الفهرس | Only 14 pages are availabe for public view |
Abstract Hospital acquired pneumonia is pneumonia that occurs more than 48 hours after admission and without any antecedent signs of infection at the time of hospital admission. It includes hospital acquired pneumonia (HAP), health care associated pneumonia (HCAP), and ventilator associated pneumonia (VAP). Atypical pneumonia is a term used to describe pneumonias that do not fit into the typical patterns of bacterial pneumonia and where causative microbe cannot be identified using conventional culture techniques. It is caused by Mycoplasma pneumoniae, Chlamydia, Coxiella burnetti, and Legionellae. Several respiratory parasites, fungi, and viruses are also part of the spectrum of causative agents. Pneumonia risk factor can be classified as patient related, intervention related and infection control related risk factors. Patient-related factors include Age, Severe underlying illness, Malnutrition and Altered mental status. Infection control related factors include Lack of appropriate hand hygiene and Contaminated respiratory care equipment. Intervention-related factors include therapeutic agents leading to central nervous system depression with decreased ventilation, impaired removal of secretions, or potential aspiration, prolonged or complicated thoracoabdominal procedures, endotracheal intubation and inappropriate use of antibiotics. The diagnosis of pneumonia in the hospitalized patient is even more challenging than the diagnosis of CAP. Clinical findings alone are not sufficient for a definitive diagnosis. Therfore, a variety of noninvasive and invasive tests have been proposed as guides for diagnosis and treatment of hospital-acquired pneumonia including microscopic examination, culture techniques, direct antigen detection, nucleic acid amplification tests and serological assay. Atypical pneumonia pathogens are not found on Gram stain, and diagnosis requires special culture techniques or serological assays. Prevention of HAP includes staff education, infection surveillance, and prevention of transmission of microorganisms through sterilization of equipment, hand hygiene and gloving. |