Presentation
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]
In this new work, leading international authorities present anupdate on current best practice for the diagnosis, treatment, andprevention of nosocomial pneumonia. [amazon.com]
Entire Body System
- Recurrent Respiratory Infections
In exceptional cases, antibiotic treatment may be considered in patients at risk and/or those with MDRO colonization with increasing purulent airway secretions or recurrent respiratory infections (weak recommendation, evidence level C). [aerzteblatt.de]
Neurologic
- Headache
They may consist of headache, malaise, diarrhea, confusion, falling, and decreased appetite. Diagnosis is confirmed by chest x-ray. [academickids.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]
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]
Workup
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]
X-Ray
- 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]
Treatment
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]
Prognosis
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]
Overall prognosis is poor, due in part to comorbidities. [msdmanuals.com]
Etiology
The etiology of 50% of the nosocomial infection cases was polymicrobial. [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]
Keywords: hospital-acquired pneumonia, ventilator-associated pneumonia, epidemiology, microbial etiology This work is published and licensed by Dove Medical Press Limited. [dovepress.com]
Two hundred seventy-five consecutive patients treated with bone marrow transplantation (BMT) during a 9-year interval were analyzed for the incidence and etiology of nosocomial pneumonia. [jco.ascopubs.org]
P. aeruginosa was the etiological agent in 3 cases (27.3%), though the susceptibility was tested in only 1 isolate. S. aureus was the etiological agent in 2 cases (18.2%), 1 case susceptible to meropenem. [scielo.br]
Epidemiology
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]
Pathophysiology
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]
Prevention
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]
These data suggest a new view, in which specific procedures for the control of these oral cavity pathogens should be considered in the prevention of NP. ( 3 ) Several studies evaluated the efficiency of mouth decontamination in the prevention of nosocomial [scielo.br]
The preventive strategies are highlighted in Table IV (page 18). [the-hospitalist.org]