Extract
Nosocomial pneumonia is an infection of lung parenchyma that occurs in patients hospitalised for more than 48 h after admission [1]. Hospital-acquired pneumonia (HAP) is nosocomial pneumonia in patients who do not require mechanical ventilation; while ventilator-associated pneumonia (VAP) is defined as a pneumonia developing in patients under mechanical ventilation for at least 48 h [2]. HAP is the second most common nosocomial infection, and is the most common hospital infection leading to death in critically ill patients [1]. VAP is the most frequent hospital-acquired infection in intensive care units. Depending on the diagnostic criteria used, its incidence ranges from 5% to 67% [3]. The risk of acquiring VAP is 3% per day during the first 5 days on mechanical ventilation, and it is decreased to 1% per day for the following days. HAP or VAP developing within 4 days of admission are defined as early HAP/VAP, and are usually caused by microorganisms sensitive to antibiotics. HAP or VAP occurring after 5 days of admission are defined as late-onset pneumonias, and are most commonly associated with multidrug-resistant (MDR) pathogens [4, 5]. The mortality of late-onset VAP is higher than the respective mortality for early-onset VAP [6]. The crude mortality of nosocomial pneumonia is estimated to reach 70%. Attributable mortality, which is defined as the percentage of deaths that would have been prevented in the absence of infection, is 10% [7].
Abstract
A detailed and comprehensive summary of the ERS/ESICM/ESCMID/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia, published in ERJ Open Research, will assist clinicians in their tasks http://ow.ly/XC7N30k8Jhu
Footnotes
Conflict of interest: None declared.
- Received April 23, 2018.
- Accepted April 29, 2018.
- Copyright ©ERS 2018
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