Modern Views on the Diagnosis of Hospital-Acquired Pneumonia

A.A. Birkun

Abstract


Diagnostics of hospital-acquired pneumonia represents a complex task for a practicing physician, since available information in this field is separate and quite inconsistent, while respective protocols and guidelines significantly differ in their content depending on country of origin and year of publication. Based on analysis of recent scientific publications and valid native and foreign guidelines, the review deals with key aspects of diagnosis of hospital-acquired pneumonia. In particular, clinical criterions, imaging methods, benefits, drawbacks and effectiveness of qualitative, quantitative and semiquantitative bacteriologic assessment, as well as practical relevance of clinical pulmonary infection score, are discussed.


Keywords


hospital-acquired pneumonia; diagnosis; criteria; guidelines

References


American Thoracic Society. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and health care-associated pneumonia / American Thoracic Society and Infectious Diseases Society of America // Am. J. Respir. Crit. Care Med. — 2005. — Vol. 171. — P. 388-416.

Fagon J.Y. Nosocomial pneumonia in ventilated patients: a cohort study evaluat-ing attributable mortality and hospital stay / Fagon J.Y., Chastre J., Hance A.J. et al. // Am. J. Med. — 1993. — Vol. 94. — P. 281-288.

Chastre J. Ventilator-associated pneumonia / Chastre J. and Fagon J.Y. // Am. J. Respir. Crit. Care Med. — 2002. — Vol. 165. — P. 867-903.

Rello J. Epidemiology and outcomes of ventilator-associated pneumonia in a large US database / Rello J., Ollendorf D.A., Oster G. et al. // Chest. — 2002. — Vol. 122. — P. 2115-2121.

Gross P. Deaths from nosocomial infections: experience in a university hospital and a community hospital / Gross P., Neu H., Aswapokee P. et al. // Am. J. Med. — 1980. — Vol. 68. — P. 219-223.

Фещенко Ю.І. Нозокоміальна пневмонія у дорослих: діагностика, лікування, профілактика (методичні рекомендації) / Фещенко Ю.І., Перцева Т.О., Дзюблик О.Я. та ін. — К.: Інститут фтизіатрії і пульмонології ім. Ф.Г. Яновського АМН України, 2004. — 39 с.

Биркун А.А. 3-й. Локальная эпидемиологическая характеристика госпитальной пневмонии в нейрохирургическом стационаре / Биркун А.А. 3-й // Мат-лы открытой научно-практической конференции «Человек и микроорганизмы — параллельные миры» // Крымский журнал экспериментальной и клинической медицины. — 2012. — № 1–2 (5–6). — С. 174.

Нозокомиальная пневмония у взрослых. Российские национальные рекомендации / Под ред. А.Г. Чучалина, Б.Р. Гельфанда // Клин. микробиол. антимикроб. химиотер. — 2009. — Т. 11, № 2. — С. 100-142.

Luna C.M. Impact of BAL data on the therapy and outcome of ventilator-associated pneumonia / Luna C.M., Vujacich P., Niederman M.S. et al. // Chest. — 1997. — Vol. 111. — P. 676-685.

Masterton R.G. Guidelines for the management of hospital-acquired pneumonia in the UK: report of the working party on hospital-acquired pneumonia of the British Society for Antimicrobial Chemotherapy / Masterton R.G., Galloway A., French G. et al. // J. Antimicrob. Chemother. — 2008. — Vol. 62. — P. 5-34.

Наказ Міністерства охорони здоров’я України «Про затвердження клінічних протоколів надання медичної допомоги за спеціальністю «Пульмонологія» від 19.03.2007 № 128 [електронний ресурс] // Веб-сайт Міністерства охорони здоров’я України. — Режим доступу: http://www.moz.gov.ua/ua/portal/dn_20070319_128.html

Гельфанд Б.Р. Нозокомиальная пневмония в хирургии. Методические рекомендации / Гельфанд Б.Р., Белоцерковский Б.З., Проценко Д.Н. и соавт. // Инфекции и антимикробная терапия. — 2003. — № 5–6. — С. 124-129.

Hess D.R. Noninvasive Positive-Pressure Ventilation and Ventilator-Associated Pneumonia / Hess D.R. // Respir. Care. — 2005. — Vol. 50. — P. 924-931.

American Thoracic Society. Hospital-acquired pneumonia in adults: diagnosis, assessment of severity, initial antimicrobial therapy, and preventive strategies. A consensus statement / American Thoracic Society // Am. J. Respir. Crit. Care Med. — 1996. — Vol. 153. — P. 1711-1725.

Kirtland S.H. The diagnosis of ventilator-associated pneumonia: a comparison of histologic, microbiologic, and clinical criteria / Kirtland S.H., Corley D.E., Winterbaur R.H. et al. // Chest. — 1997. — Vol. 112. — P. 445-457.

Анализ газов артериальной крови понятным языком / Хеннеси А.А.М. и Джапп А.Д.; пер. с англ. под ред. В.Л. Кассиля. — М.: Практическая медицина, 2009. — 140 с.

Cook D. Endotracheal aspiration in the diagnosis of ventilator associated pneumonia / Cook D. and Mandell L. // Chest. — 2000. — Vol. 117. — P. 195-197.

Blot F. Value of Gram stain examination of lower respiratory tract secretions for early diagnosis of nosocomial pneumonia / Blot F., Raynard B., Chachaty E. et al. // Am. J. Respir. Crit. Care Med. — 2000. — Vol. 162. — P. 1731-1737.

Fagon J.Y. Invasive and noninvasive strategies for management of suspected ventilator-associated pneumonia: a randomized trial / Fagon J.Y., Chastre J., Wolff M. et al. // Ann. Intern. Med. — 2000. — Vol. 132. — P. 621-630.

Timsit J.E. Usefulness of a strategy based on bronchoscopy with direct examination of bronchoalveolar lavage fluids in the initial antibiotic therapy of suspected ventilator-associated pneumonia / Timsit J.E., Cheval C., Gachot B. et al. // Intensive Care Med. — 2001. — Vol. 27. — P. 640-647.

Wood A.Y. A prospective assessment of diagnostic efficacy of blind protective bronchial brushings compared to bronchoscope-assisted lavage, bronchoscope-directed brushings, and blind endotracheal aspirates in ventilator-associated pneumonia / Wood A.Y., Davit A.J., Ciraulo D.L. et al. // J. Trauma. — 2003. — Vol. 55. — P. 825-834.

Baker A.M. Decision making in nosocomial pneumonia: an analytic approach to the interpretation of quantitative bronchoscopic cultures / Baker A.M., Bowton D.L., Haponik E.F. // Chest. — 1995. — Vol. 107. — P. 85-95.

Luna C.M. Blood cultures have limited value in predicting severity of illness and as a diagnostic tool in ventilator-associated pneumonia / Luna C.M., Videla A., Mattera J. et al. // Chest. — 1999. — Vol. 116. — P. 1075-1084.

Wermert D. Influence of pulmonary bacteriology and histology on the yield of diagnostic procedures in ventilator-acquired pneumonia / Wermert D., Marquette C.H., Copin M.C. et al. // Am. J. Respir. Crit. Care Med. — 1998. — Vol. 158. — P. 139-147.

Kollef M.H. Inadequate antimicrobial treatment: an important determi-nant of outcome for hospitalized patients / Kollef M.H. // Clin. Infect. Dis. — 2000. — Vol. 31. — P. 131-138.

Pugin J. Diagnosis of ventilator-associated pneumonia by bacteriologic analysis of bronchoscopic and nonbronchoscopic «blind» bronchoalveolar lavage fluid / Pugin J., Auckenthaler R., Mili N. et al. // Am. Rev. Respir. Dis. — 1991. — Vol. 143. — P. 1121-1129.

Zilberberg M.D. Ventilator-Associated Pneumonia: The Clinical Pulmonary Infection Score as a Surrogate for Diagnostics and Outcome / Zilberberg M.D. and Shorr A.F. // CID. — 2010. — Vol. 51. — P. 131-135.

Luna C.M. Resolution of ventilator-associated pneumonia: prospective evaluation of the clinical pulmonary infection score as an early clinical predictor of outcome / Luna C.M., Blanzaco D., Niederman M.S. et al. // Crit. Care Med. — 2003. — Vol. 31. — P. 676-682.

Singh N. Short-course empiric antibiotic therapy for patients with pulmonary infiltrates in the intensive care unit. A proposed solution for indiscriminate antibiotic prescription / Singh N., Rogers P., Atwood C.W. et al. // Am. J. Respir. Crit. Care Med. — 2000. — Vol. 162. — P. 505-511.




DOI: https://doi.org/10.22141/2224-0586.4.51.2013.89280

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