hospital acquired pneumonia from preventive med prospective

1. Hospital Acquired Pneumonia
by FAWZIAH ROUBLAH

2. Table of contents
1
4
2
5
3
Definition Of Hospital-acquired
pneumonia AND Ventilator-
associated pneumonia) .
Epidemiology of HAP
The impact of HAP Causes and Risk Factors of
HAP
Prevention of HAP
Pneumonia

3. Definitions
1

4. Ventilator-associated pneumonia
(VAP)
Definitions:
Is a type of HAP that develops in
intubated patients on mechanical
ventilation for more than 48 hours.
VAP also includes HAP that occurs
within 48 hours of extubation
Is pneumonia that occurs 48 hours or
more after admission to the hospital
Hospital-acquired (or nosocomial)
pneumonia (HAP)

5. Epidemiology of HAP
2

6. Epidemiology of HAP in USA
Publication:
Medscape: 2023
• Nosocomial pneumonia accounted for 22% of all hospital infections in the
United States.
• It is the second most common infection in hospitalized patients, and the
most common infection in the intensive care unit responsible for one-
fourth of all ICU infections.

7. Epidemiology of HAP in Asia
Key findings
Publication:
From the Department of Respiratory & Critical Care Medicine,Delhi,
India, 2008
Study title:
Epidemiology, etiology, and diagnosis of hospital-acquired pneumonia and ventilator-
associated pneumonia in Asian countries

8. Epidemiology of HAP in KSA
Key findings
:
Study title:
Prevalence and Etiology of Community and Hospital Acquired Pneumonia in Saudi Arabia and Their
Antimicrobial Susceptibility Patterns: A Systematic Review
• This systematic review included 28 studies ,present a comprehensive summary of all
relevant published data regarding pneumonia in Saudi Arabia
• HAP
v An estimated incidence between 5 to 10 cases per 1000 people per year.
• VAP
v One study conducted in a tertiary care hospital in Riyadh reported a VAP incidence rate
of 15.4%, which is higher than the global average of 7–8% .
v Another study in a pediatric intensive care unit in Jeddah reported a VAP incident of
10.2%

9. Epidemiology of HAP in KSA
Key findings
:
• highlighted the fact that gram-negative bacteria, particularly Acinetobacter spp.
and Pseudomonas aeruginosa, were the common cause of hospital-acquired
pneumonia,
• this study also found that isolated bacteria responsible for pneumonia showed high
resistance rates against several antibiotics, including cephalosporins and carbapenems.
• The high prevalence of VAP in Saudi Arabia is attributed to several factors, including the
overuse of antibiotics, inadequate infection control measures, and the use mechanical
ventilation
Publication:
• Published By BMC, 2023

10. The impact of HAP
3

11. Morbidity and Mortality in worldwide
Key findings
found that the overall mortality rate of HAP :
1. in the United States (21%)
2. In Europe was 17%,
3. in Asia (13%)
Publication:
published in 2016. by European
Respiratory Journal
Study title
International guidelines for the management
of hospital-acquired pneumonia and
ventilator-associated pneumonia- meta
analysis
1. Increased Morbidity and Mortality:

12. Morbidity and Mortality in KSA
Riyadh
Jeddah
v study conducted by Balkhair in Saudi
Arabia in 2016 found that the overall
mortality rate of HAP among
hospitalized patients was 32.4%.

13. 2-HAP increase Healthcare Costs:
The treatment of HAP, including extended hospital stays, additional medications, and
sometimes intensive care, contributes to higher healthcare costs. It can strain both
individual budgets and broader healthcare systems :

14. 3. Antibiotic Resistance:
The use of antibiotics to treat HAP can contribute to the development of antibiotic-
resistant strains of bacteria, which poses a broader public health concern.
4. Resource Utilization:
HAP often requires additional resources such as ventilators, specialized medical
personnel, and diagnostic tests. This places a burden on healthcare facilities and their
capacity to manage patient care efficiently.

15. Causes and Risk Factors of HAP
4

16. Causes and Risk Factors of HAP
1 Bacterial or Viral Infections
HAP can be caused by various pathogens,
including bacteria such as Staphylococcus
aureus and viruses like influenza.
2
Weakened Immune System
Patients with compromised immune
systems, such as those with HIV/AIDS or
undergoing chemotherapy, are more
susceptible to developing HAP. 3 Length of Hospital Stay
4
Use of Ventilators or Catheters
Mechanical ventilation and the presence of
urinary or intravascular catheters can
introduce bacteria into the respiratory
tract, increasing the likelihood of HAP.
The longer the hospital stay, the greater
the risk of HAP; risk becomes significant
after 4-5 days of hospitalization.

17. Risk Factors for HAP
1 Extreme ages
2
Underlying Health Conditions
Prior respiratory illnesses, chronic
conditions, and abdominal surgeries can
have an impact on HAP risk. 3 Use of ventilators, endotracheal tubes, and
other invasive devices increase the risk of
HAP.
Invasive Medical Procedures

19. Prevention of HAP Pneumonia
5

20. is a big part of infection prevention
standards. That can be optimize by
1- A bedside alcohol-based hand scrub is
an excellent way to promote hand
hygiene.
2-Having the antiseptic readily available
will result in increased usage and
the reduction of patient infection.
Another important infection prevention
standard involves wearing face
masks. They keep airborne agents
from getting transmitted.
1-Following infection prevention standers
Proper hand hygiene
Personal protective
equipment(PPE)

21. Objectives:
• Awareness of the importance of hand washing in preventing diseases
and the spread of infection.
• Making hand hygiene a global priority.
• Engagement with health care workers in their role in clean care and
infection prevention.

22. How to wash your
hands?

23. How to rup your
hands?

25. Establish surveillance programs to
monitor and identify trends in
nosocomial infections, allowing for
timely intervention and
improvement
2. Staff Education and Involvement
in Infection Prevention
3-Regular Surveillance:
Educate health-care workers about the epidemiology of
HAP, and infection-control procedures will:
involve the workers in the implementation of interventions
to prevent HAP

26. 4-Vaccination 5-Proper Disinfection
and Sterilization
Ensure that patients,
particularly those at higher
risk, receive vaccinations,
such as the influenza
vaccine and pneumococcal
vaccine, to reduce the risk
of respiratory infections.
Use of appropriate
agents and procedures
for cleaning and
disinfecting equipment
and patient rooms is
vital for HAP
prevention
Appropriate use of
antibiotics can prevent the
emergence of antibiotic-
resistant strains of bacteria
and reduce the risk of HAP.
6-Restrict the use of
antibiotics

27. 7- Respiratory Hygiene 8-Oral care
COUGHING, DEEP
BREATHING, covering the
mouth and nose when
coughing or sneezing.
• Hospital-acquired pneumonia is often the result of gram-
negative bacilli and Staphylococcus aureus.
• These bacteria thrive in the mouths of people hospitalized in an
acute care setting. So, oral care is vital in reducing the
prevalence of bacteria.
• It is important to educate healthcare workers on performing oral
care, documenting it, and teaching patients how to do it.

28. For more information
CDC ,Guidelines for Preventing Health Care Associated Pneumonia

29. Thank you