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Thursday, 04/22/2010
Rethinking the concepts of community-acquired and health-care-associated pneumonia
Prof. Antoni Torres suggests a reassignment of the criteria for health-care-associated pneumonia in an article published in Lancet Infectious Diseases which has an impact factor of 13.17
Prof. Antoni Torres, coordinator and team leader of the group Applied Research in Respiratory Infections-IAMR, has just published an article in the journal Lancet Infectious Diseases. Carried out along with Santiago Ewig, Tobias Welte and Jean Chastre, this review suggests a reassignment of the criteria for health-care-associated pneumonia (HCAP) in order to solve the problems caused by misleading and confusing definitions of health-care-associated pneumonia.
The introduction of a new category on pneumonia management –HCAP- due to the increasing number of patients who are elderly and severely disabled has lead, however, to heterogeneous and misleading definitions of HCAP.
An analysis of the available evidence in support of this category reveals many problems such as reliance on microbiological data of questionable validity, failure to recognise the contribution of aspiration pneumonia and to control microbial patterns for functional status, as well as failure to recognise frequently applied restrictions of treatment escalation as bias in assessing outcomes.
Given the fact that nowadays HCAP it’s a confusing concept that fails to provide a proper guide to pneumonia management, this article suggests to change the criteria for HCAP.
Besides, Prof. Antoni Torres leads another article published this month, along with Prof. Jordi Rello, entitled Update in Community-acquired and Nosocomial Pneumonia 2009 in which they present, separately, the new 2009 information regarding both Community-acquired (CAP) and Nosocomial Pneumonia (NP). This manuscript has been published in the American Journal of Respiratory and Critical Care Medicine (Am J Respir Crit Care med) which has an impact factor of 9,8.
During 2009, a reach body of new data regarding prevention was gathered. This information includes new guidelines, an insights position, oral care, endotracheal tubes, noninvasive mechanical ventilation, and most especially, bundles for implementation.