Healthcare-Associated Pneumonia (HCAP)

8/18/2019 Healthcare-Associated Pneumonia (HCAP)

1/20

Healthcare-Associated

Pneumonia (HCAP)


2/20

HCAP: Defning the Problem• Healthcare-associated pneumonia

(HCAP) is an emerging pneumoniacategory

• There is increasing recognition thatindividuals ho ac!uire in"ections

hile receiving out-o"-hospitalhealthcare di#er "rom those ithcommunity-ac!uired in"ections$


3/20

HCAP: Defning the Problem• HCAP includes patients ith healthcare-

system contact in the days and%or ee&sprior to in"ection$

• 'ultiple studies suggest that HCAP di#ers"rom community-ac!uired pneumonia(CAP) in terms o" demographics ris&"actors and disease characteristics$

• All patients ith HCAP are considered atris& "or multi-drug resistant ('D ) andatypical organisms


4/20

Di#erentiating Pneumonia Types

Pneumonia is the third leading cause o" deathamong the *ilipino people based on the Philippinehealth statistics in D+H$


5/20


6/20


7/20

4acterial 5tiology• Pseudomonas Aeruginosa• Escherichia coli• Klebsiela pneumoniae•

Enterobacter spp.• Serratia spp.• Acinetobacter • Methicillin resistant Staphylococcus Aureus• Streptococcus Pneumoniae• Heamophilus Infuenzae• Legionella pneumophila


8/20

*ungal 5tiology• andida spp.• Aspergillus spp.


9/20

1iral 5tiology• Infuenza• Parainfuenza•

Adeno!irus• Measles• "espiratory syncytial !irus


10/20


11/20

Diagnostic 6trategies• 6uspicion o" pneumonia

– Clinical fndings: "ever purulent sputumleu&ocytosis

– adiographic infltrate – Decline in arterial o7ygenation

saturation –

+ther signs: hemodynamic instabilitydeterioration o" blood gases

• Distinguish HCAP "rom CAP by history


12/20


13/20


14/20


15/20


16/20


17/20


18/20

Assessing esponse to Therapy

• Clinical improvement usually ta&es89 ;< hours and thus therapyshould not be changed during thistime unless there is rapid clinicaldecline$

• =onresponse to therapy is usuallyevident by Day 2 using anassessment o" clinical parameters$


19/20


20/20

Duration o" Therapy• 5#orts should be made to shorten

the duration o" therapy "rom thetraditional >8 to days to periodsas short as ; days provided that theetiologic pathogen is not P$aeruginosa and that the patient has

a good clinical response ithresolution o" clinical "eatures o"in"ection$

Healthcare-Associated Pneumonia (HCAP)

Documents

Transcript of Healthcare-Associated Pneumonia (HCAP)