Respirology Search
Respirology Respirology
pneumonia%20-%20hospital-acquired
PNEUMONIA - HOSPITAL-ACQUIRED
Hospital-acquired pneumonia (HAP) is defined as pneumonia occurring ≥48 hours after admission and excluding any infection that is incubating at the time of admission.
Ventilator-associated pneumonia (VAP) is described as pneumonia occurring >48-72 hours after endotracheal intubation and within 48 hours after removal of endotracheal tube.
Early-onset HAP or VAP is the pneumonia occurring within the first 4 days of hospitalization that may be cause by antibiotic-sensitive bacteria that usually carries a better diagnosis.
Late-onset HAP or VAP is the pneumonia occurring after ≥5 days. It is likely caused by multidrug-resistant pathogens associated with increased mortality and morbidity.

Pneumonia%20-%20hospital-acquired Signs and Symptoms

Definition

Hospital-acquired Pneumonia (HAP)
  • Defined as pneumonia occurring ≥48 hours after admission and excluding any infection that is incubating at the time of admission
Ventilator-associated Pneumonia (VAP)
  • Described as pneumonia occurring >48-72 hours after endotracheal intubation and within 48 hours after removal of endotracheal (ET) tube

Signs and Symptoms

Typical Signs and Symptoms
  • Fever
  • Cough with or without sputum production
  • Purulent sputum
  • Dyspnea, shortness of breath (SOB)
  • Respiratory failure
Other Findings
  • Worsening oxygenation
  • Increased heart rate
  • Increased minute ventilation

Risk Factors

Risk Factors for Hospital-acquired Pneumonia/Ventilator-Acquired Pneumonia
  • Patient-related: Age, chronic pulmonary disease, multiple organ system failure, depressed consciousness
  • Treatment-related: Intubation/mechanical ventilation, reintubation, prolonged intubation, previous exposure to antibiotics, thoracoabdominal surgery
  • Triggers of aspiration: Positioning, nasogastric tube insertion, enteral feeding, low ET tube pressure
  • Oropharyngeal colonization
Risk Factors for Hospital-acquired Pneumonia/Ventilator-Acquired Pneumonia
  • ≥5 days duration stay for the current hospitalization prior to occurrence of VAP
  • Septic shock at the time of VAP
  • Acute respiratory distress syndrome preceding VAP
  • Acute renal replacement therapy before VAP onset
  • IV antibiotics within the preceding 90 days
    • Risk factor for MDR, MRSA, and MDR Pseudomonas VAP and HAP
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Respirology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Ivermectin improves survival in COVID-19 patients with severe pulmonary involvement
21 Nov 2020
Ivermectin confers benefits in the treatment of COVID-19, with a recent study showing that its use helps reduce the risk of death especially in patients with severe pulmonary involvement.
COVID-19: Are we close to a cure?
Elvira Manzano, 12 May 2020
After months of work disruption, profound worrying, social distancing, and isolation, SARS-CoV-2* still rages on, unyielding to human interventions.
Hexavalent, pneumococcal vaccine update included in national immunisation schedule
Rachel Soon, 05 Dec 2020

The Malaysian National Immunisation Programme (NIP) will now include a hexavalent combination DTaP-IPV-HiB-HepB vaccine and a pneumococcal vaccine.
Searches for unproven COVID-19 therapies spike after high-profile endorsements
Roshini Claire Anthony, 18 Jun 2020

Endorsement of unproven COVID-19 treatments by high-profile public figures led to a drastic increase in the search and purchase of said treatments in the US, according to a research letter published in JAMA.