Adults with clinically or microbiologically documented infections and at least two signs of the systemic inflammatory response syndrome (SIRS) are enrolled. Since March 2016 all patients in the database were re-classified into non-sepsis, sepsis and septic shock using the Sepsis-3 classification criteria [7]. Exclusion criteria were: a) HIV-1 infection; b) neutropenia defined as less than 1,000 neutrophils/mm3; and c) chronic use of corticosteroids defined as more than 1 mg/kg/day of prednisone equivalent for more than 15 days. Infections and organ dysfunction are defined according to already-published international criteria [8]. Blood sampling is done within the first 24 hours from enrollment.

The following variables are recorded: i) demographics; ii) Acute Physiology and Chronic Health Evaluation (APACHE) II score, Charlson Comorbidity Index (CCI) and Sequential Organ Failure Assessment (SOFA) score; (iii) biochemistry, absolute blood cell counts and arterial gases; iv) appropriateness of the administered antimicrobial treatment defined as the susceptibility of the isolated pathogen to at least one of the empirically prescribed antimicrobials according to the antibiotic susceptibility testing; (v) quantitative cultures of blood, urine and tracheobronchial secretions (TBS) performed on baseline day 1.

Among patients entered in the database, patients with microbiologically confirmed ventilator associated pneumonia (VAP) due to monomicrobial infection by P. aeruginosa (group A); K. pneumoniae (group B) and A. baumannii (group C), were selected. Pathogens grew at ≥ 105 cfu/ml in tracheobronchial secretions. VAP was defined according to already-published international criteria [8]. Survival was recorded for 28 days. 10 ml of blood was collected after peripheral venipuncture within the first 24 h of enrollment. Serum was prepared by centrifugation at 900 g, and samples were transported within the same day to the central lab and stored at– 80°C until processing. Blood samples were also isolated from healthy volunteers, who were matched with patients with VAP for age and gender.

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