{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T01:11:20Z","timestamp":1771636280694,"version":"3.50.1"},"reference-count":34,"publisher":"European Respiratory Society (ERS)","issue":"4","license":[{"start":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T00:00:00Z","timestamp":1630540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.ersjournals.com\/user-licence"}],"funder":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Respiratorias"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2021,8,12]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Ventilator-associated pneumonia (VAP) is a leading infectious cause of morbidity in critically ill patients, yet current guidelines offer no indications for follow-up cultures. We aimed to evaluate the role of follow-up cultures and microbiological response 3\u2005days after diagnosing VAP as predictors of short- and long-term outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective analysis of a cohort prospectively collected from 2004 to 2017. VAP was diagnosed based on clinical, radiographical and microbiological criteria. For microbiological identification, a tracheobronchial aspirate was performed at diagnosis and repeated after 72\u2005h. We defined three groups when comparing the two tracheobronchial aspirate results: persistence, superinfection and eradication of causative pathogens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>157 patients were enrolled in the study, among whom microbiological persistence, superinfection or eradication was present in 67 (48%), 25 (16%) and 65 (41%), respectively, after 72\u2005h. Those with superinfection had the highest mortalities in the intensive care unit (p=0.015) and at 90\u2005days (p=0.036), while also having the fewest ventilator-free days (p=0.019). Multivariable analysis revealed shock at VAP diagnosis (OR 3.43, 95% CI 1.25\u20139.40),<jats:italic>Staphylococcus aureus<\/jats:italic>isolation at VAP diagnosis (OR 2.87, 95% CI 1.06\u20137.75) and hypothermia at VAP diagnosis (OR 0.67, 95% CI 0.48\u20130.95, per +1\u00b0C) to be associated with superinfection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our retrospective analysis suggests that VAP short- and long-term outcomes may be associated with superinfection in follow-up cultures. Follow-up cultures may help guide antibiotic therapy and its duration. Further prospective studies are necessary to verify our findings.<\/jats:p><\/jats:sec>","DOI":"10.1183\/13993003.00620-2021","type":"journal-article","created":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T14:31:11Z","timestamp":1630593071000},"page":"2100620","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Prediction of ventilator-associated pneumonia outcomes according to the early microbiological response: a retrospective observational 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