title: Non-Intensive Care Unit Acquired Pneumonia: A New Clinical Entity?
abstract: Hospital-acquired pneumonia (HAP) is a frequent cause of nosocomial infections, responsible for great morbidity and mortality worldwide. The majority of studies on HAP have been conducted in patients hospitalized in the intensive care unit (ICU), as mechanical ventilation represents a major risk factor for nosocomial pneumonia and specifically for ventilator-associated pneumonia. However, epidemiological data seem to be different between patients acquiring HAP in the ICU vs. general wards, suggesting the importance of identifying non ICU-acquired pneumonia (NIAP) as a clinical distinct entity in terms of both etiology and management. Early detection of NIAP, along with an individualized management, is needed to reduce antibiotic use and side effects, bacterial resistance and mortality. The present article reviews the pathophysiology, diagnosis, treatment and prevention of NIAP.
authors.affiliation: Department of Pathophysiology and Transplantation, Università degli Studi di Milano, IRCCS Fondazione Ospedale Maggiore Policlinico Cà Granda, Milan 20122, Italy. marta.dipasquale@gmail.com.
authors.forename: Marta
authors.initials: M
authors.lastname: Di Pasquale
authors.affiliation: School of Medicine and Surgery, University of Milan Bicocca, AO San Gerardo, Via Pergolesi 33, Monza 20090, Italy. stefano.aliberti@unimib.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Aliberti
authors.affiliation: Department of Pathophysiology and Transplantation, Università degli Studi di Milano, IRCCS Fondazione Ospedale Maggiore Policlinico Cà Granda, Milan 20122, Italy. mantero.marco@gmail.com.
authors.forename: Marco
authors.initials: M
authors.lastname: Mantero
authors.affiliation: Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan 20122, Italy. sonia.bianchini@unimi.it.
authors.forename: Sonia
authors.initials: S
authors.lastname: Bianchini
authors.affiliation: Department of Pathophysiology and Transplantation, Università degli Studi di Milano, IRCCS Fondazione Ospedale Maggiore Policlinico Cà Granda, Milan 20122, Italy. francesco.blasi@unimi.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Blasi
mesh_terms: D006757:Hospital Units / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D053717:Pneumonia, Ventilator-Associated / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control
keywords: hospital acquired pneumonia; microbiology; nosocomial infection; prevention; risk factors