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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Hospital-acquired pneumonia epidemiology and demographics

Introduction

Overview

Overview

The epidemiology of health-care-associated pneumonia varies considerably according to the type of health-care setting. Nosocomial pneumonia has been the second most common hospital-associated infection after that of the urinary tract. The primary risk factor for the development of hospital-associated bacterial pneumonia is mechanical ventilation. In long-term care facilities such as nursing homes, pneumonia is the first or second most common infection (after those of the urinary tract) acquired by patients, and accounts for 13-48% of all nursing home-associated infections. [1]

Epidemiology and Demographics

Epidemiology and Demographics

  • Pneumonia has accounted for approximately 20% of all hospital-associated infections and 27% and 24% of all infections acquired in the medical intensive-care unit (ICU) and coronary care unit, respectively. [2]

Incidence

  • The incidence of HAP is 5-15 cases per 1 000 hospital admissions. [3]
  • The incidence of VAP is 6 to 20 times more than in patients without mechanical support.
Age Females Males
18-44 years 5% 4%
45-64 years 14% 13%
≥ 65 years 34% 30%
Total 53% 47%
Table adapted from 2009–2011 National Medicare Patient Safety Monitoring System [4]

Mortality

  • HAP and VAP are nosocomial infections with a high mortality in contrast with other nosocomial infections.
  • This higher mortality rate is associated with MDR pathogens.

Age

  • HAP is more commonly reported in patients > 65 years, probably due to the fact that this age population is more commonly hospitalized.

Gender

  • There is no predominance in gender, although some data reports a higher incidence among females.

Ventilator-associated Pneumonia

  • VAP occurs in up to 25% of all people who require mechanical ventilation.
  • VAP can develop at any time during ventilation, but occurs more often in the first few days after intubation.
  • This is because the intubation process itself contributes to the development of VAP.
  • VAP occurring early after intubation typically involves fewer resistant organisms and is thus associated with a more favorable outcome.
  • Because respiratory failure requiring mechanical ventilation is itself associated with a high mortality, determination of the exact contribution of VAP to mortality has been difficult.
  • As of 2006, estimates range from 33% to 50% death in patients who develop VAP.
  • Mortality is more likely when VAP is associated with certain microorganisms (Pseudomonas, Acinetobacter), blood stream infections, and ineffective initial antibiotics.
  • VAP is especially common in people who have acute respiratory distress syndrome (ARDS).
References

References

  1. ↑ “CDC GUIDELINES FOR PREVENTING HEALTH-CARE-ASSOCIATED PNEUMONIA, 2003” (PDF).
  2. ↑ Magill, Shelley S.; Edwards, Jonathan R.; Bamberg, Wendy; Beldavs, Zintars G.; Dumyati, Ghinwa; Kainer, Marion A.; Lynfield, Ruth; Maloney, Meghan; McAllister-Hollod, Laura; Nadle, Joelle; Ray, Susan M.; Thompson, Deborah L.; Wilson, Lucy E.; Fridkin, Scott K. (2014). “Multistate Point-Prevalence Survey of Health Care–Associated Infections”. New England Journal of Medicine. 370 (13): 1198–1208. doi:10.1056/NEJMoa1306801. ISSN 0028-4793.
  3. ↑ “Guidelines for the Management of Adults with Hospital-acquired, Ventilator-associated, and Healthcare-associated Pneumonia”. American Journal of Respiratory and Critical Care Medicine. 171 (4): 388–416. 2005. doi:10.1164/rccm.200405-644ST. ISSN 1073-449X.
  4. ↑ Eckenrode, Sheila; Bakullari, Anila; Metersky, Mark L.; Wang, Yun; Pandolfi, Michelle M.; Galusha, Deron; Jaser, Lisa; Eldridge, Noel (2014). “The Association between Age, Sex, and Hospital-Acquired Infection Rates: Results from the 2009–2011 National Medicare Patient Safety Monitoring System”. Infection Control and Hospital Epidemiology. 35 (S3): S3–S9. doi:10.1086/677831. ISSN 0899-823X.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]