Table 4

Comparison of VAP surveillance criteria

Australian and New Zealand-developed checklist itemsCDC/NHSN-developed three-tiered elements33
1. PaO2/FiO2 ratio ≤300 mm Hg: decreased gas exchange in past 24 h (no cardiogenic pulmonary oedema/pulmonary disease)Increased daily FiO2 increases of ≥0.2 or PEEP values ≥3 cm H2O)=VAC
4. Inflammatory response: ≥1 of the following (when no immunocompromise)On or after day 3 of MV and within 2 calendar days of worsening oxygenation:
A. New/persistent ↑ temperature ≥38°C> 38°C orand new antimicrobials started=IVAC
B. WCC ≤4 or ≥12 cells 109/L for 2 daysWCC ≤4 or ≥12 109/L
C. Elevated C reactive protein (>100 mg/L) or procalcitonin (>2.5 ng/L)NA
5. Microbial growth: >25 neutrophils per low power field in tracheal secretionsPurulent respiratory secretions containing >25 neutrophils per low power field=VAP
2. Sputum changes: increased volume, or colour changes (yellow or green)NA
3. CXR infiltrates: new localised or diffuse infiltrates on single CXR (no cardiogenic pulmonary oedema/pulmonary disease)NA
  • CXR, chest X-ray; IVAC, infection-related ventilator-associated complication; MV, mechanical ventilation; NA, not applicable; PaO2/FiO2 ratio, arterial oxygen tension divided by fraction of inspired oxygen; PEEP, positive end-expiratory pressure; VAC, ventilator-associated condition; VAP, ventilator-associated pneumonia; WCC, white cell count.