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Table 2 Classification of hospital-acquired pneumonia in children based on microbiological results

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

Definite VAP A child who fulfils the case definitions for hospital-acquired pneumonia (Table 1) and has one of the following:
-same pathogen isolated from bronchial secretions/BAL and blood
-pathogen or virus isolated from lung biopsy, or positive growth in culture of pleural fluid, or histopathologic examination with evidence of pneumonia manifested as abscess formation, positive culture of lung parenchyma, or fungal hyphae
-Pathogen or virus isolated from BAL (bacteria ≥104 CFU/ml), or ≥5% of BAL-obtained cells contain intracellular bacteria on direct microscopic exam, or protected brush with a threshold of ≥104 CFU/ml, or distal protected aspirate with a threshold of ≥104 CFU/ml, or positive exams for particular microorganisms (Legionella, Aspergillus, mycobacteria, Mycoplasma, Pneumocystis jirovecii)
Probable VAP A child who fulfils the case definitions for hospital-acquired pneumonia (Table 1) and has one of the following:
-pathogen isolated from BAL (bacteria <104 CFU/ml)
-pathogen or virus isolated from bronchial secretions, or quantitative culture of lower respiratory tract specimen (endotracheal aspirate) with a threshold of bacteria ≥106 CFU/ml
Possible VAP A child who fulfils the case definitions for hospital-acquired pneumonia (Table 1) with non-quantitative lower respiratory tract specimen culture or no positive microbiology, but has been treated for hospital-acquired pneumonia
  1. BAL: bronchoalveolar lavage; CFU: colony-forming units.