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Introduction
Healthcare-associated Pneumonia (HCAP)
- Pneumonia occurring in any patient who was hospitalized w/in an acute care hospital for ≥2 days, w/in 90 days of the infection; resided in a nursing home/long-term care facility; received recent IV antibiotic therapy, chemotherapy or wound care w/in the past 30 days of the current infection; or attended a hospital or hemodialysis clinic
Definition
Hospital-acquired Pneumonia (HAP)
- Defined as pneumonia occurring ≥48 hours after admission & excluding any infection that is incubating at the time of admission
- Described as pneumonia occurring >48-72 hours after endotracheal intubation & w/in 48 hours after removal of endotracheal tube
- Pneumonia occurring w/in the first 4 days of hospitalization
- May be caused by antibiotic-sensitive bacteria, usually carries a better prognosis
- Pneumonia occurring after ≥5 days
- Likely to be caused by multidrug-resistant (MDR) pathogens, associated w/ increased mortality & morbidity
Signs and Symptoms
Typical Signs & Symptoms
- Fever
- Cough w/ or w/o sputum production
- Purulent sputum
- Dyspnea; shortness of breath (SOB)
- Respiratory failure
- Worsening oxygenation
- Increased heart rate
- Increased minute ventilation
Risk Factors
- ≥5 days duration stay for the current hospitalization
- High antibiotic resistance in the community or w/in the specific treatment unit
- Antibiotics w/in the preceding 90 days
- Immunosuppressive disease &/or therapy
- Presence of healthcare-associated pneumonia (HCAP) risk factors:
- Chronic dialysis w/in 30 days
- Family member w/ multidrug-resistant (MDR) organism
- Home infusion therapy (including antibiotics)
- Home wound care
- Hospitalization for ≥2 days w/in the previous 90 days
- Resident of nursing home/long-term care facility
