Table 1 Data sources and CDC/NHSN criteria for determining adverse event (AE) occurrence

Radiology

Microbiology

Laboratory

Vital signs

Pharmacy

- ≥ 1 chest imaging test results with pneumonia-related findings (e.g., air-space disease, consolidation, infiltrate, focal opacification).

- Gram stain of sputum or pleural fluid sample with ≥ 25 neutrophils and ≤ 10 squamous epithelial cells per low power field x100.

- WBC ≤ 4000/mm³ or;

- WBC ≥ 12,000/mm³ or;

- Abnormal trends in WBC for ≥ 48 h.

- Temperature > 38°C or abnormal trends in temperature ≥ 48 h;

- RR > 25 breaths/min.;

- O₂ desaturations < 94%;

- HR > 100 beats/min

- A HAP-related antimicrobial agent^a is started, and is continued for ≥ 4 days.

Ventilator settings

Microbiology

Laboratory

Vital signs

Pharmacy

- ↑ daily min. FiO₂ of ≥ 0.2 point or ↑ daily min. PEEP values of ≥ 3cmH₂O sustained for ≥ 48 h, as compared to a baseline period of ≥ 48 h of stability or improvements on the ventilator in terms of FiO₂ or PEEP values.

- Culture meeting one of the following thresholds and growing a recognized pathogen^b:

 a) EA: ≥ 10⁵ CFU/ml

 b) BAL: ≥ 10⁴ CFU/ml

 c) LT: ≥ 10⁴ CFU/g;

 d) PSB: ≥ 10³ CFU/ml

 e) Gram stain of resp. secretions  (see: HAP)

- WBC ≤ 4000/mm³ or;

- WBC ≥ 12,000/mm³ or;

- Abnormal trends in WBC for ≥ 48 h.

- Temperature > 38°C or <36°C for 48 h, or abnormal trends in temperature ≥ 48 h.

- A new antimicrobial agent^a is started, and is continued for ≥ 4 days.

ICU Database

Radiology

- Presence of an endotracheal tube and of mechanical ventilation

- For descriptive purposes, whether chest imaging test results provide evidence of pneumonia, pulmonary edema, atelectasis or ARDS.

Radiology

Microbiology

Laboratory

Vital signs

Pharmacy

- Chest imaging test results with evidence of at least one central line in place.

- Recognized pathogen(s)^b identified from ≥ 1 blood specimens by a culture based micro-biologic testing method, with the organism identified in blood not related to an infection at another site.

- WBC ≤ 4000/mm³ or;

- WBC ≥ 12,000/mm³ or;

- Abnormal trends in WBC for ≥ 48 h.

- Temperature > 38°C or; <36°C for ≥ 48 h or;

- Abnormal trends in temperatures for ≥ 48 h;

-hypotension with systolic pressure ≤ 90 mmHg.

- A CLABSI-related antimicrobial agent^a is started, and is continued for ≥ 4 days.