Overview of Nosocomial Pneumonias
Ventilator-associated and hospital-acquired pneumonia
Ventilator-associated pneumonia (VAP) is pneumonia that develops 48 hours or longer after mechanical ventilation is given by means of an endotracheal tube or tracheostomy. Ventilator-associated pneumonia (VAP) results from the invasion of the lower respiratory tract and lung parenchyma by microorganisms. Intubation compromises the integrity of the oropharynx and trachea and allows oral and gastric secretions to enter the lower airways.
Hospital-acquired pneumonia (HAP) is pneumonia that develops 48 hours or longer after admission to a hospital. HAP is the second most common nosocomial infection. HAP increases a patient’s hospital stay by approximately 7-9 days and can increase hospital costs by an average of $40,000 per patient.
Health care–associated pneumonia
Health care–associated pneumonia is pneumonia that occurs in persons in one of the following groups:
Patients who have been hospitalized in an acute care facility for 2 or more days within 90 days of the infection
Residents of a nursing home or long-term care facility
Patients who received intravenous antibiotic therapy, chemotherapy, or wound care within the last 30 days of the current infection
Patients who receive hemodialysis in any setting
Patient considerations
Multiple factors should be considered when addressing the issues of HAP and VAP. These factors include the following:
Whether or not to intubate the patient
The route of intubation or placement of tubes
Feeding the patient
Body positioning
Prevention of stress-related bleeding
Prevention of deep venous thrombosis
Use of antibiotics and control of colonization
For other discussions on pneumonia, see the following:
Imaging Pneumocystis Carinii Pneumonia
Pneumocystis (carinii) jiroveci Pneumonia
Nursing Home Acquired Pneumonia
Lymphocytic Interstitial Pneumonia
Imaging Typical Bacterial Pneumonia