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Research led by Andrew Shorr, MD, MPH, in the Department of Pulmonary and Critical Care Medicine Service at MedStar Washington Hospital Center has identified some causes of hospital-acquired infections for patients not on ventilators.
Published in Respiratory Medicine, the study, “Viruses are prevalent in non-ventilated hospital-acquired pneumonia”, looked at hospital-acquired pneumonia arising in non-ventilated patients (NVHAP) to identify the prevalence of viruses causing NVHAP and to identify any patient characteristics that could be identified as having a viral etiology.
Nosocomial can be acquired by any patient in a hospital, whether or not they are on a ventilator. Most current research focuses on ventilated patients, as it is easier to identify an occurrence within an intensive care unit. “Traditionally, most cases of pneumonia in the hospital, whether they be community-acquired pneumonia, hospital-acquired pneumonia, or ventilator-associated pneumonia are thought to be caused by bacterial pathogens,” the authors said.
This retrospective analysis identified the prevalence of a virus as the cause for NVHAP and identified patient characteristics for these infections in 174 cases. Bacterial pathogens were found in 23.6% of patients and viruses were identified in 22.4% of patients. Few differences were found between patients for whom cultures were negative for viruses and patients with either viral or bacterial etiologies.
“Our findings are important in that they help to confirm that the etiologic agents of ventilated hospital-acquired pneumonia are generally similar to those in NVHAP,” said the authors. While this research does have limitations in scope, as both testing for viral infections and cultures are not conducted for all cases of NVHAP and there are cases of false-negatives for those cultures, it suggests that further research is necessary to verfiy the conclusions.
Dr. Shorr is Associate Director of Pulmonary and Critical Care Medicine and Chief of the Pulmonary Clinic at MedStar Washington Hospital Center.
Respiratory Medicine, 2017. DOI: 10.1016/j.rmed.2016.11.023