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Ventilator-associated Pneumonia (VAP)

by
June 5, 2024


Although great care has been taken in the compilation and preparation of all directory entries to ensure accuracy, we cannot accept responsibility for any errors or omissions. Any medical information is provided for education/information purposes only and is not designed to replace medical advice by a qualified medical professional. Please see our disclaimer at the bottom of this entry.


What is a ventilator-associated pneumonia (VAP)?

A ventilator-associated pneumonia (VAP) is an infection of the lungs that develops in a patient who is on a ventilator. VAPs are healthcare-associated infections.

A ventilator is a machine that helps a patient breathe by giving oxygen through a tube. The tube may be placed in a patient’s mouth or nose, or through a hole in the front of the neck. The tube is connected to a ventilator. An infection may occur if microorganisms (such as bacteria or fungi) enter through the tube and reach the patient’s lungs.

Some VAPs (ventilator-associated pneumonias) may be difficult to treat due to the growing resistance of microorganisms to available antimicrobials. Consequently, VAPs are linked to higher mortality rates, increased healthcare costs, and longer hospital stays.

How do people get a VAP?

A ventilator may be needed when a patient is critically ill, or during and after surgery. Ventilators are life-saving machines, but they can also increase a patient’s risk of developing pneumonia.

Indeed, the tube breaches airway defences and impairs a cough, facilitating aspiration of secretions containing germs from the oropharynx and upper airways to the patient’s lungs, therefore causing a VAP.

What are the symptoms of a VAP?

Some of the common symptoms and signs of a VAP are represented by fever, increased respiratory rate or heart rate, low levels of oxygen in the blood (hypoxemia), increase in white blood cell count (leucocytosis), increased purulent secretions, and mental changes or confusion.

How is a VAP diagnosed?

Diagnosis of a VAP may be difficult. Physicians need a combination of a physical examination and diagnostic tests, such as imaging (chest x-ray) and laboratory tests.

In patients with suspected VAP, the doctors may decide to collect samples of lower respiratory tract secretions as well as blood. These samples are sent to the laboratory to grow the microorganism over time using a media on a petri dish (culture) and identify it. Then susceptibility tests can be carried out to determine which antimicrobials are most effective against it, to start the most appropriate antimicrobial therapy. Understanding which antimicrobials will work best is especially key to VAPs as resistance among respiratory pathogens is a constantly growing problem.

How is a VAP treated?

Guided by the physical examination and the results of diagnostic tests, physicians will determine the best treatment for each patient. Antimicrobials, such as antibiotics or antifungals, may be used to treat a VAP. The choice of antimicrobials depends on the type of infection, the microorganism responsible for the disease, and the results of susceptibility tests. VAPs are severe infections that require hospital treatment with intravenous antimicrobials (administered through a drip or tube) and additional therapies.

Unfortunately, due to the increasing resistance to available antimicrobials, VAPs are becoming increasingly difficult to treat, often necessitating combination therapy (the use of two or more antimicrobials).

What can caregivers do to help prevent a VAP?

Caregivers who take care of a patient on a ventilator can do the following things to help prevent a VAP:

• Ask healthcare providers to clean their hands before and after touching the patient or the ventilator. Remember: hand hygiene is our best protection against infections.
• Ask about raising the head of the patient’s bed.
• Ask when the patient will be allowed to try breathing on her or his own.
• Ask about how often healthcare providers clean the patient’s mouth.
• If you notice symptoms or signs of infection, call your doctor immediately.

Disclaimer: The information provided on this website is intended for educational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. Reliance on any information provided on this website is solely at your own risk. The website owners and authors are not responsible for any errors or omissions in the content or for any actions taken based on the information provided. It is recommended that you consult a qualified healthcare professional for individualised medical and health-related guidance.



Chris Shaffer

Chris Shaffer was a music, special education teacher, and high school principal for 45 years. At the end of his educational career, he was thrust into the world of AMR infections when a number of abdominal surgeries left him with an E-coli infection which failed to respond to antibiotics. After doctors in the USA left him with little hope for a cure, diminishing health, and a bleak prognosis, he set out on his own.

Chris found success in phage therapy at the Eliava Phage Therapy Center in Tbilisi, Georgia. With phage therapy giving Chris his life back, he has dedicated his retirement years to advocating for and helping raise awareness of phage therapy used for AMR infections. He tells the story of his phage journey in a book titled, Finding Phage: How I Partnered with a Friendly Virus to Cure My Deadly Bacterial Superinfection. His website, phagetherpyusa.com helps others learn to understand the healing power of phage therapy.

Demi Christofi

Demi is an Associate Scientific Director at a medical communications agency, with a background in microbiology and a longstanding focus on antimicrobial resistance. She holds an MSc in Microbiology, where she first became interested in the global challenge of resistance and the need to bring scientific understanding to wider audiences.

Demi’s career has centred on a simple but powerful belief: that how we communicate science matters. Her work focuses on making complex data clear, engaging, and accessible – whether for healthcare professionals, policy makers, or the patients most affected by infection and resistance. She has contributed to a wide range of AMR-focused projects, including educational programmes, congress communications and stewardship initiatives.

A central thread in Demi’s work is the importance of the patient voice. She is passionate about making sure real-world experiences of treatment failure, recurrent infections, and the anxiety surrounding resistance are not lost in the data. She believes that listening to patients and involving them meaningfully is essential for shaping more effective, human-centred responses to AMR.

Demi is also a strong advocate of the One Health approach, recognising AMR as a complex, interconnected issue that spans human health, animal health, and the environment. She is particularly drawn to efforts that move beyond siloed thinking and focus on practical, joined-up solutions.

In 2025, Demi joined The AMR Narrative as an Independent Advisor, where she supports the charity’s mission to centre communication, community, and inclusion in the global AMR response.

Outside of work, she is a Girlguiding unit leader and a qualified yoga teacher. These roles reflect her commitment to care, learning, and creating supportive spaces for others.

Andrea Hartley

Andrea has worked in health communications and campaigning for 3 decades. She is committed to fighting AMR through timely and appropriate communications globally,.

Andrea set up Skating Panda, the creative social and environmental impact consultancy, over a decade ago and drives its impact and growth. Focused on original and lasting public interest communications as well as issue strategy and advocacy, the Panda team has a track record of prompting tipping points in the status quo that drive better social and planetary outcomes.

Andrea’s combination of commercial marketing and development experience with deep issue knowledge have been sought by decision-makers at global summits, corporate and NGO board members, and have enabled her to set up multi-million fundraising platforms and push through policies that change and save lives. 

Andrea is Vice Chair of mothers2mothers, the world’s largest employer of women living with HIV, and a Board Director of Maymessy, a food poverty social enterprise.

A lifelong advocate for gender equality, she played a key role in establishing the UK’s Women’s Equality Party.

Esmita Charani

Professor Esmita Charani is a pharmacist and researcher investigating how we use antibiotics in different cultural and social contexts. She works with teams in the UK, India, and South Africa to develop research programmes investigating all aspects of antimicrobial resistance in human populations with a focus in hospital settings.

She has experience in communicating her research with patients and the public through various media including animations, blogs, and educational videos.