Nosocomial pneumonia (hospital-acquired pneumonia - HAP) is the form of pneumonia the symptoms of which present after more than 2 days (> 48 hours) of admission to hospital or as late as 14 days of discharge from hospital. The HAP pneumonias represent 13-18 % of all nosocomial infections. Incidence of HAP is the most frequent in mechanically ventilated patients. The type and representation of HAP agents primarily depends on the length of a patients stay in hospital and on their condition and character of treatment. Diagnosing of pneumonia is based on anamnesis, physical and X-ray findings, results of examination of microbiological samples from the respiratory tract, hemoculture, the pleural effusion test, serological, hematological and biochemical tests. Antibiotic treatment is key to the comprehensive treatment of HAP. The HAP treatment always requires the dosing of antibiotics near the upper limit of the possible range. A precondition for successful avoidance of HAP pneumonias is the creation of a preventive programme with active engagement of medical staff.Key words: diagnostics - HAP pneumonia - treatment - ventilator-associated pneumonia.
- MeSH
- antibakteriální látky terapeutické užití MeSH
- bakteriální pneumonie diagnóza farmakoterapie epidemiologie MeSH
- hospitalizace MeSH
- incidence MeSH
- infekce spojené se zdravotní péčí diagnóza farmakoterapie epidemiologie MeSH
- lidé MeSH
- ventilátorová pneumonie diagnóza farmakoterapie epidemiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- antibakteriální látky MeSH
Ventilator-associated pneumonia (VAP) is defined as pneumonia occurring in a patient after intubation with an endotracheal tube or tracheostomy tube lasting for 48 hours or more. It is also one of the most common and fatal infections of patients in ICUs. The diagnostic process in VAP is still underestimated and precise criteria for diagnosis are inconsistent. Delayed diagnosis and subsequent delay in starting appropriate therapy are associated with worse outcomes in patients with VAP. Appropriate dose, adequate route of administration and reasonable length of antibiotic therapy together with de-escalation are the fundamental principles of therapy. Supportive care is also an integral part of the treatment. Implementing preventive procedures according to the local ICU standards is needed for reducing the incidence of VAP effectively.
- MeSH
- lidé MeSH
- ventilátorová pneumonie * diagnóza farmakoterapie prevence a kontrola MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
Recent advances in intensive care medicine, especially in the last 30 years, have brought numerous new therapeutic methods, devices and materials. On the other hand, more complicated therapy results in higher rates of nosocomial infections, many of which are typical for intensive care. The article provides more detailed information about the issues related to ventilator-associated pneumonia and venous catheter-related infections. In the future, evidence-based medicine may bring higher quality to intensive care medicine and decrease the incidence of nosocomial infections.
