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Previous Volume 340:627-634 February 25, 1999 Number 8 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Nosocomial pneumonia is a leading cause of death from hospital-acquired infections, with an associated crude mortality rate of approximately 30 percent.¹ Ventilator-associated pneumonia refers specifically to nosocomial bacterial pneumonia that has developed in patients who are receiving mechanical ventilation. Ventilator-associated pneumonia that occurs within 48 to 72 hours after tracheal intubation is usually termed early-onset pneumonia; it often results from aspiration, which complicates the intubation process.² Ventilator-associated pneumonia that occurs after this period is considered late-onset pneumonia. Early-onset ventilator-associated pneumonia is most often due to antibiotic-sensitive bacteria (e.g., oxacillin-sensitive Staphylococcus aureus, Haemophilus influenzae, and Streptococcus pneumoniae), whereas late-onset . . . [Full Text of this Article]

General Preventive Strategy

Nonpharmacologic Strategies

Effective Hand Washing and the Use of Protective Gowns and Gloves

Semirecumbent Positioning of Patients

Avoidance of Large Gastric Volumes

Oral (Non-Nasal) Intubation

Routine Maintenance of Ventilator Circuits

Continuous Subglottic Suctioning

Type of Suction Catheter and Its Replacement

Humidification with Heat and Moisture Exchangers

Postural Changes

Pharmacologic Strategies

Stress-Ulcer Prophylaxis

Administration of Antibiotics

Combination Antibiotic Therapy

Prophylactic Antibiotic Therapy

Chlorhexidine Oral Rinse

Administration of Immune Globulin

Prophylactic Treatment of Patients with Neutropenia

Vaccines

Source Information

From the Pulmonary and Critical Care Division, Department of Internal Medicine, Washington University School of Medicine, and the Medical Intensive Care Unit and the Department of Respiratory Care Services, Barnes–Jewish Hospital — both in St. Louis.

Address reprint requests to Dr. Kollef at the Pulmonary and Critical Care Division, Washington University School of Medicine, Box 8052, 660 S. Euclid Ave., St. Louis, MO 63110, or at mkollef@pulmonary.wustl.edu.

References

Related Letters:

The Prevention of Ventilator-Associated Pneumonia
van Saene H.K.F., Baines P. B., Kollef M. H.
Extract | Full Text  
N Engl J Med 1999; 341:293-294, Jul 22, 1999. Correspondence

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