Hospital Acquired Pneumonia
Hospital Acquired Pneumonia (HAP) refers to a respiratory infection that develops more than 48 hours after hospital admission. It is differentiated from a community acquired pneumonia (CAP) as the pathogen is likely to be different and hence so will the antimicrobial treatment. HAP is more likely to be caused by bacteria rather than a virus, and there is higher risk of it being a multi-drug resistant bacteria.
HAP has a high mortality rate. It is reported that at any time in England 1.5% of patients in hospital will have a hospital acquired respiratory infection, more than half of these patients have HAP. Having HAP is estimated to increase hospital length of stay by about 8 days, with a mortality rate between 30-70%.
Diagnosis of HAP can be based on the presence of:
New/or persistent shadowing on chest x-ray which is otherwise unexplained
Other features that may be present:
Cough, fever, sputum production, breathlessness
Raised or low WBC
New oxygen requirement
Prevention
Although not entirely preventable, there are some things we can do as health care professionals to reduce the incidence of HAP.
Infection control is the most important prevention strategy in the prevention of healthcare associated infections. Some other interventions can be used in certain groups of patients to potentially reduce the incidence of HAP.
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HAP Assessment
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HAP Management