VAP - Ventilator Associated Pneumonia: Difference between revisions

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=== Pathogen exclusion list ===

*Normal respiratory ~~flora~~, ~~normal oral flora, mixed respiratory flora, mixed oral flora~~, ~~altered oral flora or any other similar results indicating isolation of commensal flora~~ of ~~the oral cavity or upper respiratory tract.~~

The following organisms are excluded because they are common upper respiratory tract commensurable, colonizers or contaminants, and are unusual causes of VAP.

*Candida Species (specified or unspecified)

*[[VAP~~#Yeast_in_Sputum_~~.~~26_VAP | YEAST]] not otherwise specified~~

*coagulase-negative staphyllococcus species (specified or unspecified) '''except [[Staphylococcus aureus]] including [[MRSA]]'''

*Enterococcus species (specified or unspecified)

If the ~~pathogen is isolated from cultures of~~: ~~LUNG TISSUE~~ or ~~PLEURAL FLUID, these organisms~~ '''~~MAY BE~~''' ~~reported as Possible or Probable VAP pathogens.~~

* Normal respiratory flora, normal oral flora, mixed respiratory flora, mixed oral flora, altered oral flora or any other similar results indicating isolation of commensal flora of the oral cavity or upper respiratory tract.

~~These organisms are excluded because they are common upper respiratory tract commensals, colonizers~~ or ~~contaminants, and are unusual causes of VAP.~~

* Candida Species (specified or unspecified)

* [[:Category:Yeast/fungus | Yeast]] (might be a [[HAP]] or [[CAP]])

* coagulase-negative staphyllococcus species (specified or unspecified) '''except [[Staphylococcus aureus]] including [[MRSA]]'''

* Enterococcus species (specified or unspecified)

Patients might be treated for infection with these pathogens, but we should still not code them as VAP. In that case you might be able to code it as a [[HAP]].

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MRSA '''colonized''' can be coded VAP if all other criteria are met and MRSA is cultured in their endotracheal secretions. They are not excluded because of previous colonization.

~~==== [[:Category:Yeast/fungus | Yeast]] in Sputum & VAP ====~~

Sputum +ve yeast: '''Do not code as a yeast associated VAP'''. This is considered to be colonization unless ''treated specifically.'''Not a VAP if yeast also at other sites; so basically don’t ever code as a cause of VAP or pneumonia.

As a general rule, yeast does not cause pneumonia at all except in immunosuppressed patients in which case they have disseminated infection with yeast at many sites (ie multiple sites other than lung will be positive).-Posted by [[User:TOstryzniuk|Trish Ostryzniuk]] 12:09, 2012 October 4 (CDT), on behalf of Dr. Kumar and reviewed by Dr. Olafson.

[[Category:Yeast/fungus]]

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 === Pathogen exclusion list ===
-*Normal respiratory flora, normal oral flora, mixed respiratory flora, mixed oral flora, altered oral flora or any other similar results indicating isolation of commensal flora of the oral cavity or upper respiratory tract.
+The following organisms are excluded because they are common upper respiratory tract commensurable, colonizers or contaminants, and are unusual causes of VAP.
-*Candida Species (specified or unspecified)
-*[[VAP#Yeast_in_Sputum_.26_VAP | YEAST]] not otherwise specified
-*coagulase-negative staphyllococcus species (specified or unspecified) '''except [[Staphylococcus aureus]] including [[MRSA]]'''
-*Enterococcus species (specified or unspecified)
-If the pathogen is isolated from cultures of:  LUNG TISSUE or PLEURAL FLUID, these organisms '''MAY BE''' reported as Possible or Probable VAP pathogens.
+* Normal respiratory flora, normal oral flora, mixed respiratory flora, mixed oral flora, altered oral flora or any other similar results indicating isolation of commensal flora of the oral cavity or upper respiratory tract.
-These organisms are excluded because they are common upper respiratory tract commensals, colonizers or contaminants, and are unusual causes of VAP.
+* Candida Species (specified or unspecified)
+* [[:Category:Yeast/fungus | Yeast]] (might be a [[HAP]] or [[CAP]])
+* coagulase-negative staphyllococcus species (specified or unspecified) '''except [[Staphylococcus aureus]] including [[MRSA]]'''
+* Enterococcus species (specified or unspecified)
 Patients might be treated for infection with these pathogens, but we should still not code them as VAP. In that case you might be able to code it as a [[HAP]].
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 MRSA '''colonized''' can be coded VAP if all other criteria are met and MRSA is cultured in their endotracheal secretions. They are not excluded because of previous colonization.
-==== [[:Category:Yeast/fungus | Yeast]] in Sputum & VAP ====
-Sputum +ve yeast: '''Do not code as a yeast associated VAP'''.  This is considered to be colonization unless ''treated specifically.'''Not a VAP if yeast also at other sites; so basically don’t ever code as a cause of VAP or pneumonia.
-As a general rule, yeast does not cause pneumonia at all except in immunosuppressed patients in which case they have disseminated infection with yeast at many sites (ie multiple sites other than lung will be positive).-Posted by [[User:TOstryzniuk|Trish Ostryzniuk]] 12:09, 2012 October 4 (CDT), on behalf of Dr. Kumar and reviewed by Dr. Olafson.
 [[Category:Yeast/fungus]]