{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T10:07:05Z","timestamp":1742378825376},"reference-count":149,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Respir Crit Care Med"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Ventilator-associated pneumonia (VAP) is a common complication occurring in critically ill patients who are mechanically ventilated and is the leading cause of nosocomial infection-related death. Etiologic agents for VAP widely differ based on the population of intensive care unit patients, duration of hospital stay, and prior antimicrobial therapy. VAP due to multidrug-resistant pathogens is associated with the highest morbidity and mortality, likely due to delays in appropriate antimicrobial treatment. International guidelines are currently available to guide diagnostic and therapeutic strategies. VAP can be prevented through various pharmacological and non-pharmacological interventions, which are more effective when grouped as bundles. When VAP is clinically suspected, diagnostic strategies should include early collection of respiratory samples to guide antimicrobial therapy. Empirical treatment should be based on the most likely etiologic microorganisms and antibiotics likely to be active against these microorganisms. Response to therapy should be reassessed after 3 to 5 days and antimicrobials adjusted or de-escalated to reduce the burden of the disease. Finally, considering that drug resistance is increasing worldwide, several novel antibiotics are being tested to efficiently treat VAP in the coming decades.<\/jats:p>","DOI":"10.1055\/s-0042-1749448","type":"journal-article","created":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T22:50:50Z","timestamp":1655506250000},"page":"426-439","source":"Crossref","is-referenced-by-count":1,"title":["Nosocomial Pneumonia in the Mechanically Ventilated Patient"],"prefix":"10.1055","volume":"43","author":[{"given":"Jonathon","family":"Fanning","sequence":"additional","affiliation":[{"name":"Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia"},{"name":"Faculty of Medicine, University of Queensland, Brisbane, Australia"},{"name":"Intensive Care Unit, Royal Brisbane and Women's Hospital, Queensland, Australia"},{"name":"Intensive Care Unit, St Andrew's War Memorial Hospital, Queensland, Australia"},{"name":"Nuffield Department of Population Health, Oxford University, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Panigada","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Intensive Care and EmergencyFondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluigi","family":"Li Bassi","sequence":"additional","affiliation":[{"name":"Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia"},{"name":"Faculty of Medicine, University of Queensland, Brisbane, Australia"},{"name":"Intensive Care Unit, St Andrew's War Memorial Hospital, Queensland, Australia"},{"name":"Queensland University of Technology, Brisbane, Australia"},{"name":"Intensive Care Unit, The Wesley Hospital, Auchenflower, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,6,17]]},"reference":[{"issue":"05","key":"ref1","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":"ref2","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"},{"issue":"12","key":"ref3","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1164\/rccm.201001-0094OC","article-title":"Nosocomial pneumonia in the intensive care unit acquired by mechanically ventilated versus nonventilated patients","volume":"182","author":"M Esperatti","year":"2010","journal-title":"Am J Respir Crit Care Med"},{"issue":"09","key":"ref4","doi-asserted-by":"crossref","first-page":"2151","DOI":"10.1097\/CCM.0b013e31828a674a","article-title":"Validation of predictors of adverse outcomes in hospital-acquired pneumonia in the ICU","volume":"41","author":"M Esperatti","year":"2013","journal-title":"Crit Care Med"},{"issue":"06","key":"ref5","first-page":"725","article-title":"The pathogenesis of ventilator-associated pneumonia: its relevance to developing effective strategies for prevention","volume":"50","author":"N Safdar","year":"2005","journal-title":"Respir Care"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1007\/BF00255791","article-title":"Early onset pneumonia: a multicenter study in intensive care units","volume":"13","author":"M Langer","year":"1987","journal-title":"Intensive Care Med"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.jinf.2014.10.004","article-title":"Resistance patterns and outcomes in intensive care unit (ICU)-acquired pneumonia. 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