Skřičková Jana
Vnitr Lek. 2017 Fall;63(7-8):518-526.
Nosocomial pneumonia (hospital-acquired pneumonia - HAP) is the form of pneumonia the symptoms of which present after more than 2 days (> 48 hours) of admission to hospital or as late as 14 days of discharge from hospital. The HAP pneumonias represent 13-18 % of all nosocomial infections. Incidence of HAP is the most frequent in mechanically ventilated patients. The type and representation of HAP agents primarily depends on the length of a patients stay in hospital and on their condition and character of treatment. Diagnosing of pneumonia is based on anamnesis, physical and X-ray findings, results of examination of microbiological samples from the respiratory tract, hemoculture, the pleural effusion test, serological, hematological and biochemical tests. Antibiotic treatment is key to the comprehensive treatment of HAP. The HAP treatment always requires the dosing of antibiotics near the upper limit of the possible range. A precondition for successful avoidance of HAP pneumonias is the creation of a preventive programme with active engagement of medical staff.Key words: diagnostics - HAP pneumonia - treatment - ventilator-associated pneumonia.
医院获得性肺炎(HAP)是指患者入院超过2天(>48小时)后或出院后长达14天出现症状的肺炎形式。HAP肺炎占所有医院感染的13% - 18%。HAP在机械通气患者中发病率最高。HAP病原体的类型和表现主要取决于患者住院时间长短及其病情和治疗特点。肺炎的诊断基于病史、体格检查和X线检查结果、呼吸道微生物样本检查结果、血培养、胸腔积液检测、血清学、血液学和生化检查结果。抗生素治疗是HAP综合治疗的关键。HAP治疗始终需要在可能范围的上限附近使用抗生素。成功避免HAP肺炎的一个前提是制定一个有医务人员积极参与的预防计划。关键词:诊断 - HAP肺炎 - 治疗 - 呼吸机相关性肺炎