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Ventilator-Associated Pneumonia: Sensitivity and Specificity

Introduction: This reflects the clinical entity of a pneumonia developing while a patient is on a ventilator (not a Community-Acquired Pneumonia). Thus, this will occur after the patient has been on the ventilator for days, not as the initial presenting disease.

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Tags: Infection Pulmonary Tag this Diagnosis.

The sensitivity and specificity of findings for Ventilator-Associated Pneumonia are listed below. See the left navigation bar to change the display.

Specific Findings

Finding SensitivitySpecificity Comments, Study
Air Bronchogram
Duplicate Edit
16.9%95.6%

'single air bronchogram' on CXR

Study: JAMA. 2007 Apr 11;297(14):1583-93. PMID: 17426278

Bronchial Aspirate Culture Edit 60.7%93.7%

blind bronchial aspirate culture >10^5 CFU/ml

Study: JAMA. 2007 Apr 11;297(14):1583-93. PMID: 17426278

Sensitive Findings

Finding SensitivitySpecificity Comments, Study
Neutrophilic BAL Edit Sensitivity = 95%

>50% neutrophils in BAL fluid

specificity varied from 38% to 94% in two studies.

Study: JAMA. 2007 Apr 11;297(14):1583-93. PMID: 17426278

Negative Findings

Finding SensitivitySpecificity Comments, Study
Atelectasis Edit 23.3%69.7%

on CXR

Study: JAMA. 2007 Apr 11;297(14):1583-93. PMID: 17426278

Poorly Diagnostic Findings

Finding SensitivitySpecificity Comments, Study
Fever, Leukocytosis, and Purulent Sputum Edit 69.1%75.3%

at least 2 of fever, leukocytosis, and purulent sputum

from one study

Study: JAMA. 2007 Apr 11;297(14):1583-93. PMID: 17426278

BAL Culture Edit 49.7%64.5%

>10^4 CFU/ml

Study: JAMA. 2007 Apr 11;297(14):1583-93. PMID: 17426278

Fever Edit 49.4%58.8%

Study: JAMA. 2007 Apr 11;297(14):1583-93. PMID: 17426278

Air Bronchogram
Duplicate Edit
83%58.5%

single or multiple air bronchograms

Study: JAMA. 2007 Apr 11;297(14):1583-93. PMID: 17426278

Leukocytosis Edit 60.4%53.6%

Study: JAMA. 2007 Apr 11;297(14):1583-93. PMID: 17426278

Hypoxemia Edit 52.1%52.6%

Study: JAMA. 2007 Apr 11;297(14):1583-93. PMID: 17426278

Chest X-Ray Edit 81.9%51.9%

new infiltrate on CXR

Study: JAMA. 2007 Apr 11;297(14):1583-93. PMID: 17426278

Intracellular Bacteria in BAL Edit 50%50%

presence of intracellular bacteria in neutrophils in BAL

Study: JAMA. 2007 Apr 11;297(14):1583-93. PMID: 17426278

Purulent Sputum Edit 72%45%

Study: JAMA. 2007 Apr 11;297(14):1583-93. PMID: 17426278