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院内感染性肺炎是机械通气最常见的并发症，目前主要的致病菌为革兰氏阴性菌，但革兰氏阳性菌有逐年增加的趋势。在机械通气的过程中，病原菌由消化道向呼吸道的移位及吸入被认为是发生院内感染性肺炎的重要机制。气管插管、呼吸机及其辅助装置的应用、病人的原发病、治疗手段和病区环境污染等因素都可通过不同的机制导致或加重院内感染性肺炎。目前对于机械通气条件下院内感染性肺炎的确诊和抗生素的选择主要依靠病原学检查。经过多家医院的实践，一项控制院内感染性肺炎的指导方针在降低该病的发病率方面已取得了显著的效果。
Nosocomial pneumonia is the most common mechanical ventilation complications, the main pathogen is Gram-negative bacteria, but Gram-positive bacteria have increased year by year trend. In the process of mechanical ventilation, the pathogen from the digestive tract to the respiratory tract displacement and inhalation is considered to be an important mechanism of nosocomial pneumonia. Endotracheal intubation, ventilator and its auxiliary devices, the patient’s primary disease, treatment and ward environmental pollution and other factors can lead to or aggravate nosocomial pneumonia by different mechanisms. Currently for the diagnosis of nosocomial pneumonia under mechanical ventilation and the choice of antibiotics mainly rely on etiological examination. After many hospital practices, a guideline to control nosocomial pneumonia has achieved remarkable results in reducing the incidence of the disease.