Hospital - acquired pneumonia ( HAP ) is a common infection in the intensive care unit ( ICU ) , with two main types: ventilator - associated pneumonia ( VAP ) and severe pneumonia acquired during the hospital stay. The incidence of VAP ranges from 1. 9 to 3. 8 cases per 1000 days of mechanical ventilation in the US and exceeds 18 cases per 1000 days of mechanical ventilation in Europe.
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Non - ventilator HAP occurs in patients admitted to the hospital for at least 48 hours, while VAP is defined as occurring more than 48 hours after the initiation of mechanical ventilation. However, standardized diagnostic criteria are lacking, which limits accurate data on the epidemiology of these infections. In the US, the incidence of non - ventilator HAP was 1. 6%, with a rate of 3. 63 cases per 1000 patient - days. The incidence of VAP remains as mentioned above.
HAP in the ICU is associated with a mortality rate of approximately 20%. However, the mortality attributable to HAP is estimated to be between 5 and 13%. This mortality rate may be higher in specific populations, such as patients with chronic obstructive pulmonary disease ( COPD ) . In other populations, like trauma patients, HAP appears to have a minor effect on mortality. HAP is also associated with increased morbidity, including prolonged mechanical ventilation, decreased ventilator - free days, and extended ICU and hospital stays. Consequently, HAP leads to overutilization of healthcare resources, such as ventilation, ICU and hospital beds, and increased costs related to hospital stay.
