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Mechanical ventilation, by tracheal intubation or tracheostomy, is the common supplementary treatment for several reasons for hospitalization. Since the advent of long-term mechanical ventilation during the polio epidemic.In the intensive care unit, VAP represents the first cause of nosocomial infection with an incidence that varies according to the diagnostic methods and the populations studied. These infections are linked to the multiple and multi-resistant bacterial ecology (BMR) of these units. Complex but not univocal: several theories have been put forward to understand the pathophysiological mechanisms of VAP, hence the distinction between "exogenous" pneumonia (with contamination by germs from outside) and "endogenous" pneumonia.Diagnosis of certainty remains difficult, and treatment can be problematic due to the emergence of bacterial resistance to antibiotics.This complication poses a therapeutic and prognostic problem. It remains burdened with a high morbidity and mortality. Mortality is attributed to isolated VAP in 10 to 13% of cases.