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Hospital-acquired pneumonia

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Illustrations

Hospital-acquired pneumonia
Hospital-acquired pneumonia
Respiratory system
Respiratory system

Alternative Names    Return to top

Nosocomial pneumonia; Ventilator-associated pneumonia

Definition    Return to top

Hospital-acquired pneumonia is an infection of the lungs contracted during a hospital stay.

Causes    Return to top

Pneumonia is a very common illness. It is caused by many different germs and can range in seriousness from mild to life-threatening.

Hospital-acquired pneumonia tends to be more serious, because a patient's defense mechanisms against infection are often impaired during a hospital stay. In addition, the types of germs present in a hospital are frequently more dangerous than those encountered in the community. Hospital-acquired pneumonia occurs more commonly in patients who require a respirator to help them breathe. It is also known as ventilator-associated pneumonia.

Risk factors for hospital-acquired pneumonia include:

Symptoms    Return to top

Exams and Tests    Return to top

A physical examination reveals respiratory distress and crackles or decreased breath sounds when listening to the chest with a stethoscope.

Tests performed may include:

Treatment    Return to top

The objective of treatment is to cure the infection with antibiotics. An antibiotic is selected based on the specific germ detected by sputum culture. However, the organism cannot always be identified with tests, so antibiotic therapy is given to fight the most common bacterial organisms that infect hospitalized patients -- Staphylococcus aureus and gram-negative rods.

Supportive treatment includes supplemental oxygen and lung treatments to loosen and remove thick secretions from the lungs.

Outlook (Prognosis)    Return to top

Most patients respond to the treatment and improve in 2 weeks. However, hospital-acquired pneumonia can be very severe and sometimes deadly.

Possible Complications    Return to top

Elderly or debilitated patients who fail to respond to treatment may die from acute respiratory failure.

Prevention    Return to top

Ongoing prevention programs to limit hospital-acquired infections are in place at most institutions.

References    Return to top

American Thoracic Society. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005 Feb 15;171(4):388-416.

Update Date: 8/3/2007

Updated by: Allen J. Blaivas, DO, Pulmonary, Critical Care, and Sleep Medicine, Department of Veteran Affairs, VA New Jersey Health Care System, East Orange, NJ. Review provided by VeriMed Healthcare Network.

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