Pneumonia caught in the hospital is referred to as hospital-acquired pneumonia (HAP). The other name for a Hospital-acquired pneumonia (HAP) is Nosocomial Pneumonia. When a patient gets admitted to a hospital or other health care facility, after which they develop Pneumonia, they are said to have Nosocomial Pneumonia. The pneumonia infection should not have been present at the time of admittance to the hospital. Hence we can distinguish community-acquired pneumonia from Nosocomial Pneumonia. It is more often than not a bacterial infection, rather than a viral infection. Nosocomial Pneumonia occurs most commonly in the intensive care unit (ICU) ward, where doctors do intensive treatment for serious diseases.
How do we establish the diagnosis of a nosocomial pneumonia ?
To establish the diagnosis of Nosocomial Pneumonia, the infection must occur only after someone was admitted for some reasons other than the infection.
- Up to 48 hours after the time of admission to the hospital
- Up to 3 days after discharge
- Up to 30 days after an operation
What are the types of nosocomial pneumonia ?
- Bacterial pneumonia: A vast majority of pneumonia cases are caused by gram-negative organisms like Staphylococcus aureus, usually of the methicillin resistant type or Pseudomonas aeruginosa. The other organisms could be Streptococcus pneumonia, Klebsiella pneumonia, Enterobacter spp. and Haemophilus influenza.
- Viral pneumonia: Influenza and respiratory syncytial virus can cause pneumonia too. Cytomegalovirus causes infection in the immunocompromised host.
- Ventilator-associated pneumonia: Ventilator-associated pneumonia (VAP) is a very important type of hospital-acquired pneumonia (HAP) which occurs in people who are on mechanical ventilation. The term VAP is limited to patients who are on mechanical ventilation whilst in a hospital.
- Healthcare-associated pneumonia (HCAP): Healthcare-associated pneumonia (HCAP) is a condition in patients who are in the community, but have regular contact with the healthcare environment. Historically, hospital-acquired pneumonia differs from community acquired pneumonia, associated with a worse prognosis and multi-drug resistant organisms.
How does nosocomial pneumonia spread ?
Bacteria, fungi, and viral infection spread largely through person-to-person contact. This includes contact via hands, inadequate sterilization or use of medical instruments such as catheters, respiratory machines, and the wide array of hospital tools. The Hospital-Acquired Infections also increase with excessive or improper use of antibiotics. This can lead to development of highly resistant infection to multiple antibiotics.
What are symptoms of nosocomial pneumonia ?
The Symptoms of Hospital-Acquired Infections will vary by type. The symptoms for these infections may include the following.
- Very high fever, chills, malaise
- Increasing white blood cells (leucocytosis)
- Cough with purulent sputum, sore throat, shortness of breathing
- Sharp Chest Pain
- Headache, fatigue
- Nausea, vomiting, diarrhea and loss of appetite
Who is at risk for nosocomial pneumonia ?
Anyone who is admitted to a hospital or healthcare facility is at risk for contracting a Hospital-Acquired Infections. For pneumonia, your risks may also be decided by the following.
- With the infection your hospital roommate has.
- With age, especially if you’re older than 70 years of age.
- How long you’ve been on antibiotics
- Whether you are using hospital devices like mechanical ventilators or are undergoing invasive techniques creating potential routes of infection
- A prolonged ICU stay
- If you’ve been in a coma
- If you have a compromised immune system
- From infection of mouth and throat (endogenous or exogenous)
- With poor infection control practices, transmission may be increased.
How are nosocomial pneumonias diagnosed ?
Many doctors can identify a Hospital-Acquired Infection by history and symptoms. Signs of Pneumonia (respiratory signs) count as a hospital-acquired infection. You may have to undergo blood and urine tests as to categorize the infection. An affirmative culture after intubation shows ventilator-associated pneumonia and is diagnosed as such.
How are nosocomial pneumonias treated ?
Treatments for a Hospital-Acquired Pneumonia depend on the infection type. Your doctor will possibly advocate antibiotics and bed rest. Initially empirical therapy will be given, later after culture, specific antibiotics are to be given. Care will have to be taken to ensure a healthy diet, adequate fluid intake, and rest. The earlier this pneumonia is detected, the faster the chances of recovery and cure. However, people who get Hospital-Acquired Pneumonias usually have to spend a longer time in the hospital, to recover from the infection.
How can we prevent nosocomial pneumonias ?
Hospital-Acquired Pneumonias can be prevented in some of the healthcare situations. Healthcare faculty directly contributes to the prevention of these infections. As a rule, hospitals and healthcare staff should follow the recommended guidelines for sterilization and disinfection. The most important measure is screening the ICU to see if people with pneumonia need to be isolated. General measures for infection control include maintaining hand hygiene, wearing appropriate gear, such as gloves, gowns, and face protection masks, cleaning all the surfaces properly and making sure rooms are adequately and well ventilated.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
