Abstract
Introduction Nosocomial pneumonia develops after ≥48 h of hospitalisation and is classified as ventilator-associated pneumonia (VAP) and hospital-acquired pneumonia (HAP); the latter may require mechanical ventilation (V-HAP) or not (NV-HAP).
Main findings VAP and HAP affect a significant proportion of hospitalised patients and are characterised by poor clinical outcomes. Among them, V-HAP has the greatest 28-day mortality rate followed by VAP and NV-HAP (27.8% versus 18% versus 14.5%, respectively). However, no differences in terms of pathophysiology, underlying microbiological pathways and subsequent therapy have been identified. International guidelines suggest specific flow charts to help clinicians in the therapeutic management of such diseases; however, there are no specific recommendations beyond VAP and HAP classification. HAP subtypes are scarcely considered as different entities and the lack of data from the clinical scenario limits any final conclusion. Hopefully, recent understanding of the pathophysiology of such diseases, as well as the discovery of new therapies, will improve the outcome associated with such pulmonary infections.
Conclusion Nosocomial pneumonia is a multifaced disease with features of pivotal interest in critical care medicine. Due to the worrisome data on mortality of patients with nosocomial pneumonia, further prospective studies focused on this topic are urgently needed.
Abstract
Due to the different mortality of each subtype of nosocomial pneumonia, including ventilator-associated pneumonia and hospital-acquired pneumonia requiring mechanical ventilation, new prospective studies are urgently needed https://bit.ly/3fFoZ6U
Footnotes
Provenance: Submitted article, peer reviewed.
Conflict of interest: M.S. Vallecoccia has nothing to disclose.
Conflict of interest: C. Dominedò has nothing to disclose.
Conflict of interest: S.L. Cutuli has nothing to disclose.
Conflict of interest: I. Martin-Loeches reports personal fees from MSD, outside the submitted work.
Conflict of interest: A. Torres has nothing to disclose.
Conflict of interest: G. De Pascale has nothing to disclose.
- Received January 28, 2020.
- Accepted June 14, 2020.
- Copyright ©ERS 2020.
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