Hospital-acquired pneumonia

Hospital-acquired pneumonia (HAP) or nosocomial pneumonia refers to any pneumonia contracted by a patient in a hospital at least 48–72 hours after being admitted. It is thus distinguished from community-acquired pneumonia. It is usually caused by a bacterial infection, rather than a virus.

HAP is the second most common nosocomial infection (after urinary tract infections) and accounts for 15–20% of the total. It is the most common cause of death among nosocomial infections and is the primary cause of death in intensive care units.

HAP typically lengthens a hospital stay by 1–2 weeks.

New or progressive infiltrate on the chest X-Ray with one of the following:

In an elderly person, the first sign of hospital-acquired pneumonia may be mental changes or confusion Other symptoms may include: –A cough with greenish or pus-like phlegm (sputum) –Fever and chills –General discomfort, uneasiness, or ill feeling (malaise) –Loss of appetite –Nausea and vomiting –Sharp chest pain that gets worse with deep breathing or coughing –Shortness of breath –Decreased blood pressure and fast heart rate

Ventilator-associated pneumonia (VAP) is a sub-type of hospital-acquired pneumonia (HAP) which occurs in people who are receiving mechanical ventilation. VAP is not characterized by the causative agents; rather, as its name implies, definition of VAP is restricted to patients undergoing mechanical ventilation while in a hospital. A positive culture after intubation is indicative of ventilator-associated pneumonia and is diagnosed as such. In order to appropriately categorize the causative agent or mechanism it is usually recommended to obtain a culture prior to initiating mechanical ventilation as a reference.

HCAP is a condition in patients who can come from the community, but have frequent contact with the healthcare environment. Historically, the etiology and prognosis of nursing home pneumonia appeared to differ from other types of community acquired pneumonia, with studies reporting a worse prognosis and higher incidence of multi drug resistant organisms as etiology agents. The definition criteria which has been used is the same as the one which has been previously used to identify bloodstream healthcare associated infections.

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