From 2,436 eligible ICU patients, 827 cases presented NP, with 18.3 episodes of VAP per 1000 ventilator-days. Most common findings were worsening oxygenation, purulent respiratory secretions and temperature increase. [ncbi.nlm.nih.gov]

Reviews " Nosocomial Pneumonia achieves its stated goal of seeking to present current knowledge on the pathophysiology, clinical presentation, diagnosis, and treatment of nosocomial pneumonia. [wiley.com]

Remote Access Favorites Save figures into PowerPoint Download tables as PDFs Go to My Dashboard Close Hospital-acquired pneumonia (HAP) occurs more than 48 hours after admission to the hospital or other health care facility and excludes any infection present [accessmedicine.mhmedical.com]

• Fever of Unknown Origin

  Engelhart et al. reported data on HAI and fever of unknown origin among adult haematology and oncology patients [20]. [journals.plos.org]

• Headache

  They may consist of headache, malaise, diarrhea, confusion, falling, and decreased appetite. Diagnosis is confirmed by chest x-ray. [academickids.com]

  Patients with HAP are likely to have a poor appetite, diaphoresis, and headache. Expect a high temperature, usually greater than 100[degrees] F (37.8[degrees] C), and a heart rate of more than 100 beats/minute. [nursingcenter.com]

  […] or sputum, coughed up from lungs fever fast breathing and shortness of breath shaking chills chest pain that usually worsens when taking a deep breath, known as pleuritic pain fast heartbeat fatigue and weakness nausea and vomiting diarrhea sweating headache [medicalnewstoday.com]

  The most common adverse reactions (occurring in more than 1% of patients) reported in the summary of product characteristics are fungal infection, insomnia, dysgeusia, headache, dizziness, nausea, constipation, diarrhoea, vomiting, increased alanine aminotransferase [nice.org.uk]

Laboratory Evaluation Lab studies are useful, and workup includes: 1. CBC and differential. 2. Liver function tests. 3. Sputum Gram’s stain and culture. 4. Blood cultures. 5. [intjinfection.com]

The diagnostic workup may offer additional data that should be interpreted in the context of the patient's condition. 5. [frca.co.uk]

If the patient receives appropriate antimicrobial therapy for 2 weeks and does not respond (ie, improved infiltrates findings on chest radiograph), initiate a diagnostic workup to detect nonbacterial infections (eg, herpesvirus type 1 [HSV-1] pneumonitis [emedicine.medscape.com]

Diagnostic Tests in the Workup of Pulmonary Infiltrates in the ICU 1. Respiratory Cultures Sputum Endotracheal or Tracheobronchial aspirate** [Toni: should this be transbronchial?] [antimicrobe.org]

• Esophageal Motility Disorder

  Aspiration is one of the pathologic mechanisms involved in HAP and is associated with supine position, dysphagia, altered mental status, esophageal motility disorders, vomiting, gastroesophageal reflux, tracheal intubation, enteral nutrition, nasogastric [aricjournal.biomedcentral.com]

The cure rate was higher in the telavancin than the vancomycin treatment group in microbiologically evaluable patients with only Gram-positive pathogens isolated at baseline [85.0% (130/153) versus 75.2% (109/145), respectively; treatment difference [ncbi.nlm.nih.gov]

Cheng (Shanghai, China) Annual Congress 2012 - Respiratory infections: prognosis and outcome [+] Health care associated pneumonia versus community acquired pneumonia: Comparison of etiology, treatment and prognosis C. Araujo, N. Andre, P. [ers-education.org]

Treatment and prognosis The early onset type has a better prognosis. High morbidity and mortality are seen patients with Hospital acquired pneumonia as they are already hospitalised for another condition. Promoted articles (advertising) [radiopaedia.org]

Early and precise identification of this pathogen can lead to better prognosis of the associated infections and an improved approach to controlling the spread of carbapenemase-resistant gram-negative bacteria. [ncbi.nlm.nih.gov]

ETIOLOGIC DIAGNOSIS OF PNEUMONIA All Patients Patients with Etiologic Diagnosis Only VAP (n = 164) NV-ICUAP (n = 151) P Value VAP (n = 117) NV-ICUAP (n = 64) P Value Etiologic diagnosis, n (%) 117 (71) 64 (42) <0.001 — — — Polymicrobial pneumonia, n [atsjournals.org]

The etiology of 50% of the nosocomial infection cases was polymicrobial. [ncbi.nlm.nih.gov]

Keywords: hospital-acquired pneumonia, ventilator-associated pneumonia, epidemiology, microbial etiology This work is published and licensed by Dove Medical Press Limited. [dovepress.com]

We always want to obtain the etiology of the pneumonia. As the MS-DRG assignment will vary based on etiology, this may require a query. The physician’s clinical opinion is sufficient to diagnose the type of infection. [hcpro.com]

The incidence and microbiologic epidemiology of NIP and VAP were studied. RESULTS: There were 873 patients enrolled. [ncbi.nlm.nih.gov]

Keywords: hospital-acquired pneumonia, ventilator-associated pneumonia, epidemiology, microbial etiology This work is published and licensed by Dove Medical Press Limited. [dovepress.com]

Keywords Costs and Cost Analysis — Cross Infection/epidemiology — Humans — Intensive Care — Intubation, Intratracheal/ adverse effects — Length of Stay — Pneumonia/economics/ epidemiology/mortality — Respiration, Artificial/ adverse effects — Risk Factors [archive-ouverte.unige.ch]

Reviews " Nosocomial Pneumonia achieves its stated goal of seeking to present current knowledge on the pathophysiology, clinical presentation, diagnosis, and treatment of nosocomial pneumonia. [wiley.com]

In critically ill patients, pathophysiological changes alter the pharmacokinetics of antibiotics. Imipenem exhibits primarily time-dependent killing. [ncbi.nlm.nih.gov]

Pathophysiology Extrinsic factors  Exposure to causative agent  Exposure to pulomary irritant Intrinsic factors (host related)  Pulmonary injury – COPD, bronchiectasis, CF, Ca  Loss of protective airway reflexes – CVA, intoxication, altered mental [slideshare.net]

Because aerobic gram-negative bacilli (eg, Pseudomonas aeruginosa ) are the major pathogens associated with HAP, the pathophysiology of nosocomial pneumonia relates to the destructive effect on lung tissue. [emedicine.medscape.com]

Various preventive strategies have been increasingly used to prevent the development of pneumonia. [ncbi.nlm.nih.gov]

Other preventive interventions Besides the above mentioned interventions, other preventive measures have been considered for the prevention of HAP. [aricjournal.biomedcentral.com]

[…] for the prevention of ventilator-associated pneumonia in adults in Ireland (Health Protection Surveillance Centre - SARI Working Group, 2011) SLOVENIA Guidelines for the prevention of nosocomial pneumonia (Ministry of Health, 2009) Smernice za preprečevanje [ecdc.europa.eu]

[…] the body’s ability to carry oxygen in the blood Oxygen may be provided in order to maintain good oxygen levels HAP Prevention Bundle Craig Hospital has adopted a group of prevention strategies to reduce the chance of getting HAP. [craighospital.org]