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The mean score for patients with confirmed VAP was 6.5 and for unconfirmed cases it was 5.9. However, the use of Gram stains of the BAL or the protected brush specimens notably improved the accuracy when incorporated into the CPIS score. Gram stains of the BAL were positive in 34 of 40 (85%) confirmed cases and in 10 of 39 (26%) unconfirmed cases. The results with Gram stain of the protected brush specimens were similar. Adding the Gram stain to the CPIS baseline increased the CPIS score to an average of 7.3 in confirmed cases compared with 6.4 in unconfirmed cases. The CPIS scoring system is summarized in Table 1
| |
Sensitivity |
Specificity |
| Clinical estimate |
50% |
58% |
| CPIS score > 6* |
60% |
59% |
| BAL Gram stain |
85% |
74% |
| Telescoping catheter |
60% |
90% |
| CPIS + BAL Gram stain |
85% |
49% |
| CPIS + telescoping catheter |
78% |
36% |
| 
