title: [Healthcare associated pneumonia].
abstract: Healthcare associated pneumonia (HCAP) is a different entity from community-acquired pneumonia and nosocomial pneumonia. There exist several risk factors that lead to it. Different features, severity and pathogens are described and there is controversy about the initial empirical treatment. The aim of this work was to analyze the etiology, clinical characteristics and evolution of the HCAP. It is a prospective and observational study that includes 60 patients; 32 had previous hospitalization during the last 90 days, 9 were under hemodialysis, 12 residents in nursing homes and 7 received outpatient intravenous therapy. The mean age was 63 years and the severity index was high. The most frequent comorbidities were cardiac. The radiological compromise was more than one lobe in 42% of cases and 18% had pleural effusion. Germ isolation was obtained in 30% of patients where the most isolated germ was Streptococcus pneumoniae (9 cases). There was only one case of multidrug-resistance. The mean length hospital stay was 11 days, six patients had complications and mortality was 5%. Complications but not mortality were significantly higher in the group of patients on hemodialysis (p value = 0.011 and 0.056 respectively). The antibiotic-resistance found do not justify a change in the antibiotic treatment commonly used for community acquired pneumonia.
authors.affiliation: Servicio de Neumonología, Hospital Nacional Profesor Doctor Alejandro Posadas, Buenos Aires, Argentina. E-mail: adrianceccato@gmail.com.
authors.forename: Adrián
authors.initials: A
authors.lastname: Ceccato
authors.forename: Alejandra
authors.initials: A
authors.lastname: González
authors.forename: Marcela
authors.initials: M
authors.lastname: Heres
authors.forename: Graciela
authors.initials: G
authors.lastname: Peluffo
authors.forename: Alfredo
authors.initials: A
authors.lastname: Monteverde
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001118:Argentina / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: health care-associated pneumonia; pneumonia
vernacular_title: Neumonía asociada al cuidado de la salud.