[Nosocomial pneumopathies]

Abstract

The criterion used for the diagnosis of nosocomial pneumonia is an infiltrate on X-ray of the chest, not present on admission, associated with new sputum production. The main causative pathogens are Staphylococcus spp. and Gram-negative bacilli. The most common pattern in the development of pneumonia is colonization of the oropharynx followed by aspiration into the lungs in patients with impaired normal defences. The factors which significantly predispose to nosocomial pneumonia are tracheal intubation, low level of consciousness, chronic lung disease, thoracic or upper abdominal surgery, large volume aspiration and age over 70 years. The fatality rate is high (32 p. 100 to 55 p. 100). In most cases the curative treatment requires a combination of antimicrobial agents. At the moment, preventive measures remain an elusive goal.