By William R. Jarvis
This well timed reference offers the newest info at the prognosis, therapy, and prevention of nosocomial pneumonia, together with hazard components, diagnostic checks used to make the definitive analysis, most likely pathogens, and the best remedy options.
Contains directions for the prevention of nosocomial pneumonia-emphasizing chosen high-risk pathogens!
Written through top experts within the box, Nosocomial Pneumonia
Nosocomial Pneumonia is a required reference for pulmonologists, physiologists, infectious affliction experts, intensivists, serious care physicians, sanatorium epidemiologists, medical microbiologists, anesthesiologists, breathing therapists, an infection keep an eye on pros, nurses, pediatricians, surgeons, internists, kin physicians, health center directors, and clinical students.
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Although some investigators have concluded that BAL provides the best reﬂection of the lung’s bacterial burden, both quantitatively and qualitatively, others have reported mixed results with poor speciﬁcity of BAL ﬂuid cultures in patients with high tracheobronchial colonization. , using a protocol based on postmortem lung biopsies, the results obtained by quantitative cultures of BAL ﬂuid proved to be as useful as those of PSB cultures (79). Although a few more microorganisms that were not present in lung tissue were grown from lavage specimens as compared with PSB specimens, there was a strong correlation between the concentrations of organisms grown in cultures of BAL ﬂuid and lung tissue specimens (see Fig.
Fagon JY, Chastre J, Domart Y, et al. Nosocomial pneumonia in patients receiving continuous mechanical ventilation. Prospective analysis of 52 episodes with use of a protected specimen brush and quantitative culture techniques. Am Rev Respir Dis 1989; 139:877–884. Bell RC, Coalson JJ, Smith JD, et al. Multiple organ system failure and infection in adult respiratory distress syndrome. Ann Intern Med 1983; 99:293–298. Sutherland KR, Steinberg KP, Maunder RJ, Milberg JA, Allen DL, Hudson LD. Pulmonary infection during the acute respiratory distress syndrome.
However, several constraints speciﬁc to the evaluation of any procedure used in the diagnosis of bacterial pneumonia must be respected even when using a model in which the gold standard includes both histological features 18 Chastre, Fagon, and Trouillet and quantitative cultures of lung tissue. First, diagnostic methods based on microbiological techniques can only document, both qualitatively and quantitatively, the bacterial burden present in lung tissue. By no means can these techniques retrospectively identify a resolving pneumonia, at a time when antimicrobial treatment and lung antibacterial defenses might have been successful in suppressing microbial growth in lung tissue.