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Alternative Names Return to topNosocomial pneumonia; Ventilator-associated pneumonia
Definition Return to top
Hospital-acquired pneumonia is an infection of the lungs contracted during a hospital stay.
Causes Return to top
Pneumonia is a very common illness. It is caused by many different germs and can range in seriousness from mild to life-threatening.
Hospital-acquired pneumonia tends to be more serious, because a patient's defense mechanisms against infection are often impaired during a hospital stay. In addition, the types of germs present in a hospital are often more dangerous than those encountered in the community.
Hospital-acquired pneumonia occurs more often in patients who require a respirator (also called a breathing machine or ventilator) to help them breathe. When pneumonia occurs in a patient who is on a ventilator, it is known as ventilator-associated pneumonia.
Risk factors for hospital-acquired pneumonia include:
Symptoms Return to top
Exams and Tests Return to top
A physical examination shows:
Tests performed may include:
Treatment Return to top
Treatment aims to cure the infection with antibiotics. An antibiotic is chosen based on the specific germ found by sputum culture.
However, the bacteria cannot always be identified with tests. Antibiotic therapy is given to fight the most common bacteria that infect hospitalized patients -- Staphylococcus aureus and gram-negative bacteria.
Supportive treatment includes:
Outlook (Prognosis) Return to top
Most patients respond to treatment and improve within 2 weeks. However, hospital-acquired pneumonia can be very severe and sometimes life-threatening.
Possible Complications Return to top
Elderly or very weak patients who do not respond to treatment may die from acute respiratory failure caused by the pneumonia.
Prevention Return to top
Ongoing prevention programs to limit hospital-acquired infections are in place at most institutions.
References Return to top
American Thoracic Society. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005 Feb 15;171(4):388-416.
Limper AH. Overview of pneumonia. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 97.Update Date: 3/17/2009 Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.