Neumonia asociada a los cuidados de salud

Hello. In this second part of the activity, discussing pneumonia, we'll now talk about healthcare-associated pneumonia. When we talk about pneumonia and associate it with healthcare, it's due to a circumstance. Unlike the previous division of pneumonia into hospital-acquired and community-acquired, the definition is now broader. When it's not community-acquired pneumonia, as we saw in the previous class, it's

healthcare-associated pneumonia. Why is this important? Because these pathologies tend to have a higher mortality rate than community-acquired pneumonia in this group of individuals. It was believed that this was because, as we'll see in the next slides, being associated with healthcare also led to greater antimicrobial resistance. So, defining this category includes patients who have had or are currently in

contact with the healthcare system. These are individuals who had contact with a healthcare provider for more than 48 hours within 90 days of discharge and have a current clinical picture compatible with pneumonia. This also includes those with chronic kidney disease who undergo three or more procedures per day. This means that they are

continuously institutionalized due to the need for dialysis in patients being treated in a day hospital. Whether they are there for one day or several times a week, but in an inpatient setting, they go home the same day. Also, those receiving home nursing care are in constant contact with, let's say, manipulation of IV lines, food handling, or

other conditions that don't occur in acute pneumonia in the community. We had said, then, that this was due to higher mortality and that antimicrobial resistance is in doubt. If these individuals actually have it, and this group of patients is heterogeneous, not all will require broad-spectrum or combination antibiotic therapy in case of suspected pneumonia,