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Hospital-acquired pneumonia: Risk factors for MDR pathogens and/or increased mortality in adults

Hospital-acquired pneumonia: Risk factors for MDR pathogens and/or increased mortality in adults
Risk factors for increased mortality:
  • Ventilatory support for HAP
  • Septic shock
Risk factor for MDR Pseudomonas, other gram-negative bacilli, and MRSA:
  • IV antibiotics within the past 90 days
Risk factors for MDR Pseudomonas and other gram-negative bacilli:
  • Structural lung disease (bronchiectasis or cystic fibrosis)
  • A respiratory specimen Gram stain with numerous and predominant gram-negative bacilli
  • Colonization with OR prior isolation of MDR Pseudomonas or other gram-negative bacilli
Risk factors for MRSA:
  • Treatment in a unit in which >20 percent of Staphylococcus aureus isolates are methicillin resistant
  • Treatment in a unit in which the prevalence of MRSA is not known
  • Colonization with OR prior isolation of MRSA
MDR: multidrug resistant; HAP: hospital-acquired pneumonia; MRSA: methicillin-resistant S. aureus; IV: intravenous.
Adapted from: Kalil AC, Metersky ML, Klompas M, et al. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis 2016; 63:e61.
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