Hospital-acquired pneumonia diagnostic criteria: Difference between revisions
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{{Hospital-acquired pneumonia}} | {{Hospital-acquired pneumonia}} | ||
'''Editor(s)-in-Chief:''' [[C. Michael Gibson, M.S., M.D.]] | '''Editor(s)-in-Chief:''' [[C. Michael Gibson, M.S., M.D.]] ; [[Philip Marcus, M.D., M.P.H.]] | ||
==Overview== | |||
In hospitalised patient who develop respiratory symptoms and fever one should consider the diagnosis. The likelyhood increases when upon investigation symptoms are found of [[respiratory insufficiency]], purulent secretions, newly developed infiltrate on the [[chest X-Ray]], and increasing [[leucocytosis|leucocyte count]]. If pneumonia is suspected material from sputum or tracheal aspirates are sent for cultures. In case of [[pleural effusion]] [[thoracentesis]] is performed for examination of [[pleural fluid]]. [[Ventilator associated pneumonia]] refers to pneumonia arising in patients who have stayed on a ventilator for more than 48–72 hours. Additionally, patients with [[health-care associated pneumonia]] who may require intubation should be treated as ventilator associated pneumonia. In suspected ventilator-associated pneumonia it has been suggested that [[bronchoscopy]]([[BAL]]) is necessary because of the known risks surrounding clinical diagnoses. | |||
==Diagnostic Criteria of Hospital Acquired Pneumonia== | |||
[[Community acquired pneumonia]] should be distinguished from healthcare-associated pneumonia as these diseases have different causative organism, prognosis, diagnostic and treatment guidelines. | [[Community acquired pneumonia]] should be distinguished from healthcare-associated pneumonia as these diseases have different causative organism, prognosis, diagnostic and treatment guidelines. | ||
According to the Infectious Diseases Society of America and the American Thoracic Society healthcare-associated pneumonia includes any patient who meet the below criteria <ref name="pmid21663884">{{cite journal |author=Attridge RT, Frei CR |title=Health care-associated pneumonia: an evidence-based review |journal=[[The American Journal of Medicine]] |volume=124 |issue=8 |pages=689–97 |year=2011 |month=August |pmid=21663884 |doi=10.1016/j.amjmed.2011.01.023 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(11)00291-9 |accessdate=2012-09-02}}</ref> | According to the Infectious Diseases Society of America and the American Thoracic Society healthcare-associated pneumonia includes any patient who meet the below criteria <ref name="pmid21663884">{{cite journal |author=Attridge RT, Frei CR |title=Health care-associated pneumonia: an evidence-based review |journal=[[The American Journal of Medicine]] |volume=124 |issue=8 |pages=689–97 |year=2011 |month=August |pmid=21663884 |doi=10.1016/j.amjmed.2011.01.023 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-9343(11)00291-9 |accessdate=2012-09-02}}</ref> | ||
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* Received recent intravenous antibiotic therapy, chemotherapy, or wound care within the past 30 days of the current infection; | * Received recent intravenous antibiotic therapy, chemotherapy, or wound care within the past 30 days of the current infection; | ||
* Attended a hospital or hemodialysis clinic | * Attended a hospital or hemodialysis clinic | ||
==American Thoracic Society (ATS) and the Infectious Disease Society of America (IDSA) definitions of Hospital acquired pneumonia, ventilator-associated pneumonia, and health care associated pneumonia <ref name="pmid15699079">{{cite journal |author= |title=Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia |journal=[[American Journal of Respiratory and Critical Care Medicine]] |volume=171 |issue=4 |pages=388–416 |year=2005 |month=February |pmid=15699079 |doi=10.1164/rccm.200405-644ST |url=http://ajrccm.atsjournals.org/cgi/pmidlookup?view=long&pmid=15699079 |accessdate=2012-09-12}}</ref> == | |||
{{cquote| | |||
====Hospital-Acquired Pneumonia (HAP)==== | |||
HAP is defined as pneumonia that occurs 48 hours or more after admission, which was not incubating at the time of admission | |||
====Ventilator-associated pneumonia (VAP)==== | |||
VAP refers to pneumonia that arises more than 48–72 hours after endotracheal intubation. Some patients may require intubation after developing severe HAP and should be managed similar to patients with VAP. | |||
====Healthcare-Associated Pneumonia (HCAP)==== | |||
HCAP includes any patient who was hospitalized in an acute care hospital for two or more days within 90 days of the infection; resided | |||
in a nursing home or long-term care facility; received recent intravenous antibiotic therapy, chemotherapy, or wound care within the past 30 days of the current infection; or attended a hospital or hemodialysis clinic. | |||
}} | |||
==References== | ==References== | ||
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[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Pulmonology]] | [[Category:Pulmonology]] | ||
[[Category:Pneumonia|Pneumonia]] | [[Category:Pneumonia|Pneumonia]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
Latest revision as of 18:02, 18 September 2017
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Hospital-acquired pneumonia Microchapters |
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Differentiating Hospital-Acquired Pneumonia from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Hospital-acquired pneumonia diagnostic criteria On the Web |
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American Roentgen Ray Society Images of Hospital-acquired pneumonia diagnostic criteria |
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Directions to Hospitals Treating Hospital-acquired pneumonia |
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Risk calculators and risk factors for Hospital-acquired pneumonia diagnostic criteria |
Editor(s)-in-Chief: C. Michael Gibson, M.S., M.D. ; Philip Marcus, M.D., M.P.H.
Overview
In hospitalised patient who develop respiratory symptoms and fever one should consider the diagnosis. The likelyhood increases when upon investigation symptoms are found of respiratory insufficiency, purulent secretions, newly developed infiltrate on the chest X-Ray, and increasing leucocyte count. If pneumonia is suspected material from sputum or tracheal aspirates are sent for cultures. In case of pleural effusion thoracentesis is performed for examination of pleural fluid. Ventilator associated pneumonia refers to pneumonia arising in patients who have stayed on a ventilator for more than 48–72 hours. Additionally, patients with health-care associated pneumonia who may require intubation should be treated as ventilator associated pneumonia. In suspected ventilator-associated pneumonia it has been suggested that bronchoscopy(BAL) is necessary because of the known risks surrounding clinical diagnoses.
Diagnostic Criteria of Hospital Acquired Pneumonia
Community acquired pneumonia should be distinguished from healthcare-associated pneumonia as these diseases have different causative organism, prognosis, diagnostic and treatment guidelines. According to the Infectious Diseases Society of America and the American Thoracic Society healthcare-associated pneumonia includes any patient who meet the below criteria [1]
- Hospitalized in an acute care hospital for 2 or more days within 90 days of the infection;
- Resided in a nursing home or long-term care facility;
- Received recent intravenous antibiotic therapy, chemotherapy, or wound care within the past 30 days of the current infection;
- Attended a hospital or hemodialysis clinic
American Thoracic Society (ATS) and the Infectious Disease Society of America (IDSA) definitions of Hospital acquired pneumonia, ventilator-associated pneumonia, and health care associated pneumonia [2]
| “ |
Hospital-Acquired Pneumonia (HAP)HAP is defined as pneumonia that occurs 48 hours or more after admission, which was not incubating at the time of admission Ventilator-associated pneumonia (VAP)VAP refers to pneumonia that arises more than 48–72 hours after endotracheal intubation. Some patients may require intubation after developing severe HAP and should be managed similar to patients with VAP. Healthcare-Associated Pneumonia (HCAP)HCAP includes any patient who was hospitalized in an acute care hospital for two or more days within 90 days of the infection; resided in a nursing home or long-term care facility; received recent intravenous antibiotic therapy, chemotherapy, or wound care within the past 30 days of the current infection; or attended a hospital or hemodialysis clinic. |
” |
References
- ↑ Attridge RT, Frei CR (2011). "Health care-associated pneumonia: an evidence-based review". The American Journal of Medicine. 124 (8): 689–97. doi:10.1016/j.amjmed.2011.01.023. PMID 21663884. Retrieved 2012-09-02. Unknown parameter
|month=ignored (help) - ↑ "Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia". American Journal of Respiratory and Critical Care Medicine. 171 (4): 388–416. 2005. doi:10.1164/rccm.200405-644ST. PMID 15699079. Retrieved 2012-09-12. Unknown parameter
|month=ignored (help)