Epidemiology
There is the outpatient form of the disease, with a cough. It is usually viral and requires symptomatic treatment.
There is the inpatient form, associated with endotracheal tubes and tracheostomy.
Microbiology
Pseudomonas aeruginosa, Staphylococcus aureus, and Escherichia coli. Whatever colonizes the tube.
Diagnosis
Ventilator-associated is a purulent tracheal aspirate, a fever > 38°C with no other recognizable cause, a positive tracheal aspirate culture with > than 1 × 10^6 colony-forming units/mL, and no new infiltrate on chest x-ray.
Treatment
It depends on what grows.
Pearls
Treating ventilator-associated tracheobronchitis decreases pneumonia and death and leads to earlier extubation. But it is not a clear cut situation (PubMed)
Rants
Always ignore the Candida in the ET tube.
Curious Cases
Relevant links to my Medscape blog
Last Update: 03/11/19.