Division of Infectious Diseases and Department of Medicine, McMaster University and Henderson Site, Hamilton Health Sciences, Hamilton;
Can J Infect Dis Med Microbiol. 2008 Jan;19(1):19-53. doi: 10.1155/2008/593289.
Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are important causes of morbidity and mortality, with mortality rates approaching 62%. HAP and VAP are the second most common cause of nosocomial infection overall, but are the most common cause documented in the intensive care unit setting. In addition, HAP and VAP produce the highest mortality associated with nosocomial infection. As a result, evidence-based guidelines were prepared detailing the epidemiology, microbial etiology, risk factors and clinical manifestations of HAP and VAP. Furthermore, an approach based on the available data, expert opinion and current practice for the provision of care within the Canadian health care system was used to determine risk stratification schemas to enable appropriate diagnosis, antimicrobial management and nonantimicrobial management of HAP and VAP. Finally, prevention and risk-reduction strategies to reduce the risk of acquiring these infections were collated. Future initiatives to enhance more rapid diagnosis and to effect better treatment for resistant pathogens are necessary to reduce morbidity and improve survival.
医院获得性肺炎（HAP）和呼吸机相关性肺炎（VAP）是发病率和死亡率的重要原因，死亡率接近 62%。HAP 和 VAP 是医院感染的第二大常见原因，但在重症监护病房中是最常见的感染原因。此外，HAP 和 VAP 导致医院感染相关死亡率最高。因此，制定了循证指南，详细介绍了 HAP 和 VAP 的流行病学、微生物病因、危险因素和临床表现。此外，还根据加拿大医疗保健系统中提供护理的现有数据、专家意见和当前实践，使用了一种方法来确定风险分层方案，以实现 HAP 和 VAP 的适当诊断、抗菌管理和非抗菌管理。最后，还整理了预防和降低风险的策略，以降低这些感染的风险。需要采取未来的举措来提高更快的诊断和更好的耐药病原体治疗，以降低发病率和提高生存率。
