Perpetual observational study of the clinical and microbiological epidemiology of ventilator-associated pneumonia in Europe
Authors' conclusion
In European ICUs, there is a considerable and heterogeneous incidence of VAP, with methicillin susceptible S. aureus most frequently identified as a causative pathogen. VAP is associated with poor clinical prognosis
Study context
- Population
- Adults in European intensive care units (ICUs) with expected invasive mechanical ventilation ≥48 h, August 2022–September 2024at risk of ventilator-associated pneumonia (VAP)
- Participants
- 3,446 adults
- Exposure
- VAP vs non-VAP patients
- VAPn = 590
- Outcome
- Incidence of VAP
Methodological detailsperpetual observational study, multicentre, 25 ICUs, 11 European countries, Followed until ICU discharge or 28 days after VAP diagnosis, Mortality calculated using cumulative incidence functions
- Perpetual observational study
- Multicentre
- 25 ICUs, 11 European countries
- Followed until ICU discharge or 28 days after VAP diagnosis
- Mortality calculated using cumulative incidence functions
Main finding
As reported in the abstract
VAP incidence
| Group | Value | Incidence rate per 1000 ventilator days |
|---|---|---|
| VAP | cumulative incidence 17.1% (95% CI 15.9%–18.4%) | 18.6 (95% CI 17.1-20.1) |
VAP
Valuecumulative incidence 17.1% (95% CI 15.9%–18.4%)
Incidence rate per 1000 ventilator days18.6 (95% CI 17.1-20.1)
- Cumulative incidence range between countries recruiting ≥100 patients
- 7.6% (Croatia)-29.6% (Romania)
Observational data: associations, not effects.
Further findings
IMV duration until first extubation · VAP: including ventilation before and after diagnosis
| Outcome | VAP | non-VAP |
|---|---|---|
| Microbiological documentation and pathogens | 60.8% | |
| Staphylococcus aureus | 26.2% | — not stated in the abstract |
| Haemophilus influenzae | 16.2% | — not stated in the abstract |
| Pseudomonas aeruginosa | 15.0% | — not stated in the abstract |
| ICU mortality (cumulative incidence) | 34.2% (95% CI 30.4%–38.0%) | 29.3% (95% CI 27.6%–30.9%) |
— not stated in the abstract
Antimicrobial resistance
- Methicillin resistance in S. aureus VAP
- 14 (18.2%) of 77
- Ceftazidime resistance, P. aeruginosa
- 10/46 (21.7%)
- Carbapenem resistance, P. aeruginosa
- 8/47 (17.0%)
VAP prevention measures
- Head-of-bed elevation (most widely implemented)
- 3207 patients, 93.1%
- No prevention measures
- 4 patients (0.1%)
Original publication
Perpetual observational study of the clinical and microbiological epidemiology of ventilator-associated pneumonia in Europe. Crit Care. Published 12 March 2026. doi:10.
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