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If it occurs within 4-5 days of admission it is more likely to be CAP bacteria, what about the type of bacteria after this point?

More likely to be Gram negative such as pseudonomas, Klebsiella, MRSA


What factors predispose an individual to HAP?

Reduced defences (corticosteroid therapy, diabetes), aspiration of nasopharyngeal or gastric secretions (NG intubation, immobility, GORD), bacteria in lower resp tract (intubation, ventilators), bacteraemia (sepsis, cannula infection)


When should HAP be considered?

Any patient developing g a persistant fever above 38 degrees, purulant sputum, raised WBC, new shadowing on CXR


Management is?

Same as CAP but antibiotics differ. Instead cefotaxime, gentamicin, meropenem and flucloxacillin.


Mortality is roughly what?



What is HAP?

Pneumonia that occurs at least 2 days after admission to hospital