Consensus document on nosocomial pneumonia

Froes, Filipe; Paiva, José Artur; Amaro, Piedade; Baptista, João Pedro; Brum, Gabriela; Bento, Henrique; Duarte, Paula; Dias, Conceição Sousa; Glória, Carlos; Estrada, Helena; Telo, L.; Silva, Eduardo; Pereira, João; Carmo, Germano do

doi:10.1016/s2173-5115(07)70346-9

Cited by 8 publications

(9 citation statements)

References 113 publications

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“…The classification of the HCAP used was based on the Consensus Document on Nosocomial Pneumonia [ 5 ]. The guarantee of confidentiality of the information and the anonymity of the participants was a concern in this study, so that in the data collection and analysis process, there was no element that could identify the individuals in the sample.…”

Section: Methodsmentioning

confidence: 99%

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Epidemiological Characterization and the Impact of Healthcare-Associated Pneumonia in Patients Admitted in a Northern Portuguese Hospital

Méndez

Castro

Ferreira

et al. 2021

JCM

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Pneumonia is one of the main causes of hospitalization and mortality. It’s the fourth leading cause of death worldwide. Healthcare-associated infections are the most frequent complication of healthcare and affect hundreds of millions of patients around the world, although the actual number of patients affected is unknown due to the difficulty of reliable data. The main goal of this manuscript is to describe the epidemiological characteristics of patients admitted with pneumonia and the impact of healthcare-associated pneumonia (HCAP) in those patients. It is a quantitative descriptive study with retrospective analysis of the clinical processes of 2436 individuals for 1 year (2018) with the diagnosis of pneumonia. The individuals with ≤5 years old represented 10.4% (n = 253) and ≥65 were 72.6% (n = 1769). 369 cases resulted in death, which gives a sample lethality rate of 15.2%. The severity and mortality index were not sensitive to the death event. We found 30.2% (n = 735) individuals with HCAP and 0.41% (n = 59) with ventilator-associated pneumonia (VAP). In only 59 individuals (2.4%) the agent causing pneumonia was isolated. The high fatality rate obtained shows that pneumonia is a major cause of death in vulnerable populations. Moreover, HCAP is one of the main causes of hospital admissions from pneumonia and death and the most pneumonias are treated empirically. Knowledge of the epidemiology characterization of pneumonia, especially associated with healthcare, is essential to increase the skills of health professionals for the prevention and efficient treatment of pneumonia.

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Section: Methodsmentioning

confidence: 99%

“…Nosocomial infections are infections acquired by a patient during healthcare that did not have it or was not incubating it at the time of admission [ 5 ]. They constitute the most frequent complication of health care, but the actual number of patients affected is unknown due to the difficulty of reliable data [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Epidemiological Characterization and the Impact of Healthcare-Associated Pneumonia in Patients Admitted in a Northern Portuguese Hospital

Méndez

Castro

Ferreira

et al. 2021

JCM

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“…Exclusion criteria comprised respiratory infections which were in the course of admission found to be caused by mycobacteria or Pneumocystis , either by molecular, microbiological or histopathological methods. Patients hospitalised within 90 days prior to admission or meeting risk factors for health care-associated pneumonia 4 and patients with immunosuppression due to causes other than HIV infection (ongoing chemo- or radiotherapy, haematological malignancy, steroid use and asplenia) were also excluded.…”

Section: Methodsmentioning

confidence: 99%

“…1,2 Community-acquired pneumonia (CAP) is defined as an acute lower respiratory tract infection associated with new radiographic shadowing for which there is no other explanation and which is deemed to be community-acquired, as opposed to hospital-acquired or health care associated. 3,4 HIV infection has been consistently described as a major risk factor for CAP, [5][6][7][8] which is considered a stage 3 disease in the World Health Organization HIV staging classification 9 and an AIDS-defining illness by the American Centers for Disease Control and Prevention (CDC) when recurrent. 10 Despite a reported decline in incidence over the last two decades, [7][8]11 this condition remains frequent in this population, with its relative burden presently greater than before.…”

Section: Introductionmentioning

confidence: 99%

“…13,15,17,18 In order to assess CAP severity on presentation and consequently guide therapeutic options, several prediction scales based on clinical and laboratorial criteria have been developed, which are nowadays widely used and endorsed by clinical societies worldwide. 3,4,22 The Pneumonia Severity Index (PSI), developed in the USA, uses a total of 20 variables, including clinical background and signs, and venous and arterial blood markers. 23 CURB-65, introduced by researchers from the UK, the Netherlands and New Zealand, uses a more elementary prediction rule based on four clinical and one laboratory parameter.…”

Section: Introductionmentioning

confidence: 99%

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CURB-65 and other markers of illness severity in community-acquired pneumonia among HIV-positive patients

Almeida

Vesza

et al. 2016

Int J STD AIDS

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As the relative burden of community-acquired bacterial pneumonia among HIV-positive patients increases, adequate prediction of case severity on presentation is crucial. We sought to determine what characteristics measurable on presentation are predictive of worse outcomes. We studied all admissions for community-acquired bacterial pneumonia over one year at a tertiary centre. Patient demographics, comorbidities, HIV-specific markers and CURB-65 scores on Emergency Department presentation were reviewed. Outcomes of interest included mortality, bacteraemia, intensive care unit admission and orotracheal intubation. A total of 396 patients were included: 49 HIV-positive and 347 HIVnegative. Mean CURB-65 score was 1.3 for HIV-positive and 2.2 for HIV-negative patients (p < 0.0001), its predictive value for mortality being maintained in both groups (p ¼ 0.03 and p < 0.001, respectively). Adjusting for CURB-65 scores, HIV infection by itself was only associated with bacteraemia (adjusted odds ratio [AOR] 7.1, 95% CI [2.6-19.5]). Patients with < 200 CD4 cells/mL presented similar CURB-65 adjusted mortality (aOR 1.7, 95% CI [0.2-15.2]), but higher risk of intensive care unit admission (aOR 5.7, 95% CI [1.5-22.0]) and orotracheal intubation (aOR 9.1, 95% CI [2.2-37.1]), compared to HIV-negative patients. These two associations were not observed in the > 200 CD4 cells/mL subgroup (aOR 2.2, 95% CI [0.7-7.6] and aOR 0.8, 95% CI [0.1-6.5], respectively). Antiretroviral therapy and viral load suppression were not associated with different outcomes (p > 0.05). High CURB-65 scores and CD4 counts < 200 cells/mL were both associated with worse outcomes. Severity assessment scales and CD4 counts may both be helpful in predicting severity in HIV-positive patients presenting with community-acquired bacterial pneumonia.

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Community-Acquired Pneumonia in HIV-Positive Patients: an Update on Etiologies, Epidemiology and Management

Almeida

Boattini

2017

Curr Infect Dis Rep

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While the specific infectious etiologies are very diverse, bacterial infection and tuberculosis are the main causes of CAP in this population. Bacterial CAP mostly affects high-income countries, while tuberculosis is mostly in low-/middle-income countries. Early antiretroviral therapy is of benefit for all patients regardless of etiology and immune status. Specific etiologies require individualized approaches, both therapeutically and prophylatically. Antiretroviral therapy is recommended for all patients.

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Consensus document on nosocomial pneumonia

Cited by 8 publications

References 113 publications

Epidemiological Characterization and the Impact of Healthcare-Associated Pneumonia in Patients Admitted in a Northern Portuguese Hospital

Epidemiological Characterization and the Impact of Healthcare-Associated Pneumonia in Patients Admitted in a Northern Portuguese Hospital

CURB-65 and other markers of illness severity in community-acquired pneumonia among HIV-positive patients

Community-Acquired Pneumonia in HIV-Positive Patients: an Update on Etiologies, Epidemiology and Management

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