Year: 2023
Type: review
Abstract: Nosocomial pneumonia, or hospital-acquired pneumonia (HAP), and ventilator-associated pneumonia (VAP) are important health problems worldwide, with both being associated with substantial morbidity and mortality. HAP is currently the main cause of death from nosocomial infection in critically ill patients. Although guidelines for the approach to this infection model are widely implemented in international health systems and clinical teams, information continually emerges that generates debate or requires updating in its management. This scientific manuscript, written by a multidisciplinary team of specialists, reviews the most important issues in the approach to this important infectious respiratory syndrome, and it updates various topics, such as a renewed etiological perspective for updating the use of new molecular platforms or imaging techniques, including the microbiological diagnostic stewardship in different clinical settings and using appropriate rapid techniques on invasive respiratory specimens. It also reviews both Intensive Care Unit admission criteria and those of clinical stability to discharge, as well as those of therapeutic failure and rescue treatment options. An update on antibiotic therapy in the context of bacterial multiresistance, in aerosol inhaled treatment options, oxygen therapy, or ventilatory support, is presented. It also analyzes the out-of-hospital management of nosocomial pneumonia requiring complete antibiotic therapy externally on an outpatient basis, as well as the main factors for readmission and an approach to management in the emergency department. Finally, the main strategies for prevention and prophylactic measures, many of them still controversial, on fragile and vulnerable hosts are reviewed.
Source: Journal of Clinical Medicine
DOI: 10.3390/jcm12206526
Authors: Francisco Javier Candel, Miguel Salavert, Angel Estella, Miquel Ferrer, Ricard Ferrer, Julio Javier Gamazo, Carolina García-Vidal, Juan González del Castillo, Víctor José González-Ramallo, Federico Gordo, Manuel Mirón-Rubio, Javier Pérez-Pallarés, Cristina Pitart, José Luís del Pozo, Paula Ramírez, Pedro Rascado, Soledad Reyes, Patricia Ruiz-Garbajosa, Borja Suberviola, Pablo Vidal, Rafael Zaragoza
Institutions: Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Hospital Universitari i Politècnic La Fe, Instituto de Investigación Sanitaria La Fe, Universidad de Cádiz, Biomedical Research and Innovation Institute of Cadiz, Hospital Universitario de Jerez, Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Universitat de Barcelona, Vall d'Hebron Hospital Universitari, Hospital de Galdakao, Hospital General Universitario Gregorio Marañón, Hospital Universitario del Henares, Hospital Universitario de Torrejón, Santa Lucía University General Hospital, Barcelona Institute for Global Health, Navarre Institute of Health Research, Clinica Universidad de Navarra, Complejo Hospitalario Universitario de Santiago, Hospital Universitario Ramón y Cajal, Marqués de Valdecilla University Hospital, Instituto de Investigación Marqués de Valdecilla, Complejo Hospitalario de Ourense, Hospital Universitario Doctor Peset
Language: English
Topic: Nosocomial Infections in ICU
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,892
OpenAlex ID: W4387639028