{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T05:20:18Z","timestamp":1780982418108,"version":"3.54.1"},"reference-count":64,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Respir Crit Care Med"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Nosocomial pneumonia, including hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), are the most common nosocomial infections occurring in critically ill patients requiring intensive care. However, challenges exist in making a timely and accurate diagnosis of HAP and VAP. Under diagnosis of HAP and VAP can result in greater mortality risk, especially if accompanied by delays in the administration of appropriate antimicrobial treatment. Over diagnosis of HAP and VAP results in the unnecessary administration of broad spectrum antibiotics that can lead to further escalation of antibiotic resistance. Optimal diagnosis and management of HAP and VAP require a systematic approach that combines clinical and radiographic assessments along with proper microbiologic techniques. The use of more invasive sampling methods (bronchoalveolar lavage and protected specimen brush) may enhance specimen collection resulting in more specific diagnoses to limit unnecessary antibiotic exposure. Molecular techniques, currently in use and investigational technique, may improve the diagnosis of HAP and VAP by allowing more rapid identification of offending pathogens, if present, thus increasing both appropriate antibiotic treatment and avoiding unnecessary drug exposure.<\/jats:p>","DOI":"10.1055\/s-0041-1739359","type":"journal-article","created":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T23:48:40Z","timestamp":1642549720000},"page":"219-228","source":"Crossref","is-referenced-by-count":5,"title":["Classical and Molecular Techniques to Diagnose HAP\/VAP"],"prefix":"10.1055","volume":"43","author":[{"given":"Cherie","family":"Renaud","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marin H.","family":"Kollef","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,1,18]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"2370","DOI":"10.1016\/j.chest.2020.06.034","article-title":"PROPHETIC: Prospective Identification of Pneumonia in Hospitalized Patients in the ICU","volume":"158","author":"S P Bergin","year":"2020","journal-title":"Chest"},{"issue":"15","key":"ref2","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.1001\/jama.2020.2717","article-title":"Prevalence and outcomes of infection among patients in intensive care units in 2017","volume":"323","author":"J L Vincent","year":"2020","journal-title":"JAMA"},{"issue":"18","key":"ref3","doi-asserted-by":"crossref","first-page":"1732","DOI":"10.1056\/NEJMoa1801550","article-title":"Changes in prevalence of health care-associated infections in U.S. hospitals","volume":"379","author":"S S Magill","year":"2018","journal-title":"N Engl J Med"},{"issue":"13","key":"ref4","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1056\/NEJMoa1306801","article-title":"Multistate point-prevalence survey of health care-associated infections","volume":"370","author":"S S Magill","year":"2014","journal-title":"N Engl J Med"},{"issue":"05","key":"ref5","doi-asserted-by":"crossref","first-page":"e61","DOI":"10.1093\/cid\/ciw353","article-title":"Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the infectious Diseases Society of America and the American Thoracic Society","volume":"63","author":"A C Kalil","year":"2016","journal-title":"Clin Infect Dis"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"1700582","DOI":"10.1183\/13993003.00582-2017","article-title":"International ERS\/ESICM\/ESCMID\/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia: Guidelines for the management of hospital-acquired pneumonia (HAP)\/ventilator-associated pneumonia (VAP) of the European Respiratory Society (ERS), European Society of Intensive Care Medicine (ESICM), European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and Asociaci\u00f3n Latinoamericana del T\u00f3rax (ALAT)","volume":"50","author":"A Torres","year":"2017","journal-title":"Eur Respir J"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"177S","DOI":"10.1378\/chest.117.4_suppl_2.177S","article-title":"Evidence-based assessment of diagnostic tests for ventilator-associated pneumonia. 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