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Clinical Infectious Diseases 2008;46:S296–S334
SUPPLEMENT ARTICLE
Health Care–Associated Pneumonia (HCAP): A Critical Appraisal to Improve Identification, Management, and Outcomes—Proceedings of the HCAP Summit
医院内肺炎进展
Marin H. Kollef,1
Lee E. Morrow,3
Robert P. Baughman,4
Donald E. Craven,5
John E. McGowan, Jr.,6
Scott T. Micek,2
Michael S. Niederman,7
David Ost,8
David L. Paterson,9 and
John Segreti10
1Washington University School of Medicine and 2Barnes-Jewish Hospital, St. Louis, Missouri; 3Creighton University Medical Center, Omaha, Nebraska; 4University of Cincinnati Medical Center, Cincinnati, Ohio; 5Tufts University School of Medicine, Boston, Massachusetts; 6Rollins School of Public Health of Emory University, Atlanta, Georgia; 7State University of New York at Stony Brook, Stony Brook, and 8New York University School of Medicine, New York, New York; 9University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and 10Rush-Presbyterian–St. Luke’s Medical Center, Chicago, Illinois
Increasingly, patients are receiving treatment at facilities other than hospitals, including long-term–health care facilities, assisted-living environments, rehabilitation facilities, and dialysis centers. As with hospital environments, nonhospital settings present their own unique risks of pneumonia. Traditionally, pneumonia in these facilities has been categorized as community-acquired pneumonia (CAP). However, the new designation for pneumonias acquired in these settings is health care–associated pneumonia (HCAP), which covers pneumonias acquired in health care environments outside of the traditional hospital setting and excludes hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and CAP. Although HCAP is currently treated with the same protocols as CAP, recent evidence indicates that HCAP differs from CAP with respect to pathogens and prognosis and, in fact, more closely resembles HAP and VAP. The HCAP Summit convened national infectious disease opinion leaders for the purpose of analyzing current literature, clinical trial data, diagnostic considerations, therapeutic options, and treatment guidelines related to HCAP. After an in-depth analysis of these areas, the infectious disease investigators participating in the summit were surveyed with regard to 10 clinical practice statements. The results were then compared with results of the same survey as completed by 744 Infectious Diseases Society of America members. The similarities and differences between those survey results are the basis of this publication.
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