title: Incidence and characteristics of hospital-acquired pneumonia in a pulmonary rehabilitation setting.
abstract: BACKGROUND
  The incidence of Hospital Acquired Pneumonia (HAP) varies according to the setting. It is estimated to be approximately 0.5% to 1% in hospitalized subjects but higher in mechanically ventilated patients in intensive care units. The incidence of HAP in a pulmonary rehabilitation unit has not been investigated.
  
  
  METHODS
  Patients with chronic obstructive pulmonary disease (COPD), admitted for pulmonary rehabilitation between January 1 and December 31, 2006, were included. HAP was defined by symptoms, signs, and radiograph imaging of pulmonary infiltrate. Chest radiography allowed us to distinguish HAP from COPD exacerbations. The disease course also was evaluated.
  
  
  RESULTS
  In total, 143 subjects (85 men, 58 women; mean age, 74.2 years) were enrolled. Nine of them (6.3%; 6 men, 3 women; mean age, 72.8+/-3.2 years) developed HAP. Twenty-four (16.8%) had pneumonia signs and symptoms but no radiologic findings. In these patients, a diagnosis of COPD exacerbation was made. Seven of 9 patients with HAP were successfully treated with empiric antibiotic therapy, while the other 2 required a modification of the antibiotic regimen after resistant Klebsiella pneumoniae and Pseudomonas aeruginosa had been detected in sputum culture.
  
  
  CONCLUSIONS
  The incidence of HAP in a pulmonary rehabilitation setting was approximately 6%, higher than that previously described in hospitalized subjects. The clinical course of HAP was favorable, no mortality occurred. This could be explained either by patient-related or by environment-related factors.
authors: Pulmonary Rehabilitation Unit, ICP Hospital, Milan, Italy. cristoforo.incorvaia@fastwebnet.it
authors: Cristoforo
authors: C
authors: Incorvaia
authors: Gian Galeazzo
authors: GG
authors: Riario-Sforza
authors: Chiara
authors: C
authors: Pravettoni
authors: Raffaella
authors: R
authors: Megali
authors: Mona-Rita
authors: MR
authors: Yacoub
authors: Franco
authors: F
authors: Frati
mesh_terms: D000368:Aged; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011014:Pneumonia / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation*; D013997:Time Factors; D016138:Walking