Managing health care facility associated pneumonias: diagnosis, treatment and prevention.

Pneumonias acquired in a healthcare facility have different epidemiology, risk factors, responsible pathogens, treatments and outcomes than those acquired in the community. Patients with such infections generally have greater mortality and incur greater medical costs. Initially, hospitals were regarded as the major site for this paradigm; more recently, long term care facilities, rehabilitation institutions, dialysis centers and outpatient infusion facilities have also been recognized as posing similar risks. Pneumonias that occur in the ICU carry particularly serious implications. In 2005, a joint committee of the Infectious Diseases Society of America and the American Thoracic Society issued guidelines to help diagnose and manage these infections.1 Additional research has shown that these infections are not inevitable and that focused, coordinated efforts can reduce their risk and the subsequent serious consequences.