• A Sachdev, K Chugh, M Sethi, D Gupta, C Wattal, and G Menon.
• Department of Pediatrics, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi 110 060, India. anilcriticare@hotmail.com
• Indian Pediatr. 2011 Dec 1; 48 (12): 949-54.

BackgroundThere is a need to validate and suggest easy clinical method for diagnosis of ventilator-associated pneumonia (VAP) in developing countries.ObjectivesTo validate the use of simplified Clinical Pulmonary Infection Score (CPIS) for the diagnosis of VAP.DesignProspective study.SettingPediatric intensive care unit of a tertiary care teaching hospital.Subjects30 children receiving mechanical ventilation for more than 48 hours and with simplified CPIS=6.MethodsAll patients underwent flexible bronchoscopy to obtain bronchoalveolar lavage which was analyzed quantitatively. Colony count = 10(4) cfu/mL was considered reference standard for definite VAP.ResultsOf the five variables used for simplified CPIS, only patients temperature (P=0.013) and PaO2/FiO2 ratio were significant (P<0.001) to differentiate the presence of definite VAP. Patients with definite VAP (BAL colony count = 10(4) cfu/mL) had CPIS of 8.4 while in no definite VAP group it was 6.4 (P=0.007). CPIS of 8 was found to have sensitivity of 80%, specificity 80%, PPV 86.9%, NPV 70.5% and accuracy 80%. The area under Receiver operating characteristic curve of CPIS against reference standard was 0.81± 0.069 (P=0.001).ConclusionSimplified CPIS is useful in patients on mechanical ventilation to diagnose ventilator-associated pneumonia.

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