Hospital-acquired Pneumonia in Adults: Diagnosis, Assessment of Severity, Initial Antimicrobial Therapy, and Preventative Strategies: A Consensus Statement

摘要

Hospital-acquired pneumonia (HAP) remains an important cause of mortality and morbidity despite the introduction of potent broad-spectrum antimicrobial agents, complex supportive care modalities, and the use of preventive measures. HAP, defined as pneumonia occurring ≥ 48 h after admission and excluding any infection that is incubating at the time of admission, is not a reportable illness. However, available data suggest that it occurs at a rate of between 5 to 10 cases per 1,000 hospital admissions, with the incidence increasing by as much as six- to 20-fold in patients who are being ventilated mechanically. Pneumonia is currently the second most common nosocomial infection in the United States but has the highest mortality and morbidity, and its presence increases hospital stay by an average of 7-9 d per patient.