ABSTRACT
Of the four routes of infection pathogenic bacteria can take, the inhalation and aspiration
ones are the most important. Inhalation pneumonia is usually due to manipulation of
the ventilator tubing and aspiration of the infected condensate. Aspiration of the
colonized oropharyngeal contents through the open vocal cords and eventually around
the blown up endotracheal cuff allows bacteria to invade the trachea and main bronchi.
Reflux of the bacteria and infection of the biofilm on the inner surface of the endotracheal
tube is the source for recurrent seeding of pathogenic bacteria into the lungs, causing
ventilator-associated pneumonia.
KEYWORDS
Ventilator-associated pneumonia - etiology - pathogenesis - aspiration - inhalation