Book contents
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- 28 Acute and Chronic Bronchitis
- 29 Croup, Supraglottitis, and Laryngitis
- 30 Atypical Pneumonia
- 31 Community-Acquired Pneumonia
- 32 Nosocomial Pneumonia
- 33 Aspiration Pneumonia
- 34 Lung Abscess
- 35 Empyema and Bronchopleural Fistula
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
32 - Nosocomial Pneumonia
from Part V - Clinical Syndromes – Respiratory Tract
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- 28 Acute and Chronic Bronchitis
- 29 Croup, Supraglottitis, and Laryngitis
- 30 Atypical Pneumonia
- 31 Community-Acquired Pneumonia
- 32 Nosocomial Pneumonia
- 33 Aspiration Pneumonia
- 34 Lung Abscess
- 35 Empyema and Bronchopleural Fistula
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
Summary
INTRODUCTION
Nosocomial pneumonia (NP) may be defined as a pneumonia that occurs in the hospital. Nosocomial pneumonia is synonymous with hospital-acquired pneumonia (HAP). There is a subset of NP and HAP of patients who are on ventilators, and this subset of patients are referred to as ventilator-associated pneumonias (VAP). NP/HAP may be considered as early NP/HAP, ie, occurring ≤5 days after hospital admission, or as late NP/HAP occurring ≤5 days after hospital admission. There is little clinical rationale for this distinction except that it can skew the data in studies and affect mortality outcomes and initial empiric therapy that differ between the “early” and “late” NP/HAP. “Early” NP/HAP really represents incubating community-acquired pneumonia (CAP) that has become clinically manifest within 5 days of admission to the hospital. Therefore, the organisms in the early NP/HAP group are really CAP pathogens, predominantly Streptococcus pneumoniae. In the traditional group of NP/HAP, ie, the late-onset NP/HAP, the organisms are reflective of the aerobic gram-negative bacillary flora of the hospital. Because early NP/HAP is really CAP manifesting in the hospital, henceforth it will be termed late onset NP/HAP. The most important, albeit not the most frequent, pathogen in the NP/HAP group is Pseudomonas aeruginosa. Other gram-negative bacilli are also major pathogens in NP/HAP, eg, Klebsiella pneumoniae and Serratia marcescens.
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- Clinical Infectious Disease , pp. 229 - 232Publisher: Cambridge University PressPrint publication year: 2008
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