HAI (Healthcare Associated Infection)

Management of Adults With HAP and VAP: 2016 Clinical Practice Guidelines by the IDSA and the ATS Management of Adults With HAP and VAP: 2016 Clinical Practice Guidelines by the IDSA and the ATS Management of Adults With HAP and VAP: 2016 Clinical Practice Guidelines by the IDSA and the ATS http://www.idsociety.org/uploadedFiles/IDSA/.pdf http://www.idsociety.org/uploadedFiles/IDSA/.pdf http://www.idsociety.org/uploadedFiles/IDSA/.pdf Risk factor for HCAI Hospital-Acquired Infections Due to Gram-Negative Bacteria NEJM 2010 HCAP / VAP / HAP  ATS/IDSA Guidelines for the Management of Adults with HAP, VAP, HCAP 2005 Guidelines for hospital-acquired pneumonia and health-care-associated pneumonia: a vulnerability, a pitfall, and a fatal flaw. Lancet Infect Ds 2011  Hospital-Acquired Infections Due to Gram-Negative Bacteria NEJM 2010 CAP NEJM 2014 CAP NEJM 2014 Hospital-Acquired Infections Due to Gram-Negative Bacteria NEJM 2010 Nosocomial Meningitis Infection  Nosocomial Bacterial Meningitis NEJM 2010 Hospital acquired Gm -ve rods  Hospital-Acquired Infections Due to Gram-Negative Bacteria NEJM 2010 SPACE organisms Serretia Pseudomonas If you are covering for Psedomonas, make sure sputum culture is obtained to at least identify the organisms.  Double coverage  Acinetobacter  Carbapenam  Citrobacter Enterobactareace family  Aspiration Chemical Pneumonitis Rapid recovery in < 36 hrs. Deescalation of abx.  Anaerobic Pleuropneumonia - Classic, subacute purulent cough, cavitary pneumonia with emyema. More likely to be community acquired  Aspiration Pneumonia - large volume of aspiration of oropharyngeal or Gupper GI contents with a high enough PH to avoid chemical pneumonitis (when on H2 Blocker, or PPI) Isolation in hospital  Contact precautions: GNR with > 3 class resistance  Zoster RSV Droplet Precautoin Flu RSV Airborne Precaution