Nosocomial pneumonia: pathogenesis and recent advances in diagnosis and therapy.
Despite recent progress in the prevention and treatment of hospital-acquired infections, nosocomial pneumonia remains an important problem among critically ill patients. Nosocomial pneumonia develops in five to 10 patients per 1,000 admissions and has a mortality rate of 20%-50%. This review focuses on three areas of nosocomial pneumonia that have been the subject of investigation in recent years: (1) pathogenesis, especially the role of gastric colonization with gram-negative bacilli in retrograde pharyngeal spread; (2) diagnosis, particularly by means of bronchoalveolar lavage and the protected specimen brush during bronchoscopy; and (3) therapy with extended-spectrum penicillins, third-generation cephalosporins, imipenem, aztreonam, and quinolones.
Scheld
W M
WM
Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville.
Mandell
G L
GL
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification; D001992:Bronchoalveolar Lavage Fluid; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D011014:Pneumonia / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*
D000900:Anti-Bacterial Agents