BACKGROUND: Traditionally, pneumonia developing in patients who receive healthcare services in the outpatient environment has been classified as community-acquired pneumonia (CAP). However, recent investigations suggest that this type of infection, known as healthcare-associated pneumonia (HCAP), is distinct from CAP in terms of its epidemiology, etiology, and risk for infection with multidrug-resistant (MDR) pathogens. METHODS: A Medline literature review of available clinical studies using the term HCAP was conducted to determine outcomes compared to CAP and effective empiric treatment strategies. RESULTS: Analysis of multi-institutional clinical data showed that mortality in hospitalized patients with HCAP is greater than that in CAP, and patients with HCAP received inappropriate initial empiric antibiotic treatment more frequently than CAP patients. The bacterial pathogens associated with HCAP also differed from CAP with potentially MDR Gram-positive and Gram-negative bacteria being more common in HCAP. CONCLUSIONS: All patients hospitalized with suspected HCAP should be evaluated for their underlying risk of infection with MDR pathogens. Because HCAP is similar to hospital-acquired pneumonia (HAP), both clinically and etiologically, it should be treated as HAP until culture data become available.
BACKGROUND: Traditionally, pneumonia developing in patients who receive healthcare services in the outpatient environment has been classified as community-acquired pneumonia (CAP). However, recent investigations suggest that this type of infection, known as healthcare-associated pneumonia (HCAP), is distinct from CAP in terms of its epidemiology, etiology, and risk for infection with multidrug-resistant (MDR) pathogens. METHODS: A Medline literature review of available clinical studies using the term HCAP was conducted to determine outcomes compared to CAP and effective empiric treatment strategies. RESULTS: Analysis of multi-institutional clinical data showed that mortality in hospitalized patients with HCAP is greater than that in CAP, and patients with HCAP received inappropriate initial empiric antibiotic treatment more frequently than CAP patients. The bacterial pathogens associated with HCAP also differed from CAP with potentially MDR Gram-positive and Gram-negative bacteria being more common in HCAP. CONCLUSIONS: All patients hospitalized with suspected HCAP should be evaluated for their underlying risk of infection with MDR pathogens. Because HCAP is similar to hospital-acquired pneumonia (HAP), both clinically and etiologically, it should be treated as HAP until culture data become available.
Authors: Marco Falcone; Salvatore Corrao; Giuseppe Licata; Pietro Serra; Mario Venditti Journal: Intern Emerg Med Date: 2012-06-12 Impact factor: 3.397
Authors: Marco Falcone; Francesco Blasi; Francesco Menichetti; Federico Pea; Francesco Violi Journal: Intern Emerg Med Date: 2012-06-12 Impact factor: 3.397
Authors: Chad R Marion; Jianmiao Wang; Lokesh Sharma; Ashley Losier; Wei Lui; Nathaniel Andrews; Jack A Elias; Barbara I Kazmierczak; Craig R Roy; Charles S Dela Cruz Journal: Infect Immun Date: 2016-06-23 Impact factor: 3.441
Authors: Dheeraj Gupta; Ritesh Agarwal; Ashutosh Nath Aggarwal; Navneet Singh; Narayan Mishra; G C Khilnani; J K Samaria; S N Gaur; S K Jindal Journal: Lung India Date: 2012-07