Does this patient have VAP?

International audienceVentilator-associated pneumonia (VAP) is the most frequent intensive care unit (ICU)-acquired infection among patients on mechanical ventilation (MV). Because VAP leads to substantial antibiotic use and is associated with increased morbidity, prolonged MV and higher mortality rates, its diagnosis is of paramount importance, with two major objectives [1, 2]: first, to immediately recognize patients with true VAP versus an extrapulmonary bacterial infection, in order to start effective antibiotics against the causative microorganisms as soon as possible; second, to avoid overusing antibiotics in patients with only proximal airway colonization and no ongoing bacterial infection. Epidemiological results have clearly demonstrated that indiscriminate antimicrobial use in ICU patients can have immediate and long-term consequences, which contribute to the emergence of multiresistant pathogens and increase the risk of serious superinfections [3–5]