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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 in Critically Ill Children: A New Paradigm.

Author information

1
Section of Critical Care, Department of Pediatrics, University of Colorado Denver, School of Medicine, Children's Hospital Colorado, 13121 East 17th Avenue, MS8414, Aurora, CO 80045, USA. Electronic address: Peter.Mourani@childrenscolorado.org.
2
Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, 13001 East 17th, B119, Aurora, CO 80045, USA.

Abstract

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

PMID:
28941534
DOI:
10.1016/j.pcl.2017.06.005
[Indexed for MEDLINE]

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