HFNC use decreased the treatment failure rate and the duration of both oxygen therapy and ICU treatment compared to the diffuser mask, which implies that an HFNC should be the first choice for treating patients admitted to the ICU with severe bronchiolitis. What is known: • A high-flow nasal cannula (HFNC) does not significantly reduce the time on oxygen compared to standard therapy in children with moderate to severe bronchiolitis. Observational studies show that, since the introduction of HFNC, fewer children with bronchiolitis need intubation. For children with moderate to severe bronchiolitis there is no proof of its benefit. What Is New: • In children with moderate to severe bronchiolitis, HFNC provides faster and more effective improvement than can be achieved with a diffuser mask.

Objective: The aim of this study was to identify microorganisms causing ventilator-associated pneumonia (VAP) and also study the antibiotic resistance/susceptibility. Materials and Methods:We retrospectively assessed microorganisms isolated from patients diagnosed with VAP in a pediatric intensive care unit between January 1, 2014, and June 30, 2016. Results:We included 44 patients diagnosed with VAP. The prevalence thereof was 8.6 patients per 1,000 ventilator days. Mechanical ventilation was required for 56.5% of patients. Thirty-three patients (75%) died. An underlying chronic disease was detected in 75% of patients (n=33). Fifty microorganisms were isolated from 44 patients. Single microorganisms were isolated from 86.4% (n=38) and two from 13.6% (n=6) of patients. Of all the isolated bacteria, 96% (n=48) were gram-negative; the most common was Pseudomonas aeruginosa (32%), followed by Klebsiella pneumoniae (24%) and Acinetobacter baumannii (22%). The isolates were most susceptible to colistin (92.6%), followed by piperacillin-tazobactam (71.4%), amikacin (65.2%), and gentamicin (52.2%). No enterobacterium or Acinetobacter strain was resistant to colistin; however, 13% of P. aeruginosa isolates were resistant. Conclusion:In VAP, it is essential to catalog antibiotic resistance patterns of bacteria present in the unit to ensure that empirical antibiotic therapy is effective.Keywords: Ventilator-associated pneumonia, pediatric intensive care, microorganism, antibiotic Bulgular: Çalışmaya VİP tanısı alan 44 hasta alındı. VİP hızı 1000 ventilatör gününde 8,6 olarak saptandı. Mekanik ventilatör kullanım oranı %56,5 idi. VİP tanısı alan olguların %75 (n=33)'nin öldüğü saptandı. VİP tanısı alan hastaların %75 (n=33)'inde altta yatan kronik hastalık tespit edildi. VİP tespit edilen 44 olguda 50 mikroorganizma izole edildi. Olguların %86,4'nda (n=38) tek mikroorganizma, %13.6 (n=6)'nda iki mikroorganizma etken olarak izole edildi. İzole edilen suşların %96' sının (n=48) gram negatif bakteri olduğu saptandı. Çalış-mamızda en sık izole edilen gram negatif ajan Pseudomonas Aeruginosa (%32) iken bunu Klebsiella pneumonia (%24) ve Acinetobacter baumannii (%22) izlemekte idi. Genel antibiyotik duyarlılığı incelendiğinde mikroorganizmaların en hassas olduğu antibiyotikler sırasıyla Kolistin (%92,6), Piperasilin-tazobaktam (% 71,4), Amikasin (%65,2) ve Gentamisin (%52,2) olarak saptandı. Enterobacteriaceae ve Acinetobacter suşlarında Kolistin direnci görülmezken P. aeruginosa izolatlarında, kolistin direnci %13 olarak saptandı.Sonuç: Ventilatör ilişkili pnömonidee, etkili ampirik antibiyotik tedavisi için her ünitenin kendi florasının direnç özelliklerini bilmesi gerekmektedir.Anahtar Kelimeler: Ventilatör ilişkili pnömoni, çocuk yoğun bakım, mikroorganizma, antibiyotik Eurasian J Med