Hospital acquired Pneumonia (HAP)
Definition
infection acquired in the course of hospital stay.
It is divided into early hospital acquired pneumonia HAP (within 48 hours) of hospital admission and it is mostly due to and treated like community acquired pneumonia AND late HAP after 48 hours of hospital admission.
At-risk patients:
1- Severe underlying diseases or associated multiple serious co-morbidities like diabetes, renal diseases or cancer.
2-Immunosuupresion like cancer patients receiving chemotherapy or AIDS patients.
3-Intravascular devices as central venous lines inserted into big veins like internal jugular or subclavian to measure superior vena caval pressure to guide fluid management.
4-mechanical ventilation causing ventilator associated pneumonia (resistant organisms and difficult to treat)
Natural Prevention and Treatment of Urinary Tract Infections
Causative organism
1- Early HAP : pneumococci, H. influenza
2- Late HAP: Gram negative organisms (Klebsiella/E. coli/Pseudomonas) and methicillin resistant Staph. Aureus which are resistant organisms.
Prevention of hospital acquired pneumonias:
1-hand wash better with antimicrobial soap.
2- Head elevation of the bed in intensive care units beds. All patients should be sitting at 30-45 degree unless contraindicated.
3- Daily weaning trials with sedation vacation.
4- Non-invasive mechanical ventilation (face/nasal masks) has less incidence of infection than the invasive mechanical ventilation using of endotracheal tube.
5- Antimicrobial coated endotracheal tube.
6- Early tracheostomy within seven days of endotracheal intubation.