Hospital-acquired pneumonia
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Hospital-acquired pneumonia (HAP) develops at least 48 hours after hospital admission. The most common pathogens are gram-negative bacilli and Staphylococcus aureus; antibiotic-resistant organisms are an important concern. Symptoms and signs include malaise, fever, chills, rigor, cough, dyspnea, and chest pain. Diagnosis is suspected on the basis of clinical presentation and chest x-ray and is confirmed by blood culture or bronchoscopic sampling of the lower respiratory tract. Treatment is with antibiotics. Overall prognosis is poor, due in part to comorbidities.
(See also Overview of Pneumonia.)
Hospital-acquired pneumonia includes pneumonia that was not incubating at the time of hospital admission and develops at least 48 hours after hospital admission in patients who are not receiving mechanical ventilation. Hospital-acquired pneumonia includes postoperative pneumonia but does not include patients with ventilator-associated pneumonia (VAP).
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