Hospital-acquired pneumonias

Česká verzia

Authors: Petr Jakubec; Aneta Křenková; Vítězslav Kolek
Authors place of work: Klinika plicních nemocí a tuberkulózy LF UP a FN Olomouc
Published in the journal: Vnitř Lék 2017; 63(11): 776-785
Category: Reviews

Summary

Nosocomial infections are a common complication of hospital care. Hospital-acquired (HAP) pneumonia is one of the most common nosocomial infections and it is the most dangerous in terms of mortality. The problem is mainly selected hospital bacterial strains with rising antibiotic resistance. Diagnosis of the cause of pneumonia is difficult and often does not lead to a positive result. Management is complex and is based on timely and appropriate empirical antibiotic treatment. Local and extrapulmonary complications are relatively common and they increase morbidity and mortality. Prognosis of the HAP is often unfavorable, especially in the elderly and polymorbid individuals.

Key words:
complications – etiology – hospital-acquired pneumonia – management

Zdroje

1. Kalil AC, Metersky ML, Klompas M et al. Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Disease Society of America and the American Thoracic Society. Clin Infect Dis 2016; 63(5): e61-e111. Dostupné z DOI: <http://dx.doi.org/10.1093/cid/ciw353>.

2. Ewig S, Welte T, Chastre J et al. Rethinking the concepts of comunity-acquired and health-care-associated pneumonia. Lancet Infect Dis 2010; 10(4): 279–287.Dostupné z DOI: <http://dx.doi.org/10.1016/S1473–3099(10)70032–3>.

3. Magill SS, Edwards JR, Fridkin SK. [Emerging Infections Programme Healthcare-Associated Infections Antimicrobial Use Prevalence Survey Team]. Survey of healthcare-associated infections. N Engl J Med 2014, 370(26): 2542–2543. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMc1405194>.

4. Jakubec P, Kolář M, Kolek V. Diagnostika a léčba těžké pneumonie. In: Kolek V et al. Doporučené postupy v pneumologii. 2. ed. Maxdorf: Praha 2016. ISBN 978–80–7345–507–1.

5. Vincent JL, Bassetti M, François B et al. Advances in antibiotic therapy in the critically ill. Crit Care 2016; 20(1): 133. Dostupné z DOI: <http://dx.doi.org/10.1186/s13054–016–1285–6>.

6. Craven DE, Chroneou A. Nosocomial pneumonia. In: Madell GL, Benett JE, Dolin R (eds). Principles and Practices of Infectoius Diseases. 2 voll. 7th ed. Elsevier Churchill Livingstone: Philadelphia (PA) 2009: 3717–3724. ISBN 978–0443068393.

7. Torres A, Ewig S, Lode H et al. [European HAP working group]. Defining, treating and preventing hospital acquired pneumonia. Intensive Care Med 2009; 35(1): 9–29. Dostupné z DOI: <http://dx.doi.org/10.1007/s00134–008–1336–9>.

8. Wang Y, Eldridge N, Metersky ML et al. National trends in patient safety for four common conditions, 2005–2011. N Engl J Med 2014, 370(4): 341–351. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMsa1300991>.

9. Ego A, Preiser JC, Vincent JL. Impact of diagnostic criteria on the incidence of ventilator-associated pneumonia. Chest 2015; 147(2): 347–355. Dostupné z DOI: <http://dx.doi.org/10.1378/chest.14–0610>.

10. [American Thoracic Society; Infectious Diseases Society of America]. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med 2005; 171(4): 388–416.

11. [National Institute for Health and Care Excellence (NICE)]. Pneumonia in adults: diagnosis and manamagement. NICE 2014. [20.3.2017]. Dostupné z WWW: http://www.nice.org.uk/guidance/cg191. ISBN 978–1-4731–0864–6.

12. Sopena M, Heras E, Casas I et al. Risk factors for hospital-acquired pneumonia outside the intensive care unit: A case-control study. Am J Infect Control 2014, 42(1): 38–42. Dostupné z DOI: <http://dx.doi.org/10.1016/j.ajic.2013.06.021>.

13. Fabregas N, Ewig S, Torres A et al. Clinical diagnosis of ventilator associated pneumonia revisited: comparative validation using immediate post-mortem lung biopsies. Thorax 1999; 54(10): 867–873.

14. Di Pasquale M, Ferrer M, Esperatti M et al. Assessment of severity of ICU-acquired pneumonia and association with etiology. Crit Care Med 2014, 42(2): 303–312. Dostupné z DOI: <http://dx.doi.org/10.1097/CCM.0b013e3182a272a2>.

15. Blot S, Koulenti D, Dimopoulos G et al. Prevalence, risk factors, and mortality for ventilator-associated pneumonia in middle-aged, old, and very old critically ill patients. Crit Care Med 2014; 42(3): 601–609.

16. Torres A, Ewig S (eds). Nosocomial and Ventilator-Associated Pneumonia. European Respiratory Society Monograph: Plymouth 2011. Vol. 53. ISBN 978–1-84984–016–3. Dostupné z DOI: <http://dx.doi.org/10.1183/1025448x.erm5310>.

17. Kalanuria AA, Zai W, Mirski M. Ventilator-associated pneumonia in the ICU. Crit Care 2014; 18(2): 208. Dostupné z DOI: <http://dx.doi.org/10.1186/cc13775>. Erratum in Ventilator-associated pneumonia in the ICU. [Crit Care. 2016]

18. Gamache J, Harrington A, Kamangar N et al. Bacterial pneumonia. Medscape. Updated 07.12.2016. [25.03.2017]. Dostupné z WWW: <http://emedicine.medscape.com/article/300157-overview>.

19. Amanullah S (ed), Posner DH, Talavera F et al. Ventilator-Associated Pneumonia Overview of Nosocomial Pneumonias, Medscape, Medscape. Updated 31.12.2015. [18.03.2017]. Dostupné z WWW: <http://emedicine.medscape.com/article/304836-overview#a1>.

20. Cook DJ, Walter SD, Cook RJ et al. Incidence of and risk factors for ventilator-associated pneumonia in critically ill patients. Ann Intern Med 1998; 129(6): 433–440.

21. Restrepo M, Peterson J, Fernandez JF et al. Comparison of the bacterial etiology of early-onset and late-onset ventilator-associated pneumonia in subjects enrolled in 2 large clinical studies. Respir Care 2013; 58(7): 1220–1225. Dostupné z DOI: <http://dx.doi.org/10.4187/respcare.02173>.

22. Giantsou E, Liratzopoulos N, Efraimidou E et al. Both early-onset and late-onset ventilator-associated pneumonia are caused mainly by potentially multiresistant bacteria. Intensive Care Med 2005; 31(11): 1488–1494.

23. Nair GB, Niederman MS. Ventilator-associated pneumonia: present understanding and ongoing debate. Intensive Care Med 2015; 41(1): 34–48. Dostupné z DOI: <http://dx.doi.org/10.1007/s00134–014–3564–5>.

24. Ferrer M, Difrancesco LF, Liapikou A et al. Polymicrobial Intensive Care Unit-acquired Pneumonia: Prevalence, Microbiology and Outcome. Crit Care 2015; 19: 450. Dostupné z DOI: <http://dx.doi.org/10.1186/s13054–015–1165–5>.

25. Jones RN. Microbial etiologies of hospital-acquired bacterial pneumonia and ventilator-associated pneumonie. Clin Infect Dis 2010; 51(Suppl 1): S81-S87. Dostupné z DOI: <http://dx.doi.org/10.1086/653053>. Erratum in Clin Infect Dis 2010; 51(9): 1114.

26. Weber DJ, Rutala WA, Sickbert-Bennett EE et al. Microbiology of ventilator-associated pneumonia compared with that of hospital-acquired pneumonia. Infect Control Hosp Epidemiol 2007; 28(7): 825–831.

27. Sopena M, Sabria M. [Neunos Study Group]. Multicenter study of hospital-acquired pneumonia in non-ICU patients. Chest 2005; 127(1): 213–219.

28. Hanulík V, Uvízl R, Husičková V et al. Bakteriální původci pneumonií u pacientů v intenzivní péči. Klin Mikrobiol Infekc Lek 2011; 17(4): 135–140.

29. Uvizl R, Hanulik V, Husickova V et al. Hospital-acquired pneumonia in ICU patients. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2011; 155(4): 373–378.

30. Herkeĺ T, Uvízl R, Adamus M et al. Epidemiology of hospital-acquired pneumonia: results of a Central European multicenter, prospective, observational study compared with data from the European region. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2016; 160(3): 448–455.

31. Rhodes A, Evans LE, Alhazzani W et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med 2017; 43(3): 304–377. Dostupné z DOI: <http://dx.doi.org/10.1007/s00134–017–4683–6>.

32. Chastre J, Combes A, Luyt CE. The Invasive (Quantitative) Diagnosis of Ventilator-Asssociated Pneumonia. Respir Care 2005; 50(6): 797–807.

33. Meduri GU, Chastre J. The Standardization of Bronchoscopic Techniques for Ventilator-Associated Pneumonia. Chest 1992; 102(5 Suppl 1): S557-S564.

34. [Japanese Respiratory Society]. Diagnosis of hospital-acquired pneumonia and methods of testing for pathogens. Respirology 2009; 14(Suppl 2): S10-S22. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1440–1843.2009.01572.x>.

35. Chastre J, Fagon JY. Ventilator-associated pneumonia. Am J Respir Crit Care 2002; 165(7): 867–903.

36. Campbell GD Jr. Blinded invasive diagnostic procedures in ventilator-associated pneumonia. Chest 2000; 117(4/Suppl 2): S207-S211.

37. Torres A, El-Ebiary M. Bronchoscopic BAL in the diagnosis of ventilator-associated pneumonia. Chest 2000; 117(4 Suppl 2): S198-S202.

38. Meduri GU, Beals DH, Maijub AG et al. Protected bronchoalveolar lavage. A new bronchoscopic technique to retrieve uncontaminated distal airway secretion. Am Rev Respir Dis 1991; 143(4 Pt 1): 855–864.

39. Baughman RP. Protected-specimen brush technique in the diagnosis of ventilator-associated pneumonia. Chest 2000; 117(4 Suppl 2): S203-S206.

40. Torres A, El-Ebiary M, Padro L et al. Validation of different techniques for the diagnosis of ventilator-associated pneumonia. Comparison with immediate postmortem pulmonary biopsy. Am J Respir Crit Care Med 1994; 149(2 Pt 1): 324–331.

41. Rea-Neto A, Youssef NCM, Tuche F et al. Diagnosis of ventilator-associated pneumonia: a systematic review of the literature. Crit Care 2008; 12(2): R56. Dostupné z DOI: <http://dx.doi.org/10.1186/cc6877>.

42. Shorr AF, Sherner JH, Jackson WL et al. Invasive approaches to the diagnosis of ventilator-associated pneumonia: a meta-analysis. Crit Care Med 2005; 33(1): 46–53.

43. Rello J, Vidaur L, Sandiumenge A et al. De-escalation therapy in ventilator-associated pneumonia. Crit Care Med 2004; 32(11): 2183–2190.

44. [Canadian Critical Care Trials Group]. A randomized trial of diagnostic techniques for ventilator-associated pneumonia. N Engl J Med 2006; 355(25): 2619–2630.

45. Kowalczyk W, Rybicki Z, Tomaszewski D et al. The comparison of different bronchial aspirate culturing methods in patients with ventilator-associated pneumonia. Anestezjol Intens Ter 2011; 43(2): 74–79.

46. Clec´h C, Jauréguy F, Hamza L et al. Agreement Between Quantitative Cultures of Postintubation Tracheal Aspiration and Plugged Telescoping Catheter, Protected Specimen Brush, or BAL for the Diagnosis of Nosocomial Pneumonia. Chest 2006; 130(4): 956–961.

47. Papazian L, Thomas P, Garbe L et al. Bronchoscopic or blind sampling techniques for the diagnosis of ventilator-associated pneumonia. Am J Respir Crit Care Med 1995; 152(6 Pt 1): 1982–1991.

48. Gabrhelík T, Hanulik V, Jakubec P et al. Porovnání validity různých vzorků biologického materiálu z dýchacích cest a jejich přínosu v detekci původců nozokomiální pneumonie. Klin Mikrobiol Infekc Lek 2015; 21(1): 4–9.

49. Dalhoff K, Ewig S. [Guideline Development Group]. Clinical Practise Guideline: Adult patients with nosocomial pneumonia – epidemiology, diagnosis and treatment. Dtsch Arztebl Int 2013; 110(38): 634–640. Dostupné z DOI: <http://dx.doi.org/10.3238/arztebl.2013.0634>.

50. Caliendo AM, Gilbert DN, Ginocchio CC et al. Better tests, better care: improved diagnostics for infectious diseases. Clin Infect Dis 2013; 57(Suppl 3): S139-S170. Dostupné z DOI: <http://dx.doi.org/10.1093/cid/cit578>. Erratum in Clin Infect Dis 2014; 58(9): 1346.

51. Lung M, Codina G. Molecular diagnosis in HAP/VAP. Curr Opin Crit Care 2012; 18(5): 487–494. Dostupné z DOI: <http://dx.doi.org/10.1097/MCC.0b013e3283577d37>.

52. Iregui M, Ward S, Sherman G. et al. Clinical importance of delaying the initiation of appropriate antibiotic treatment for ventilator associated pneumonia. Chest 2002; 122(1): 262–268.

53. Rello J, Lisboa T, Koulenti D. Respiratory infections in patients undergoing mechanical ventilation. Lancet Respir Med 2014; 2(9): 764–774. Dostupné z DOI: <http://dx.doi.org/10.1016/S2213–2600(14)70171–7>.

54. Schuetz P, Muller B, Christ-Crain M et al. Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections. Cochrane Database Syst Rev 2012; (9): CD007498. Dostupné z DOI: <http://dx.doi.org/10.1002/14651858.CD007498.pub2>.

55. Stolz D, Smyrnios N, Eggimann P et al. Procalcitonin for reduced antibiotic exposure in ventilator-associated pneumonia: a randomized study. Eur Respir J 2009; 34(6): 1364–1375. Dostupné z DOI: <http://dx.doi.org/10.1183/09031936.00053209>.

56. Frat, JPD, Thille AW, Mercat A et al. High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory Failure. N Engl J Med 2015; 372(23): 2185–2196. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1503326>.

57. Ferrer M, Esquinas A, Leon M et al. Noninvasive ventilation in severe hypoxemic respiratory failure: a randomized clinical trial. Am J Respir Crit Care Med 2003; 168(12): 1438–1444.

58. Briel M, Meade M, Mercat A et al. Higher vs. lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. JAMA 2010; 303(9): 865–873. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.2010.218>.

59. Gattinoni L, Carlesso E, Taccone P et al. Prone positioning improves survival in severe ARDS: a pathophysiologic review and individual patient metaanalysis. Minerva Anestesiol 2010; 76(6): 448–454.

60. Sud S, Friedrich JO, Taccone P et al. Prone ventilation reduces mortality in patients with acute respiratory failure and severe hypoxemia: systematic review and meta-analysis. Intensive Care Med 2010; 36(4): 585–599. Dostupné z DOI: <http://dx.doi.org/10.1007/s00134–009–1748–1>.

61. Di Pasquale M, Aliberti S, Mantero M et al. Non-Intensive Care Unit Acquired Pneumonia: A New Clinical Entity? Int J Mol ASc. 2016; 17(3): 287. <http://dx.doi.org/10.3390/ijms17030287>.

62. Bouadma L, Wolff M, Lucet JC. Ventilator-associated pneumonia and its prevention. Curr Opin Infect Dis 2012; 25(4): 395–404. Dostupné z DOI: <http://dx.doi.org/10.1097/QCO.0b013e328355a835>.

63. Nair GB, Niederman MS. Ventilator-associated pneumonia: present understanding and ongoing debate. Intensive Care Med 2015; 41(1): 34–48. Dostupné z DOI: <http://dx.doi.org/10.1007/s00134–014–3564–5>.

64. Corrales-Medina VF, Musher DM, Shachkina S et al. Acute pneumonia and the cardiovascular system. Lancet 2013; 381(9865): 496–505. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(12)61266–5>.

65. Schulgen G, Kropec A, Kappstein I et al. Estimation of extra hospital stay attributable to nosocomial infections: heterogenity and timing of events. J Clin Epidemiol 2000; 53(4): 409–417.

66. Craven DE, Palladino R, McQuillen DP. Healthcare-associated pneumonia in adults: management principles to improve outcomes. Infect Dis Clin North Am 2004; 18(4): 939–962.

67. Melsen WG, Rovers MM, Groenwold RH et al. Atributable mortality of ventilator-associated pneumonia: a meta-analysis of individual patient data from randomized prevention studies. Lancet Infect Dis 2013; 13(8): 665–671. Dostupné z DOI: <http://dx.doi.org/10.1016/S1473–3099(13)70081–1>.

68. Kollef MH, Snorr A, Tabak YP et al. Epidemiology and outcomes of health-care-associated pneumonia: results from a large US database of culture-positive pneumonia. Chest 2005; 128(6): 3854–3862.Erratum in Chest 2006; 129(3): 831.