The Pathogenesis of Nosocomial Pneumonia in Mechanically Ventilated Patients

  • M. J. M. Bonten
  • C. A. Gaillard
  • G. Ramsay
Conference paper
Part of the Yearbook of Intensive Care and Emergency Medicine book series (YEARBOOK, volume 1995)


Among mechanically ventilated patients, pneumonia is an important infection associated with increased morbidity and mortality [1–6]. Due to its association with mechanical ventilation, this infection has also been called ventilator-associated pneumonia (VAP), although this falsely suggests a predominant causative role of the ventilator in its pathogenesis. Many studies elucidating pathogenic pathways, therapeutic options, prevention and accurate diagnosis of VAP have been performed over the last twenty years. The pathogens causing VAP have been assumed to be from endogenous origin, and current hypothesis suggests that the gastropulmonary route of colonization is of major importance in the pathogenesis of VAP [7, 8]. The gastropulmonary route assumes that enteric microorganisms colonize the stomach, migrate to the oropharynx and eventually reach the lungs of mechanically ventilated patients by aspiration. Although the gastropulmonary route has been assumed to be of major importance, other routes of colonization, like exogenous colonization and the rectopulmonary route, may also lead to the development of VAP. The possible role of these routes will be discussed as well.


Enteral Feeding Nosocomial Pneumonia Stress Ulcer Prophylaxis Multiple Trauma Patient Selective Decontamination 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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© Springer-Verlag Berlin Heidelberg 1995

Authors and Affiliations

  • M. J. M. Bonten
  • C. A. Gaillard
  • G. Ramsay

There are no affiliations available

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