Neumonía nosocomial

Abstract

Nosocomial pneumonia is an acute infectious disease of the pulmonary parenchyma that is acquired in the hospital after at least 48hours of hospitalization. It is the second most frequent cause of hospital-acquired infection and the main cause of death due to nosocomial infection, with a high economic impact. Preventative measures have taken on great relevance in order to avoid its onset. In regard to etiology, it can be caused by a wide variety of microorganisms; it can even be polymicrobial, including multidrug-resistant organisms. The diagnosis of nosocomial pneumonia is complicated and requires the sum of compatible clinical, analytical, radiological, and microbiological findings. Treatment must be started early when nosocomial pneumonia is suspected, especially ventilator-associated pneumonia and in the case of septic or intensely affected patients. Treatment should offer empirical coverage of multidrug-resistant organisms in accordance with the patient's characteristics, prevalences, and the usual flora of each center and unit. Starting inappropriate antibiotic treatment is associated with greater mortality. Once the microorganism responsible and its antibiogram are known, antibiotic treatment must be adjusted or «scaled down». This allows for reducing the inappropriate use of antibiotics or even decreasing mortality compared to empirical antibiotic treatment.