Intensive Care Medicine

, Volume 35, Issue 1, pp 9–29 | Cite as

Defining, treating and preventing hospital acquired pneumonia: European perspective

  • Antoni Torres
  • Santiago Ewig
  • Harmut Lode
  • Jean Carlet
  • For The European HAP working group
Special Article

Abstract

Introduction

Many controversies still remain in the management of hospital acquired pneumonia (HAP), and ventilation-acquired pneumonia (VAP), Three European Societies, European Respiratory Society (ERS), European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and European Society of Intensive Care Medicine (ESICM), were interested in producing a document on HAP and VAP with European perspective.

Materials and methods

The scientific committees from each Society designated one chairman; Antoni Torres (ERS), Harmut Lode (ESCMID) and Jean Carlet (ESICM). The chairmen of this Task Force suggested names from each Society to be a member of the panel. They also choose controversial topics on the field and others that were not covered by the last IDSA/ATS guidelines. Each topic was assigned to a pair of members to be reviewed and written. Finally, the panel defined 20 consensual points that were circulated several times among the members of the panel until total agreement was reached. A combination of evidences and clinical-based medicine was used to reach these consensus.

Conclusion

This manuscript reviews in depth several controversial or new topics in HAP and VAP. In addition 20 consensual points are presented. This manuscript may be useful for the development of future guidelines and to stimulate clinical research by lying out what is currently accepted and what is unknown or controversial.

Keywords

Hospital acquired pneumonia Ventilator-associated pneumonia Ventilation-acquired pneumonia Nosocomial pneumonia 

Abbreviations

CDC

Centre for diseases control

HAP

Hospital acquired pneumonia

IAP

ICU acquired pneumonia

VAP

Ventilation-acquired pneumonia

ARDS

Acute respiratory distress syndrome

ERS

European Respiratory Society

ESICM

European Society of Intensive Care Medicine

ESCMID

European Society of Clinical Microbiology and Infectious Diseases

ATS

American Thoracic Society

HELICS

Hospital in Europe link for infection control through surveillance

BAL

Broncho alveolar lavage

PSB

Protected specimen brush

TBA

Tracheo bronchial aspirates

CRP

C Reative protein

PCT

Procalcitonin

CPIS

Clinical pulmonary infection score

SDD

Selective digestive decontamination

ICU

Intensive care unit

LTCF

Long term care facilities

NH

Nursing homes

LOS

Length of stay

MRSA

Methicillin resistant Staphylococcus aureus

ESBL

Extended spectrum β lactamases

OR

Odd ratio

RR

Risk ratio

RCT

Randomized clinical trials

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Antoni Torres
    • 1
  • Santiago Ewig
    • 2
  • Harmut Lode
    • 3
  • Jean Carlet
    • 4
  • For The European HAP working group
  1. 1.Cap de Servei de Pneumologia i Al·lèrgia Respiratòria. Institut Clínic del TòraxHospital Clínic de Barcelona, Universitat de Barcelona. IDIBAPS.CIBERES 06/06/0028.BarcelonaSpain
  2. 2.Thoraxzentrum Ruhrgebiet, Kliniken für Pneumologie und InfektiologieEv. Krankenhaus Herne und Augusta-Kranken-Anstalt BochumBochumGermany
  3. 3.Hospital Heckeshorn, Chest and Infectious DiseasesBerlinGermany
  4. 4.Groupe Hospitalier Paris Saint JosephParisFrance

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