An infection of the lungs contracted during a hospital stay.
Causes, incidence, and risk factors
Pneumonia is a very common serious illness. It is caused by many different organisms and can range in seriousness from mild to life-threatening. Hospital-acquired pneumonia tends to be more serious because defense mechanisms against infection are often impaired, and the kinds of infecting organisms are more dangerous than those generally encountered in the community. Risk factors predisposing people to hospital-acquired pneumonia are alcoholism , older age, immunosuppression from medications or diseases, recent illness, and risk of aspiration .
Signs and tests
A physical examination reveals respiratory distress and crackles or decreased breath sounds when listening to the chest with a stethoscope. Tests performed may include:
chest X-ray or CT scan sputum Gram stain sputum culture to determine causative organism blood cultures CBC (complete blood cell count) arterial blood gases
Treatment
The objective of treatment is to cure the infection with antibiotics. An antibiotic is selected based on the specific causative organism detected by sputum culture . However, the organism cannot always be identified from testing, so antibiotic therapy is given to fight the most common bacterial organisms that infect hospitalized patients (Staphylococcus aureus and Gram negative rods). Supportive treatment includes supplemental oxygen and respiratory treatments to loosen and remove thick secretions from the lungs.
Expectations (prognosis)
Most patients respond to the treatment and improve in 2 weeks. However, hospital-acquired pneumonias can be very severe and sometimes fatal.
Complications
Elderly or debilitated patients who fail to respond to treatment may die from acute respiratory failure.
Calling your health care provider
This disorder usually develops in the hospital and is detected there.
Prevention
Ongoing prevention programs to limit hospital-acquired infections are in place at most institutions.