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Treating nosocomial pneumonia: what's new

机译:治疗医院内肺炎:最新消息

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Nosocomial pneumonia is an infection of lung parenchyma that occurs in patients hospitalised for more than 48?h after admission [1]. Hospital-acquired pneumonia (HAP) is nosocomial pneumonia in patients who do not require mechanical ventilation; while ventilator-associated pneumonia (VAP) is defined as a pneumonia developing in patients under mechanical ventilation for at least 48?h [2]. HAP is the second most common nosocomial infection, and is the most common hospital infection leading to death in critically ill patients [1]. VAP is the most frequent hospital-acquired infection in intensive care units. Depending on the diagnostic criteria used, its incidence ranges from 5% to 67% [3]. The risk of acquiring VAP is 3% per day during the first 5?days on mechanical ventilation, and it is decreased to 1% per day for the following days. HAP or VAP developing within 4?days of admission are defined as early HAP/VAP, and are usually caused by microorganisms sensitive to antibiotics. HAP or VAP occurring after 5?days of admission are defined as late-onset pneumonias, and are most commonly associated with multidrug-resistant (MDR) pathogens [4, 5]. The mortality of late-onset VAP is higher than the respective mortality for early-onset VAP [6]. The crude mortality of nosocomial pneumonia is estimated to reach 70%. Attributable mortality, which is defined as the percentage of deaths that would have been prevented in the absence of infection, is 10% [7].A detailed and comprehensive summary of the ERS/ESICM/ESCMID/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia, published in ERJ Open Research , will assist clinicians in their tasks http://ow.ly/XC7N30k8Jhu
机译:医院内肺炎是肺实质感染,在入院后住院48小时以上的患者中发生[1]。医院获得性肺炎(HAP)是不需要机械通气的患者的医院内肺炎。呼吸机相关性肺炎(VAP)定义为在机械通气下持续至少48?h的患者发生的肺炎[2]。 HAP是第二常见的医院感染,也是导致重症患者死亡的最常见的医院感染[1]。 VAP是重症监护室中最常见的医院获得性感染。根据使用的诊断标准,其发生率范围为5%至67%[3]。机械通气的前5天内,每天获得VAP的风险为3%,随后几天降低为每天1%。入院后4天内出现的HAP或VAP被定义为早期HAP / VAP,通常是由对抗生素敏感的微生物引起的。入院5天后发生的HAP或VAP被定义为迟发性肺炎,最常与耐多药(MDR)病原体相关[4,5]。迟发性VAP的死亡率高于早发性VAP的死亡率[6]。医院内肺炎的粗死亡率估计达到70%。可归因的死亡率(定义为在没有感染的情况下可以避免的死亡百分比)为10%[7]。有关ERS / ESICM / ESCMID / ALAT医院管理指南的详细详尽概述在ERJ开放研究中发表的后天性肺炎和呼吸机相关性肺炎将协助临床医生完成任务。

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