Vnitr Lek 2017, 63(11):776-785 | DOI: 10.36290/vnl.2017.149

Hospital-acquired pneumonias

Petr Jakubec*, Aneta Křenková, Vítězslav Kolek
Klinika plicních nemocí a tuberkulózy LF UP a FN Olomouc

Nosocomial infections are a common complication of hospital care. Hospital-acquired (HAP) pneumonia is one of the most common nosocomial infections and it is the most dangerous in terms of mortality. The problem is mainly selected hospital bacterial strains with rising antibiotic resistance. Diagnosis of the cause of pneumonia is difficult and often does not lead to a positive result. Management is complex and is based on timely and appropriate empirical antibiotic treatment. Local and extrapulmonary complications are relatively common and they increase morbidity and mortality. Prognosis of the HAP is often unfavorable, especially in the elderly and polymorbid individuals.

Keywords: complications; etiology; hospital-acquired pneumonia; management

Received: August 20, 2017; Accepted: September 26, 2017; Published: November 1, 2017  Show citation

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Jakubec P, Křenková A, Kolek V. Hospital-acquired pneumonias. Vnitr Lek. 2017;63(11):776-785. doi: 10.36290/vnl.2017.149.
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References

  1. Kalil AC, Metersky ML, Klompas M et al. Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Disease Society of America and the American Thoracic Society. Clin Infect Dis 2016; 63(5): e61-e111. Dostupné z DOI: <http://dx.doi.org/10.1093/cid/ciw353>. Go to original source... Go to PubMed...
  2. Ewig S, Welte T, Chastre J et al. Rethinking the concepts of comunity-acquired and health-care-associated pneumonia. Lancet Infect Dis 2010; 10(4): 279-287. Dostupné z DOI: <http://dx.doi.org/10.1016/S1473-3099(10)70032-3>. Go to original source... Go to PubMed...
  3. Magill SS, Edwards JR, Fridkin SK. [Emerging Infections Programme Healthcare-Associated Infections Antimicrobial Use Prevalence Survey Team]. Survey of healthcare-associated infections. N Engl J Med 2014, 370(26): 2542-2543. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMc1405194>. Go to original source...
  4. Jakubec P, Kolář M, Kolek V. Diagnostika a léčba těžké pneumonie. In: Kolek V et al. Doporučené postupy v pneumologii. 2. ed. Maxdorf: Praha 2016. ISBN 978-80-7345-507-1.
  5. Vincent JL, Bassetti M, François B et al. Advances in antibiotic therapy in the critically ill. Crit Care 2016; 20(1): 133. Dostupné z DOI: <http://dx.doi.org/10.1186/s13054-016-1285-6>. Go to original source... Go to PubMed...
  6. Craven DE, Chroneou A. Nosocomial pneumonia. In: Madell GL, Benett JE, Dolin R (eds). Principles and Practices of Infectoius Diseases. 2 voll. 7th ed. Elsevier Churchill Livingstone: Philadelphia (PA) 2009: 3717-3724. ISBN 978-0443068393. Go to original source...
  7. Torres A, Ewig S, Lode H et al. [European HAP working group]. Defining, treating and preventing hospital acquired pneumonia. Intensive Care Med 2009; 35(1): 9-29. Dostupné z DOI: <http://dx.doi.org/10.1007/s00134-008-1336-9>. Go to original source... Go to PubMed...
  8. Wang Y, Eldridge N, Metersky ML et al. National trends in patient safety for four common conditions, 2005-2011. N Engl J Med 2014, 370(4): 341-351. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMsa1300991>. Go to original source... Go to PubMed...
  9. Ego A, Preiser JC, Vincent JL. Impact of diagnostic criteria on the incidence of ventilator-associated pneumonia. Chest 2015; 147(2): 347-355. Dostupné z DOI: <http://dx.doi.org/10.1378/chest.14-0610>. Go to original source... Go to PubMed...
  10. [American Thoracic Society; Infectious Diseases Society of America]. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med 2005; 171(4): 388-416. Go to original source... Go to PubMed...
  11. [National Institute for Health and Care Excellence (NICE)]. Pneumonia in adults: diagnosis and manamagement. NICE 2014. [20.3.2017]. Dostupné z WWW: http://www.nice.org.uk/guidance/cg191. ISBN 978-1-4731-0864-6.
  12. Sopena M, Heras E, Casas I et al. Risk factors for hospital-acquired pneumonia outside the intensive care unit: A case-control study. Am J Infect Control 2014, 42(1): 38-42. Dostupné z DOI: <http://dx.doi.org/10.1016/j.ajic.2013.06.021>. Go to original source... Go to PubMed...
  13. Fabregas N, Ewig S, Torres A et al. Clinical diagnosis of ventilator associated pneumonia revisited: comparative validation using immediate post-mortem lung biopsies. Thorax 1999; 54(10): 867-873. Go to original source... Go to PubMed...
  14. Di Pasquale M, Ferrer M, Esperatti M et al. Assessment of severity of ICU-acquired pneumonia and association with etiology. Crit Care Med 2014, 42(2): 303-312. Dostupné z DOI: <http://dx.doi.org/10.1097/CCM.0b013e3182a272a2>. Go to original source... Go to PubMed...
  15. Blot S, Koulenti D, Dimopoulos G et al. Prevalence, risk factors, and mortality for ventilator-associated pneumonia in middle-aged, old, and very old critically ill patients. Crit Care Med 2014; 42(3): 601-609. Go to original source... Go to PubMed...
  16. Torres A, Ewig S (eds). Nosocomial and Ventilator-Associated Pneumonia. European Respiratory Society Monograph: Plymouth 2011. Vol. 53. ISBN 978-1-84984-016-3. Dostupné z DOI: <http://dx.doi.org/10.1183/1025448x.erm5310>. Go to original source...
  17. Kalanuria AA, Zai W, Mirski M. Ventilator-associated pneumonia in the ICU. Crit Care 2014; 18(2): 208. Dostupné z DOI: <http://dx.doi.org/10.1186/cc13775>. Erratum in Ventilator-associated pneumonia in the ICU. [Crit Care. 2016] Go to original source... Go to PubMed...
  18. Gamache J, Harrington A, Kamangar N et al. Bacterial pneumonia. Medscape. Updated 07.12.2016. [25.03.2017]. Dostupné z WWW: <http://emedicine.medscape.com/article/300157-overview>.
  19. Amanullah S (ed), Posner DH, Talavera F et al. Ventilator-Associated Pneumonia Overview of Nosocomial Pneumonias, Medscape, Medscape. Updated 31.12.2015. [18.03.2017]. Dostupné z WWW: <http://emedicine.medscape.com/article/304836-overview#a1>.
  20. Cook DJ, Walter SD, Cook RJ et al. Incidence of and risk factors for ventilator-associated pneumonia in critically ill patients. Ann Intern Med 1998; 129(6): 433-440. Go to original source... Go to PubMed...
  21. Restrepo M, Peterson J, Fernandez JF et al. Comparison of the bacterial etiology of early-onset and late-onset ventilator-associated pneumonia in subjects enrolled in 2 large clinical studies. Respir Care 2013; 58(7): 1220-1225. Dostupné z DOI: <http://dx.doi.org/10.4187/respcare.02173>. Go to original source... Go to PubMed...
  22. Giantsou E, Liratzopoulos N, Efraimidou E et al. Both early-onset and late-onset ventilator-associated pneumonia are caused mainly by potentially multiresistant bacteria. Intensive Care Med 2005; 31(11): 1488-1494. Go to original source... Go to PubMed...
  23. Nair GB, Niederman MS. Ventilator-associated pneumonia: present understanding and ongoing debate. Intensive Care Med 2015; 41(1): 34-48. Dostupné z DOI: <http://dx.doi.org/10.1007/s00134-014-3564-5>. Go to original source... Go to PubMed...
  24. Ferrer M, Difrancesco LF, Liapikou A et al. Polymicrobial Intensive Care Unit-acquired Pneumonia: Prevalence, Microbiology and Outcome. Crit Care 2015; 19: 450. Dostupné z DOI: <http://dx.doi.org/10.1186/s13054-015-1165-5>. Go to original source... Go to PubMed...
  25. Jones RN. Microbial etiologies of hospital-acquired bacterial pneumonia and ventilator-associated pneumonie. Clin Infect Dis 2010; 51(Suppl 1): S81-S87. Dostupné z DOI: <http://dx.doi.org/10.1086/653053>. Erratum in Clin Infect Dis 2010; 51(9): 1114. Go to original source... Go to PubMed...
  26. Weber DJ, Rutala WA, Sickbert-Bennett EE et al. Microbiology of ventilator-associated pneumonia compared with that of hospital-acquired pneumonia. Infect Control Hosp Epidemiol 2007; 28(7): 825-831. Go to original source... Go to PubMed...
  27. Sopena M, Sabria M. [Neunos Study Group]. Multicenter study of hospital-acquired pneumonia in non-ICU patients. Chest 2005; 127(1): 213-219. Go to original source... Go to PubMed...
  28. Hanulík V, Uvízl R, Husičková V et al. Bakteriální původci pneumonií u pacientů v intenzivní péči. Klin Mikrobiol Infekc Lek 2011; 17(4): 135-140. Go to PubMed...
  29. Uvizl R, Hanulik V, Husickova V et al. Hospital-acquired pneumonia in ICU patients. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2011; 155(4): 373-378. Go to original source... Go to PubMed...
  30. Herkeĺ T, Uvízl R, Adamus M et al. Epidemiology of hospital-acquired pneumonia: results of a Central European multicenter, prospective, observational study compared with data from the European region. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2016; 160(3): 448-455. Go to original source... Go to PubMed...
  31. Rhodes A, Evans LE, Alhazzani W et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med 2017; 43(3): 304-377. Dostupné z DOI: <http://dx.doi.org/10.1007/s00134-017-4683-6>. Go to original source... Go to PubMed...
  32. Chastre J, Combes A, Luyt CE. The Invasive (Quantitative) Diagnosis of Ventilator-Asssociated Pneumonia. Respir Care 2005; 50(6): 797-807.
  33. Meduri GU, Chastre J. The Standardization of Bronchoscopic Techniques for Ventilator-Associated Pneumonia. Chest 1992; 102(5 Suppl 1): S557-S564. Go to original source... Go to PubMed...
  34. [Japanese Respiratory Society]. Diagnosis of hospital-acquired pneumonia and methods of testing for pathogens. Respirology 2009; 14(Suppl 2): S10-S22. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1440-1843.2009.01572.x>. Go to original source... Go to PubMed...
  35. Chastre J, Fagon JY. Ventilator-associated pneumonia. Am J Respir Crit Care 2002; 165(7): 867-903. Go to original source... Go to PubMed...
  36. Campbell GD Jr. Blinded invasive diagnostic procedures in ventilator-associated pneumonia. Chest 2000; 117(4/Suppl 2): S207-S211. Go to original source... Go to PubMed...
  37. Torres A, El-Ebiary M. Bronchoscopic BAL in the diagnosis of ventilator-associated pneumonia. Chest 2000; 117(4 Suppl 2): S198-S202. Go to original source... Go to PubMed...
  38. Meduri GU, Beals DH, Maijub AG et al. Protected bronchoalveolar lavage. A new bronchoscopic technique to retrieve uncontaminated distal airway secretion. Am Rev Respir Dis 1991; 143(4 Pt 1): 855-864. Go to original source... Go to PubMed...
  39. Baughman RP. Protected-specimen brush technique in the diagnosis of ventilator-associated pneumonia. Chest 2000; 117(4 Suppl 2): S203-S206. Go to original source... Go to PubMed...
  40. Torres A, El-Ebiary M, Padro L et al. Validation of different techniques for the diagnosis of ventilator-associated pneumonia. Comparison with immediate postmortem pulmonary biopsy. Am J Respir Crit Care Med 1994; 149(2 Pt 1): 324-331. Go to original source... Go to PubMed...
  41. Rea-Neto A, Youssef NCM, Tuche F et al. Diagnosis of ventilator-associated pneumonia: a systematic review of the literature. Crit Care 2008; 12(2): R56. Dostupné z DOI: <http://dx.doi.org/10.1186/cc6877>. Go to original source... Go to PubMed...
  42. Shorr AF, Sherner JH, Jackson WL et al. Invasive approaches to the diagnosis of ventilator-associated pneumonia: a meta-analysis. Crit Care Med 2005; 33(1): 46-53. Go to original source... Go to PubMed...
  43. Rello J, Vidaur L, Sandiumenge A et al. De-escalation therapy in ventilator-associated pneumonia. Crit Care Med 2004; 32(11): 2183-2190. Go to original source... Go to PubMed...
  44. [Canadian Critical Care Trials Group]. A randomized trial of diagnostic techniques for ventilator-associated pneumonia. N Engl J Med 2006; 355(25): 2619-2630. Go to original source... Go to PubMed...
  45. Kowalczyk W, Rybicki Z, Tomaszewski D et al. The comparison of different bronchial aspirate culturing methods in patients with ventilator-associated pneumonia. Anestezjol Intens Ter 2011; 43(2): 74-79. Go to PubMed...
  46. Clec'h C, Jauréguy F, Hamza L et al. Agreement Between Quantitative Cultures of Postintubation Tracheal Aspiration and Plugged Telescoping Catheter, Protected Specimen Brush, or BAL for the Diagnosis of Nosocomial Pneumonia. Chest 2006; 130(4): 956-961. Go to original source... Go to PubMed...
  47. Papazian L, Thomas P, Garbe L et al. Bronchoscopic or blind sampling techniques for the diagnosis of ventilator-associated pneumonia. Am J Respir Crit Care Med 1995; 152(6 Pt 1): 1982-1991. Go to original source... Go to PubMed...
  48. Gabrhelík T, Hanulik V, Jakubec P et al. Porovnání validity různých vzorků biologického materiálu z dýchacích cest a jejich přínosu v detekci původců nozokomiální pneumonie. Klin Mikrobiol Infekc Lek 2015; 21(1): 4-9. Go to PubMed...
  49. Dalhoff K, Ewig S. [Guideline Development Group]. Clinical Practise Guideline: Adult patients with nosocomial pneumonia - epidemiology, diagnosis and treatment. Dtsch Arztebl Int 2013; 110(38): 634-640. Dostupné z DOI: <http://dx.doi.org/10.3238/arztebl.2013.0634>. Go to original source... Go to PubMed...
  50. Caliendo AM, Gilbert DN, Ginocchio CC et al. Better tests, better care: improved diagnostics for infectious diseases. Clin Infect Dis 2013; 57(Suppl 3): S139-S170. Dostupné z DOI: <http://dx.doi.org/10.1093/cid/cit578>. Erratum in Clin Infect Dis 2014; 58(9): 1346. Go to original source... Go to PubMed...
  51. Lung M, Codina G. Molecular diagnosis in HAP/VAP. Curr Opin Crit Care 2012; 18(5): 487-494. Dostupné z DOI: <http://dx.doi.org/10.1097/MCC.0b013e3283577d37>. Go to original source... Go to PubMed...
  52. Iregui M, Ward S, Sherman G. et al. Clinical importance of delaying the initiation of appropriate antibiotic treatment for ventilator associated pneumonia. Chest 2002; 122(1): 262-268. Go to original source... Go to PubMed...
  53. Rello J, Lisboa T, Koulenti D. Respiratory infections in patients undergoing mechanical ventilation. Lancet Respir Med 2014; 2(9): 764-774. Dostupné z DOI: <http://dx.doi.org/10.1016/S2213-2600(14)70171-7>. Go to original source... Go to PubMed...
  54. Schuetz P, Muller B, Christ-Crain M et al. Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections. Cochrane Database Syst Rev 2012; (9): CD007498. Dostupné z DOI: <http://dx.doi.org/10.1002/14651858.CD007498.pub2>. Go to original source... Go to PubMed...
  55. Stolz D, Smyrnios N, Eggimann P et al. Procalcitonin for reduced antibiotic exposure in ventilator-associated pneumonia: a randomized study. Eur Respir J 2009; 34(6): 1364-1375. Dostupné z DOI: <http://dx.doi.org/10.1183/09031936.00053209>. Go to original source... Go to PubMed...
  56. Frat, JPD, Thille AW, Mercat A et al. High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory Failure. N Engl J Med 2015; 372(23): 2185-2196. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1503326>. Go to original source... Go to PubMed...
  57. Ferrer M, Esquinas A, Leon M et al. Noninvasive ventilation in severe hypoxemic respiratory failure: a randomized clinical trial. Am J Respir Crit Care Med 2003; 168(12): 1438-1444. Go to original source...
  58. Briel M, Meade M, Mercat A et al. Higher vs. lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. JAMA 2010; 303(9): 865-873. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.2010.218>. Go to original source... Go to PubMed...
  59. Gattinoni L, Carlesso E, Taccone P et al. Prone positioning improves survival in severe ARDS: a pathophysiologic review and individual patient metaanalysis. Minerva Anestesiol 2010; 76(6): 448-454. Go to PubMed...
  60. Sud S, Friedrich JO, Taccone P et al. Prone ventilation reduces mortality in patients with acute respiratory failure and severe hypoxemia: systematic review and meta-analysis. Intensive Care Med 2010; 36(4): 585-599. Dostupné z DOI: <http://dx.doi.org/10.1007/s00134-009-1748-1>. Go to original source... Go to PubMed...
  61. Di Pasquale M, Aliberti S, Mantero M et al. Non-Intensive Care Unit Acquired Pneumonia: A New Clinical Entity? Int J Mol ASc. 2016; 17(3): 287. <http://dx.doi.org/10.3390/ijms17030287>. Go to original source... Go to PubMed...
  62. Bouadma L, Wolff M, Lucet JC. Ventilator-associated pneumonia and its prevention. Curr Opin Infect Dis 2012; 25(4): 395-404. Dostupné z DOI: <http://dx.doi.org/10.1097/QCO.0b013e328355a835>. Go to original source... Go to PubMed...
  63. Nair GB, Niederman MS. Ventilator-associated pneumonia: present understanding and ongoing debate. Intensive Care Med 2015; 41(1): 34-48. Dostupné z DOI: <http://dx.doi.org/10.1007/s00134-014-3564-5>. Go to original source... Go to PubMed...
  64. Corrales-Medina VF, Musher DM, Shachkina S et al. Acute pneumonia and the cardiovascular system. Lancet 2013; 381(9865): 496-505. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140-6736(12)61266-5>. Go to original source... Go to PubMed...
  65. Schulgen G, Kropec A, Kappstein I et al. Estimation of extra hospital stay attributable to nosocomial infections: heterogenity and timing of events. J Clin Epidemiol 2000; 53(4): 409-417. Go to original source... Go to PubMed...
  66. Craven DE, Palladino R, McQuillen DP. Healthcare-associated pneumonia in adults: management principles to improve outcomes. Infect Dis Clin North Am 2004; 18(4): 939-962. Go to original source... Go to PubMed...
  67. Melsen WG, Rovers MM, Groenwold RH et al. Atributable mortality of ventilator-associated pneumonia: a meta-analysis of individual patient data from randomized prevention studies. Lancet Infect Dis 2013; 13(8): 665-671. Dostupné z DOI: <http://dx.doi.org/10.1016/S1473-3099(13)70081-1>. Go to original source... Go to PubMed...
  68. Kollef MH, Snorr A, Tabak YP et al. Epidemiology and outcomes of health-care-associated pneumonia: results from a large US database of culture-positive pneumonia. Chest 2005; 128(6): 3854-3862.Erratum in Chest 2006; 129(3): 831. Go to original source... Go to PubMed...




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