An Overview of Pneumonia in Community and Hospital Settings

Abstract

ABSTRACT Pneumonia is a common infection among patients both in the community and in the institutional setting and is a leading cause of morbidity and mortality in Canada. In the hospital setting, pneumonia is commonly associated with mechanical ventilation. The impact is significant, with the combined indirect and direct costs of community-acquired pneumonia in the United States estimated at US$12.2 billion and the direct costs of nosocomial pneumonia at US$2.2 billion. Several risk factors, such as altered level of consciousness, immunosuppression, obstruction, and malnutrition, may impair normal pulmonary defences. This article provides an overview of the epidemiology, pathogenesis, risk factors, diagnosis, management, and prevention of community- and hospital-acquired pneumonia, as well as issues related to antimicrobial resistance. RESUME La pneumonie est une infection courante chez les patients autant dans la collectivite que dans les etablissements de sante et l’une des principales causes de morbidite et de mortalite au Canada. Dans les etablissements de sante, la pneumonie est souvent associee a l’utilisation de la ventilation artificielle. Les consequences sont considerables, comme en temoignent les couts globaux directs et indirects de la pneumonie extrahospitaliere qui s’elevent aux Etats-Unis a environ 12,2 milliards de dollars US et les couts directs de la pneumonie nosocomiale a 2,2 milliards de dollars US. Plusieurs facteurs de risque, comme une alteration de la conscience, l’immunosuppression, une obstruction ou la malnutrition peuvent entraver les defenses naturelles des poumons. Cet article presente un apercu de l’epidemiologie, de la pathogenese, des facteurs de risque, du diagnostic, du traitement et de la prevention de la pneumonie extra-hospitaliere et nosocomiale, de meme que des problemes lies a la resistance aux antimicrobiens.