology (biopsy showing histologic evidence of pneumonia OR positive culture from the sterile tissue ALONE

  • Endobronchial stent associated:

  • • Tracheobronchitis

  • • Bronchial anastomotic infection

  • • Pneumonia

  • At least one of the following:

  •  • New-onset purulent sputum OR change in character/quantity of sputum OR increased respiratory secretions suctioned

  •  • New-onset or worsening cough, dyspnea, tachypnea OR pleural rub, rales OR bronchial breath sounds

  • AND endobronchial lesions restricted to the extent of endobrochial stent with or without involvement of anastomosis or other parts of bronchial tree or lung parenchyma

  • Chest radiograph without:

  •  • New or progressive and persistent infiltrate

  •  • Consolidation

  •  • Cavitation

  •  • Nodules

  • OR CT scan without:

  •  • New or progressive and persistent infiltrate

  •  • Consolidation

  •  • Cavitation

  •  • Nodules

  •  • Positive respiratory culture (sputum, bronchial secretions, BAL, bronchial protected sterile brushing)

  •  • ≥5% BAL-obtained cells containing intracellular bacteria on direct microscopic exam

  •  • Positive culture for mold/yeast

  •  • OR positive PCR for mold /yeast

  •  • OR positive GM in the BAL

  • OR at least TWO positive sputum cultures/PCRs of fungal organisms (including Candida species)

 Not applicable