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Hospital-acquired pneumonia
Nosocomial pneumonia; Ventilator-associated pneumonia; Health-care associated pneumonia; HCAP
Hospital-acquired pneumonia is an infection of the lungs that occurs during a hospital stay. This type of pneumonia can be very severe. Sometimes it can be fatal.
Causes
Pneumonia is a common illness. It is caused by many different germs. Pneumonia that starts in the hospital tends to be more serious than other lung infections because:
Pneumonia
Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...
- People in the hospital are often very sick and cannot fight off germs.
- The types of germs present in a hospital are often more dangerous and more resistant to treatment than those outside in the community.
Pneumonia occurs more often in people who are using a respirator. This machine helps them breathe.
Hospital-acquired pneumonia can also be spread by health care workers, who can pass germs from their hands or clothes from one person to another. This is why hand-washing, wearing gowns, and using other safety measures is so important in the hospital.
People can be more likely to get pneumonia while in the hospital if they:
- Abuse alcohol
- Have had chest surgery or other major surgery
- Have a weak immune system from cancer treatment, certain medicines, or severe wounds
-
Have long-term (chronic)
lung disease
Lung disease
Lung disease is any problem in the lungs that prevents the lungs from working properly. There are three main types of lung disease:Airway diseases -...
ImageRead Article Now Book Mark Article - Breathe saliva or food into their lungs as a result of not being fully alert or having swallowing problems (for example, after a stroke)
- Are older
Symptoms
In an elderly person, the first sign of hospital-acquired pneumonia may be mental changes or confusion
Other symptoms may include:
- A cough with greenish or pus-like phlegm (sputum)
- Fever and chills
- General discomfort, uneasiness, or ill feeling (malaise)
- Loss of appetite
- Nausea and vomiting
- Sharp chest pain that gets worse with deep breathing or coughing
- Shortness of breath
- Decreased blood pressure and fast heart rate
Exams and Tests
Tests to check for hospital-acquired pneumonia may include:
-
Arterial blood gases
, to measure oxygen levels in the blood
Arterial blood gases
Blood gases are a measurement of how much oxygen and carbon dioxide are in your blood. They also determine the acidity (pH) of your blood.
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Blood cultures
, to see if the infection has spread to the blood
Blood cultures
A blood culture is a laboratory test to check for bacteria or other germs in a blood sample.
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Chest x-ray
or
CT scan
, to check the lungs
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
ImageRead Article Now Book Mark ArticleCT scan
A chest CT (computed tomography) scan is an imaging method that uses x-rays to create cross-sectional pictures of the chest and upper abdomen....
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Complete blood count (
CBC
)
CBC
A complete blood count (CBC) test measures the following:The number of red blood cells (RBC count)The number of white blood cells (WBC count)The tota...
ImageRead Article Now Book Mark Article - Pulse oximetry, to measure oxygen levels in the blood
-
Sputum culture
or
sputum gram stain
, to check what germs are causing the pneumonia
Sputum culture
Routine sputum culture is a laboratory test that looks for germs that cause infection. Sputum is the material that comes up from air passages when y...
ImageRead Article Now Book Mark ArticleSputum gram stain
A sputum Gram stain is a laboratory test used to detect bacteria in a sputum sample. Sputum is the material that comes up from your air passages whe...
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Treatment
Treatments may include:
- Antibiotics through your veins (IV) to treat the lung infection. The antibiotic you are given will fight the germs that are found in your sputum culture.
- Oxygen to help you breathe better and lung treatments to loosen and remove thick mucus from your lungs
- Ventilator (breathing machine) to support your breathing
Outlook (Prognosis)
People who have other serious illnesses do not recover as well from pneumonia as people who are not as sick.
Hospital-acquired pneumonia can be a life-threatening illness. Long-term lung damage may occur.
Prevention
People visiting loved ones in the hospital need to take steps to prevent spreading germs . The best way to stop the spread of germs is to wash your hands often. Stay home if you are sick. Keep your immunizations up to date.
Prevent spreading germs
No definition available for this article.
After any surgery, you will be asked to take deep breaths and move around as soon as possible to help keep your lungs open. Follow the advice of your health care provider to help prevent pneumonia.
Most hospitals have programs to prevent hospital-acquired infections.
References
American Thoracic Society. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med . 2005;171:388-416. PMID: 15699079 www.ncbi.nlm.nih.gov/pubmed/15699079 .
Chastre J, Luyt CE. Ventilator-associated pneumonia. In: Mason RJ, Broaddus VC, Martin TR, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 34.
Klompas M. Nosocomial pneumonia. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 303.
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Hospital-acquired pneumonia - illustration
Pneumonia acquired in the hospital is a very serious infection because the patient's defense mechanisms are often impaired by illness, and the infecting organisms are more dangerous than the ones generally encountered in the community.
Hospital-acquired pneumonia
illustration
-
Respiratory system - illustration
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Respiratory system
illustration
-
Hospital-acquired pneumonia - illustration
Pneumonia acquired in the hospital is a very serious infection because the patient's defense mechanisms are often impaired by illness, and the infecting organisms are more dangerous than the ones generally encountered in the community.
Hospital-acquired pneumonia
illustration
-
Respiratory system - illustration
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Respiratory system
illustration
-
Pneumonia
(In-Depth)
Review Date: 2/2/2015
Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
