Key messages

• The majority of cases of nosocomial pneumonia are the result of aspiration of oropharyngeal and gastric contents to the lower airways.

• The development of pneumonia depends on interaction between bacterial virulence, innoculum size, and local lung defenses.

• Etiology in nosocomial pneumonia results from the selection of certain pathogens by local or systemic host factors, the virulence of the organism, the underlying disease of the patient, and exposure to antimicrobial agents.

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