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Respiratory Diseases
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Aref T. Senno, Ryan K. Brannon
Pneumonia is classified by setting of infection: (1) community acquired pneumonia (CAP): Acute infection acquired outside of the hospital, (2) hospital acquired pneumonia (HAP): Acquired 48 hours or more after admission to the hospital, (3) ventilator-associated pneumonia (VAP): Acquired 48 hours or more after endotracheal intubation. The category of healthcare-associated pneumonia introduced in the 2005 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines have since been abandoned due to likely over-treatment of antibiotic-sensitive organisms. The vast majority of cases of pneumonia in pregnant women in clinical practice and in the literature are cases of CAP.
Skin: Resilience
Published in Philip Berry, Necessary Scars, 2021
As to the physical dangers of hospitalisation, the degree of detail we should go into varies. Hospital-acquired infections overall are less frequent nowadays (the incidence of the ‘superbugs’ MRSA and C Diff has fallen dramatically in recent years), but hospital-acquired pneumonia does remain a common development in the frail population. Should we explain this, or quote the incidence? Do elderly patients and their families, who are coping with the news that they are ill and need to be admitted, need to be told that ‘…by the way, there’s a chance you could catch something else as well…’?
Paper 4
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
A hospital-acquired pneumonia is possible, although the patient has only had a brief admission so far. An aspiration pneumonia is also possible, especially if there has been vomiting with recent alcohol excess, but in an intensive care patient with pancreatitis and such typical features of ARDS, this is less likely.
Profiles of oral microbiome associated with nasogastric tube feeding
Published in Journal of Oral Microbiology, 2023
Ding-Han Wang, Fa-Tzu Tsai, Hsi-Feng Tu, Cheng-Chieh Yang, Ming-Lun Hsu, Lin-Jack Huang, Chiu-Tzu Lin, Wun-Eng Hsu, Yu-Cheng Lin
A general notion exists that long-term fixation of NG tubes impairs swallowing function, thereby increasing the risk of aspiration pneumonia. Studies have shown that community-based older patients fed with NG tubes are generally at high risk of aspiration pneumonia [50]. Moreover, pathogens of community-acquired pneumonia are generally different from those causing hospital-acquired pneumonia and thus require a different set of antimicrobials to treat [15,51]. Our survey of tongue microbes in patients with NG tubes showed mostly Gram-negative bacteria with a mixture of aerobes and anaerobes such as Pseudomonas, and also the Gram-positive Corynebacterium (Supplemental Table S2). The spectrum of tongue microbes in NG-tube patients may provide predictive information for empiric antimicrobial therapy.
An overview of cilastatin + imipenem + relebactam as a therapeutic option for hospital-acquired and ventilator-associated bacterial pneumonia: evidence to date
Published in Expert Opinion on Pharmacotherapy, 2021
Júlia Sellarès-Nadal, Simeón Eremiev, Joaquin Burgos, Benito Almirante
Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are frequent complications that occur during hospitalization. HAP refers to pneumonia occurring at least 48 hours after hospital admission. VAP correspond a subgroup of HAP that consists of pneumonia contracted 48 to 72 hours after the initiation of mechanical ventilation [1,2]. HAP is the second most frequent nosocomial infection in hospitalized patients, with VAP being the main nosocomial infection in the intensive care unit (ICU), accounting for two-thirds of ICU infections [3]. The incidence of HAP/VAP has not changed significantly in the last years despite the incorporation of new care bundles [4,5]. Moreover, these infections are associated with significant morbidity and mortality, prolonged hospital stay, and important antibiotic use. The crude mortality of VAP may be as high as 20%–50%, and that of nonventilated HAP is lower [6].
Safety considerations of current drug treatment strategies for nosocomial pneumonia
Published in Expert Opinion on Drug Safety, 2021
Adrian Ceccato, Pierluigi Di Giannatale, Stefano Nogas, Antoni Torres
Nosocomial pneumonia (NP) is a serious complication of hospital admission, and its incidence, prevalence, and etiology vary by both setting and region [1]. In particular, the variation in etiologic pathogen suggests that empirical antibiotic treatment and stewardships should be individualized to the characteristics and risks of each setting [2,3]. Ventilator associated pneumonia (VAP) is probably the most common and most studied NP, with an estimated incidence of 5.82–18.3 cases per 1000 ventilator days in Europe [4–6]. Although several care bundles have been shown to reduce its incidence, VAP remains a common adverse event that results in antibiotic prescriptions, increase length of hospital stay, and increased mortality [7]. Hospital-acquired pneumonia (HAP) in nonventilated patients has an estimated incidence of 3.63 cases per 1000 patient-days in USA [8], and among this group, those who require mechanical ventilation have the highest mortality.