Comparison between the Clinical Pulmonary Infection Score and Modified Centre for Disease Control Criteria for Diagnosis of Ventilator-associated Pneumonia: A Cross-sectional Study
Introduction: Ventilator-Associated Pneumonia (VAP) is a frequent complication of Mechanical Ventilation (MV). The incidence of VAP is not precisely known and ranges from 13 to 51 per 1,000 ventilator days. A uniform surveillance definition for VAP is not available. The Centre for Disease Control (C...
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JCDR Research and Publications Private Limited
2025-06-01
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| author | Aniket Debnath Saikat Batabyal Sumit Roy Tapadar Arunabha Datta Chaudhuri |
| author_facet | Aniket Debnath Saikat Batabyal Sumit Roy Tapadar Arunabha Datta Chaudhuri |
| author_sort | Aniket Debnath |
| collection | DOAJ |
| description | Introduction: Ventilator-Associated Pneumonia (VAP) is a frequent complication of Mechanical Ventilation (MV). The incidence of VAP is not precisely known and ranges from 13 to 51 per 1,000 ventilator days. A uniform surveillance definition for VAP is not available. The Centre for Disease Control (CDC)/National Healthcare Safety Network (NHSN) and the Clinical Pulmonary Infection Score (CPIS) algorithms are widely used.
Aim: To compare the modified CDC criteria and the CPIS algorithm for VAP.
Materials and Methods: A cross-sectional study was conducted at the respiratory care unit of the Department of Respiratory Medicine at RG Kar Medical College and Hospital in Kolkata, West Bengal, India, over a period of 18 months, from January 2021 to June 2022. A total of 60 adult patients on MV for more than 48 hours, with a high index of suspicion for VAP, clinically and radiologically, were included in this study. The microbiological (bacteriological quantitative culture) and radiological profiles {CXR parenchymal opacities, Ultrasonography (USG) and Contrast-Enhanced Computed Tomography (CECT) thorax} of VAP infections were assessed and compared. Statistical analysis was conducted after entering the data into a Microsoft Excel spreadsheet.
Results: Among the 60 patients, most were male (76.67%) and aged between 51 and 60 years (40%). A total of 48 (80%) patients had a positive CPIS score, while 42 (70%) had positive modified CDC criteria. A fair degree of concordance was found between the two algorithms. Pseudomonas was the most common organism identified in both early and late-onset VAP. Among all antibiotics, Polymyxin B was found to be sensitive to all the organisms.
Conclusion: The VAP is the most frequent infection associated with Intensive Care Unit (ICU) admissions. Polymicrobial aetiology and MDR strains were found in a significant number of cases. In the present study, the CPIS criteria demonstrated a fair concordance with the modified CDC criteria and slightly better sensitivity than the modified CDC criteria in diagnosing VAP. |
| format | Article |
| id | doaj-art-9dea093ea2b240d1badb69a68ce34e37 |
| institution | DOAJ |
| issn | 2249-782X 0973-709X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | JCDR Research and Publications Private Limited |
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| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj-art-9dea093ea2b240d1badb69a68ce34e372025-08-20T03:20:55ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2025-06-01196OC12OC1610.7860/JCDR/2025/74334.21103Comparison between the Clinical Pulmonary Infection Score and Modified Centre for Disease Control Criteria for Diagnosis of Ventilator-associated Pneumonia: A Cross-sectional StudyAniket Debnath0Saikat Batabyal1Sumit Roy Tapadar2Arunabha Datta Chaudhuri3Senior Resident, Department of Respiratory Medicine, Calcutta National Medical College, Kolkata, West Bengal, India.Assistant Professor, Department of Respiratory Medicine, Burdwan Medical College, Burdwan, West Bengal, India.Associate Professor, Department of Respiratory Medicine, R.G. Kar Medical College, Kolkata, West Bengal, India.Professor, Department of Pulmonary Medicine, R.G. Kar Medical College, Kolkata, West Bengal, India.Introduction: Ventilator-Associated Pneumonia (VAP) is a frequent complication of Mechanical Ventilation (MV). The incidence of VAP is not precisely known and ranges from 13 to 51 per 1,000 ventilator days. A uniform surveillance definition for VAP is not available. The Centre for Disease Control (CDC)/National Healthcare Safety Network (NHSN) and the Clinical Pulmonary Infection Score (CPIS) algorithms are widely used. Aim: To compare the modified CDC criteria and the CPIS algorithm for VAP. Materials and Methods: A cross-sectional study was conducted at the respiratory care unit of the Department of Respiratory Medicine at RG Kar Medical College and Hospital in Kolkata, West Bengal, India, over a period of 18 months, from January 2021 to June 2022. A total of 60 adult patients on MV for more than 48 hours, with a high index of suspicion for VAP, clinically and radiologically, were included in this study. The microbiological (bacteriological quantitative culture) and radiological profiles {CXR parenchymal opacities, Ultrasonography (USG) and Contrast-Enhanced Computed Tomography (CECT) thorax} of VAP infections were assessed and compared. Statistical analysis was conducted after entering the data into a Microsoft Excel spreadsheet. Results: Among the 60 patients, most were male (76.67%) and aged between 51 and 60 years (40%). A total of 48 (80%) patients had a positive CPIS score, while 42 (70%) had positive modified CDC criteria. A fair degree of concordance was found between the two algorithms. Pseudomonas was the most common organism identified in both early and late-onset VAP. Among all antibiotics, Polymyxin B was found to be sensitive to all the organisms. Conclusion: The VAP is the most frequent infection associated with Intensive Care Unit (ICU) admissions. Polymicrobial aetiology and MDR strains were found in a significant number of cases. In the present study, the CPIS criteria demonstrated a fair concordance with the modified CDC criteria and slightly better sensitivity than the modified CDC criteria in diagnosing VAP.https://jcdr.net/articles/PDF/21103/74334_CE[Ra1]_F(IS)_QC(AN_SS)_PF1(RI_SS)_redo_PFA_NC(IS)_PN(IS).pdfintensive care unit infectionlung infection scorepseudomonas |
| spellingShingle | Aniket Debnath Saikat Batabyal Sumit Roy Tapadar Arunabha Datta Chaudhuri Comparison between the Clinical Pulmonary Infection Score and Modified Centre for Disease Control Criteria for Diagnosis of Ventilator-associated Pneumonia: A Cross-sectional Study Journal of Clinical and Diagnostic Research intensive care unit infection lung infection score pseudomonas |
| title | Comparison between the Clinical Pulmonary Infection Score and Modified Centre for Disease Control Criteria for Diagnosis of Ventilator-associated Pneumonia: A Cross-sectional Study |
| title_full | Comparison between the Clinical Pulmonary Infection Score and Modified Centre for Disease Control Criteria for Diagnosis of Ventilator-associated Pneumonia: A Cross-sectional Study |
| title_fullStr | Comparison between the Clinical Pulmonary Infection Score and Modified Centre for Disease Control Criteria for Diagnosis of Ventilator-associated Pneumonia: A Cross-sectional Study |
| title_full_unstemmed | Comparison between the Clinical Pulmonary Infection Score and Modified Centre for Disease Control Criteria for Diagnosis of Ventilator-associated Pneumonia: A Cross-sectional Study |
| title_short | Comparison between the Clinical Pulmonary Infection Score and Modified Centre for Disease Control Criteria for Diagnosis of Ventilator-associated Pneumonia: A Cross-sectional Study |
| title_sort | comparison between the clinical pulmonary infection score and modified centre for disease control criteria for diagnosis of ventilator associated pneumonia a cross sectional study |
| topic | intensive care unit infection lung infection score pseudomonas |
| url | https://jcdr.net/articles/PDF/21103/74334_CE[Ra1]_F(IS)_QC(AN_SS)_PF1(RI_SS)_redo_PFA_NC(IS)_PN(IS).pdf |
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