Ventilator-Associated Pneumonia in Critically Ill Children: A New Paradigm

Pediatr Clin North Am. 2017 Oct;64(5):1039-1056. doi: 10.1016/j.pcl.2017.06.005. Epub 2017 Aug 18.


Ventilator-associated pneumonia (VAP) is a serious complication of critical illness. Surveillance definitions have undergone revisions for more objective and consistent reporting. The 1 organism-1 disease paradigm for microbial involvement may not adequately apply to many cases of VAP, in which pathogens are introduced to a pre-existing and often complex microbial community that facilitates or hinders the potential pathogen, consequently determining whether progression to VAP occurs. As omics technology is applied to VAP, a paradigm is emerging incorporating simultaneous assessments of microbial populations and their activity, as well as the host response, to personalize prevention and treatment.

Keywords: Mechanical ventilation; Metagenomics; Microbiome; Pediatric intensive care; Ventilator-associated pneumonia.

Publication types

  • Review

MeSH terms

  • Child
  • Critical Care / methods
  • Critical Illness
  • Humans
  • Lung / microbiology
  • Metagenomics
  • Microbiota
  • Pneumonia, Ventilator-Associated* / diagnosis
  • Pneumonia, Ventilator-Associated* / etiology
  • Pneumonia, Ventilator-Associated* / therapy
  • Proteomics
  • Risk Factors