Pneumonia - Revision history

Bosmana fem at 15:45, 12 April 2023

2023-04-12T15:45:06Z

Bosmana fem at 15:43, 12 April 2023

2023-04-12T15:43:45Z

← Older revision		Revision as of 15:43, 12 April 2023
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			'''The “Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals” protocol adopts the following definition of Pneumonia (PN).'''
			The definition of pneumonia (PN) is based on three types of criteria: radiological, clinical and microbiological.

			;Radiological
			: two or more serial chest x-rays or CT-scans with a suggestive image of pneumonia for patients with underlying cardiac or pulmonary disease, and at least one of the following (in patients without underlying cardiac or pulmonary disease one definitive chest x-ray or CT-scan is sufficient).

			;Clinical
			: fever> 38 °C with no other cause;
			: leukopenia (<4000 WBC/mm3) or leucocytosis (≥ 12 000 WBC/mm3);
			: and at least one of the following (or at least two if clinical pneumonia only = PN 4 and PN 5):
			: new onset of purulent sputum, or change in character of sputum (colour, odour, quantity, consistency);
			: cough or dyspnoea or tachypnoea;
			: suggestive auscultation (rales or bronchial breath sounds), rhonchi, wheezing;
			: worsening gas exchange (e.g. O2 desaturation or increased oxygen requirements or increased ventilation demand);

			;and (microbiological)
			: according to the used diagnostic method:
			:a) bacteriologic diagnostic test performed by:
			:* positive quantitative culture from minimally contaminated LRT (lower respiratory tract) specimen (PN 1):
			:* bronco-alveolar lavage (BAL) with a threshold of > 104 CFU*/ml or ≥ 5 % of BAL obtained cells contain intracellular bacteria on direct microscopic exam (classified on the diagnostic category BAL);
			:* protected brush (PB Wimberley) with a threshold of > 103 CFU/ml;
			:* distal protected aspirate (DPA) with a threshold of > 103 CFU/ml;
			:* positive quantitative culture from possibly contaminated LRT specimen (PN 2):
			:* quantitative culture of LRT specimen (e.g. endotracheal aspirate) with a threshold of 106 CFU/ml
			:b) Alternative microbiology methods (PN 3):
			:* positive blood culture not related to another source of infection;
			:* positive growth in culture of pleural fluid;
			:* pleural or pulmonary abscess with positive needle aspiration;
			:* histologic pulmonary exam shows evidence of pneumonia;
			:* positive exams for pneumonia with virus or particular germs (Legionella spp., Aspergillusspp., mycobacteria, mycoplasma, Pneumocystis carinii):
			:* positive detection of viral antigen or antibody from respiratory secretions (e.g. EIA, FAMA, shell vial assay, PCR);
			:* positive direct exam or positive culture from bronchial secretions or tissue;
			:* seroconversion (e.g. influenza viruses, Legionella spp., Chlamydiaspp.);
			:* detection of antigens in urine (Legionella spp.).
			:c) Others:
			:* positive sputum culture or non-quantitative LRT specimen culture (PN 4);
			:* no positive microbiology (PN 5).
			Note:

			PN 1 and PN 2 criteria were validated without previous antimicrobial therapy.

			==Link to European IC/HH Core Competencies==
			* Area 3. Surveillance and investigation of healthcare-associated infection (HAI)

			=References=
			* http://www.ecdc.europa.eu/en/publications/Publications/0512-TED-PPS-HAI-antimicrobial-use-protocol.pdf


	[[Category:HAI case definitions for use in hospitals]]		[[Category:HAI case definitions for use in hospitals]]

Bosmana fem: Created page with " Category:HAI case definitions for use in hospitals"

2023-03-23T12:59:04Z

Created page with " Category:HAI case definitions for use in hospitals"

New page

[[Category:HAI case definitions for use in hospitals]]

← Older revision		Revision as of 15:45, 12 April 2023
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	:a) bacteriologic diagnostic test performed by:		:a) bacteriologic diagnostic test performed by:
	:* positive quantitative culture from minimally contaminated LRT (lower respiratory tract) specimen (PN 1):		:* positive quantitative culture from minimally contaminated LRT (lower respiratory tract) specimen (PN 1):
	:* bronco-alveolar lavage (BAL) with a threshold of > 104 CFU*/ml or ≥ 5 % of BAL obtained cells contain intracellular bacteria on direct microscopic exam (classified on the diagnostic category BAL);		:** bronco-alveolar lavage (BAL) with a threshold of > 104 CFU*/ml or ≥ 5 % of BAL obtained cells contain intracellular bacteria on direct microscopic exam (classified on the diagnostic category BAL);
	:* protected brush (PB Wimberley) with a threshold of > 103 CFU/ml;		:** protected brush (PB Wimberley) with a threshold of > 103 CFU/ml;
	:* distal protected aspirate (DPA) with a threshold of > 103 CFU/ml;		:** distal protected aspirate (DPA) with a threshold of > 103 CFU/ml;
	:* positive quantitative culture from possibly contaminated LRT specimen (PN 2):		:* positive quantitative culture from possibly contaminated LRT specimen (PN 2):
	:* quantitative culture of LRT specimen (e.g. endotracheal aspirate) with a threshold of 106 CFU/ml		:** quantitative culture of LRT specimen (e.g. endotracheal aspirate) with a threshold of 106 CFU/ml
	:b) Alternative microbiology methods (PN 3):		:b) Alternative microbiology methods (PN 3):
	:* positive blood culture not related to another source of infection;		:* positive blood culture not related to another source of infection;
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	:* histologic pulmonary exam shows evidence of pneumonia;		:* histologic pulmonary exam shows evidence of pneumonia;
	:* positive exams for pneumonia with virus or particular germs (Legionella spp., Aspergillusspp., mycobacteria, mycoplasma, Pneumocystis carinii):		:* positive exams for pneumonia with virus or particular germs (Legionella spp., Aspergillusspp., mycobacteria, mycoplasma, Pneumocystis carinii):
	:* positive detection of viral antigen or antibody from respiratory secretions (e.g. EIA, FAMA, shell vial assay, PCR);		:** positive detection of viral antigen or antibody from respiratory secretions (e.g. EIA, FAMA, shell vial assay, PCR);
	:* positive direct exam or positive culture from bronchial secretions or tissue;		:** positive direct exam or positive culture from bronchial secretions or tissue;
	:* seroconversion (e.g. influenza viruses, Legionella spp., Chlamydiaspp.);		:** seroconversion (e.g. influenza viruses, Legionella spp., Chlamydiaspp.);
	:* detection of antigens in urine (Legionella spp.).		:** detection of antigens in urine (Legionella spp.).
	:c) Others:		:c) Others:
	:* positive sputum culture or non-quantitative LRT specimen culture (PN 4);		:* positive sputum culture or non-quantitative LRT specimen culture (PN 4);