A 65 year old woman was admitted to the ICU for management of septic shock associated with an infected hemodialysis catheter. She was initially intubated on hospital Day 1 with acute respiratory distress syndrome. She has slowly been improving such that her fraction of inspired oxygen has been weaned to 0.40,and she was no longer febrile or requiring vassopressors.
On hospital Day 7 ,however she develops a fever to 102.9 degree F with increased thick yellow green sputum in her endotracheal tube. We suspect patient has ventilator associated pneumonia.
Which of the following makes the VAP (Ventilator-associated pneumonia) in this patient?
A: An endotracheal aspirate yielding a new organism typical of VAP
B: Presence of New infiltrate on RADIOGRAPHS
C: Quantitative culture from a protected brush specimen yielding more than 10^3 organisms typical of VAP
D: There is No single set of criteria that is reliably diagnostic of pneumonia in ventilated patient.
ANSWER WILL BE POSTED SHORTLY.