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Table 1 Case definitions of hospital-acquired pneumonia in children stratified by different age groups

From: Ventilator-associated pneumonia in neonates, infants and children

Neonates Onset >72 h after birth and one of the following radiologic criteria:
-new or progressive infiltrates
-consolidations
-adhesions or fluid in lobar fissures/pleura
And
Worsening gas exchange (SaO2 ↓; O2 requirement ↑; Ventilation parameters ↑)
And
Four of the following signs and symptoms:
-fever (>38.0°C), hypothermia (<36.5°C), or temperature instability
-new onset or increasing bradycardia (<80/min) or tachycardia (>200/min)
-new onset or increasing tachypnoea (>60/min) or apnoea (>20 seconds)
-new onset or increasing signs of dyspnoea (retractions, nasal flaring, grunting)
-increasing production of respiratory secretions and need for suctioning
-purulent tracheal secretion
-isolation of a pathogen in respiratory secretions
  -elevated C-reactive protein (>20 mg/L)
I/T-ratio >0.2
Infants: 2–11 months One of the following radiologic criteria:
-new or progressive infiltrate
-consolidations
-cavitations
-pneumatoceles
And
Worsening gas exchange (SaO2 ↓; O2 requirement ↑; Ventilation parameters ↑)
And
Three of the following signs and symptoms:
-fever (>38.0°C), hypothermia (<36.5°C), or temperature instability
-leucopenia (<4000 WBC/mm3) or leucocytosis (≥15,000 WBC/mm3) with left shift (≥10% band forms)
-new onset of purulent sputum, or change in character of sputum, or increased respiratory secretions, or increased suctioning requirements
-apnoea or dyspnoea (tachypnoea, nasal flaring, retraction of chest wall, grunting)
-wheezing, rales, or rhonchi
-cough
-bradycardia (<100/min) or tachycardia (>170/min)
Children: 1–16 years One of the following radiologic criteria:
-new or progressive and persistent infiltrate
-consolidation
-cavitation
And
Three of the following signs and symptoms:
-fever (>38.4°C) or hypothermia (<36.5°C)
-leukopenia (<4000 WBC/mm3) or leucocytosis (≥15,000 WBC/mm3)
-new onset of purulent sputum or change in character of sputum or increased respiratory secretions or increased suctioning requirements
-new onset or worsening cough or dyspnoea, apnoea, or tachyponea
-rales or bronchial breath sounds
  -worsening gas exchange (SaO2 ↓; O2 requirement ↑; Ventilation parameters ↑)
  1. SaO2: Oxygen saturation; I/T-ratio: immature to total neutrophil ratio; WBC: white blood cell count; ↑: increase; ↓: decrease.