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Unifying Concepts

Criteria for Health Care–Associated Pneumonia

Health care-associated pneumonia has been categorized as a discrete entity, with the goal of identifying patients with pneumonia that develops outside the hospital yet is caused by pathogens usually associated with hospital-acquired pneumonia or even ventilator-associated pneumonia, including methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant (MDR) gram-negative pathogens.

Criteria for Health Care–Associated Pneumonia.

Original criteria

  • Hospitalization for >/=2 days during the previous 90 days
  • Residence in a nursing home or extended-care facility
  • Long-term use of infusion therapy at home, including antibiotics
  • Hemodialysis during the previous 30 days
  • Home wound care
  • Family member with multidrug-resistant pathogen
  • Immunosuppressive disease or therapy

Pneumonia-specific criteria

  • Hospitalization for >/=2 days during the previous 90 days
  • Antibiotic use during the previous 90 days
  • Nonambulatory status
  • Tube feedings
  • Immunocompromised status
  • Use of gastric acid suppressive agents

 

References:

  1. Wunderink RG, Waterer GW. Clinical practice. Community-acquired pneumonia. N Engl J Med. 2014 Feb 6;370(6):543-51. [Medline]
  2. American Thoracic Society; Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005 Feb 15;171(4):388-416. [Medline]
  3. Shindo Y, Ito R, Kobayashi D, Ando M, Ichikawa M, Shiraki A, Goto Y, Fukui Y, Iwaki M, Okumura J, Yamaguchi I, Yagi T, Tanikawa Y, Sugino Y, Shindoh J, Ogasawara T, Nomura F, Saka H, Yamamoto M, Taniguchi H, Suzuki R, Saito H, Kawamura T, Hasegawa Y. Risk factors for drug-resistant pathogens in community-acquired and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2013 Oct 15;188(8):985-95. [Medline]

 

Created Feb 20, 2014.

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