Nosocomial pneumonia

Abstract

Nosocomial pneumonia causes significant morbidity and mortallity in hospital inpatients. The risk of nosocomial pneumonia is greatest in Medical lntensive Care Units, particulary in intubated and mechanically ventilated patients (20- 67%). Riskfactors are consideredfor ali hospi­tal inpatients, for those patients that were ad­mitted in Medical lntensive Care Units and for those who were mechanically ventilated. The di­agnosis typically requires the appearance of a new infiltrate on the chest X-ray, fever, leucocyto­sis and purulent secretions occurring more than 48 hours after admission. The differential diag­nosis of fever and/or densities on chest radio­ graphs are considered Pseudomonas aeruginosa is the most common pathogen (16-31%), with Sta­phylococcus aureus the second pathogen most commonly encountered (8-20%). The treatement is with supportive measures and antimicrobial therapy, that is often empirical. lf Pseudomonas aeruginosa is suspected, consider empirical the­rapy. The duration of antibiotic therapy can be 21 days and it depends on the severity ofilness, alterations on the chest X-ray and the pathogen.