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Of 13 patients, LRT and VC were concurrently colonized with the same bacteria, where colonization of VC occurred before patient's LRT. PFGE results demonstrated high correlation between bacteria from LRT and VC in 11 patients. Among 114 mechanically ventilated children, VAP caused by bacteria from VC occurred in six patients, accounting for 18.8% (6/32) of VAP overall rate in this study. CONCLUSIONS Bacterial colonization of VC is a significant cause of VAP development in mechanically ventilated children. Preventive strategies of early