Guideline for prevention of nosocomial pneumonia

O. C. Tablan, L. J. Anderson, N. H. Arden, R. F. Braiman, J. C. Butler, M. M. McNeil, W. J. Hierholzer, J. S. Garner, D. E. Craven, D. W. Fleming, S. W. Forlenza, M. J. Gilchrist, D. A. Goldmann, R. W. Haley, C. G. Mayhall, R. D. McCormick, R. L. Nichols, C. C. Sanders, E. S. Wong

Research output: Contribution to journalArticle

95 Citations (Scopus)

Abstract

Pneumonia is the second most common nosocomial infection in the United States and is associated with substantial morbidity and mortality. Most patients with nosocomial pneumonia are those with extremes of age, severe underlying disease, immunosuppression, depressed sensorium, and cardiopulmonary disease, and those who have had thoracoabdominal surgery. Although patients with mechanically assisted ventilation do not comprise a major proportion of patients with nosocomial pneumonia, they have the highest risk of developing the infection. Most bacterial nosocomial pneumonias occur by aspiration of bacteria colonizing the oropharynx or upper gastrointestinal tract of the patient. Intubation and mechanical ventilation greatly increase the risk of nosocomial bacterial pneumonia because they alter first-line patient defenses. Pneumonias due to Legionella spp., Aspergillus spp., and influenza virus are often caused by inhalation of contaminated aerosols. Respiratory syncytial virus (RSV) infection usually follows viral inoculation of the conjunctive or nasal mucosa by contaminated hands. Traditional preventive measures for nosocomial pneumonia include decreasing aspiration by the patient, preventing cross-contamination or colonization via hands of personnel, appropriate disinfection or sterilization of respiratory therapy devices, use of available vaccines to protect against particular infections, and education of hospital staff and patients. New measures under investigation involve reducing oropharyngeal and gastric colonization by pathogenic microorganisms.

Original languageEnglish (US)
Pages (from-to)1191-1236
Number of pages46
JournalRespiratory Care
Volume39
Issue number12
StatePublished - 1994
Externally publishedYes

Fingerprint

Pneumonia
Guidelines
Bacterial Pneumonia
Cross Infection
Hand
Respiratory Therapy
Respiratory Syncytial Virus Infections
Legionella
Oropharynx
Upper Gastrointestinal Tract
Nasal Mucosa
Disinfection
Aspergillus
Orthomyxoviridae
Aerosols
Artificial Respiration
Intubation
Immunosuppression
Inhalation
Ventilation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Tablan, O. C., Anderson, L. J., Arden, N. H., Braiman, R. F., Butler, J. C., McNeil, M. M., ... Wong, E. S. (1994). Guideline for prevention of nosocomial pneumonia. Respiratory Care, 39(12), 1191-1236.

Guideline for prevention of nosocomial pneumonia. / Tablan, O. C.; Anderson, L. J.; Arden, N. H.; Braiman, R. F.; Butler, J. C.; McNeil, M. M.; Hierholzer, W. J.; Garner, J. S.; Craven, D. E.; Fleming, D. W.; Forlenza, S. W.; Gilchrist, M. J.; Goldmann, D. A.; Haley, R. W.; Mayhall, C. G.; McCormick, R. D.; Nichols, R. L.; Sanders, C. C.; Wong, E. S.

In: Respiratory Care, Vol. 39, No. 12, 1994, p. 1191-1236.

Research output: Contribution to journalArticle

Tablan, OC, Anderson, LJ, Arden, NH, Braiman, RF, Butler, JC, McNeil, MM, Hierholzer, WJ, Garner, JS, Craven, DE, Fleming, DW, Forlenza, SW, Gilchrist, MJ, Goldmann, DA, Haley, RW, Mayhall, CG, McCormick, RD, Nichols, RL, Sanders, CC & Wong, ES 1994, 'Guideline for prevention of nosocomial pneumonia', Respiratory Care, vol. 39, no. 12, pp. 1191-1236.
Tablan OC, Anderson LJ, Arden NH, Braiman RF, Butler JC, McNeil MM et al. Guideline for prevention of nosocomial pneumonia. Respiratory Care. 1994;39(12):1191-1236.
Tablan, O. C. ; Anderson, L. J. ; Arden, N. H. ; Braiman, R. F. ; Butler, J. C. ; McNeil, M. M. ; Hierholzer, W. J. ; Garner, J. S. ; Craven, D. E. ; Fleming, D. W. ; Forlenza, S. W. ; Gilchrist, M. J. ; Goldmann, D. A. ; Haley, R. W. ; Mayhall, C. G. ; McCormick, R. D. ; Nichols, R. L. ; Sanders, C. C. ; Wong, E. S. / Guideline for prevention of nosocomial pneumonia. In: Respiratory Care. 1994 ; Vol. 39, No. 12. pp. 1191-1236.
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