Considere, abaixo, 3 diferentes pacientes com pneumonia. 1....

Talvez essa questão esteja desatualizada. Ela parece levar em conta a classificação de 2005 que incluia o termo healthcare-associated pneumonia. Em 2016, a Infectious Disease Society of America/American Thoracic Society (IDSA/ATS) retirou esse termo. Veja a bibliografia abaixo.

The term healthcare-associated pneumonia (HCAP) was defined as pneumonia in nonhospitalized patients who had significant experience with the healthcare system. Such contact could include (1) intravenous therapy for wound care within the preceding 30 days, (2) residence in a long-term care facility, (3) hospitalization in an acute-care hospital within the preceding 90 days, and/or (4) outpatient treatment in a hospital or hemodialysis clinic within the preceding 30 days. These individuals were believed to be at an increased risk for infection with multidrug-resistant (MDR) organisms because of such contact. [1] However, more recent studies have indicated that many individuals who met the criteria for HCAP were not infected with MDR pathogens. [2] The risk of infection with MDR organisms appears to depend much more on specific risk factors of the given patient than on contact with various aspects of the healthcare system. Patients who would have met the criteria for HCAP should not be empirically treated with antibiotics to cover MDR bacteria unless they have valid risk factors for acquiring MDR organisms.

(Medscape)

2016 Infectious Disease Society of America/American Thoracic Society (IDSA/ATS) guidelines define 2 types of pneumonia acquired in hospital(1)

hospital acquired pneumonia (HAP) refers to pneumonia acquired ≥ 48 hours after hospital admission in non-ventilated patients

ventilator-associated pneumonia (VAP) refers to pneumonia that develops ≥ 48 hours after endotracheal intubation

nosocomial pneumonia encompasses both hospital-acquired pneumonia and ventilator-associated pneumonia(2, 3, 4)

healthcare associated pneumonia (HCAP) is a term used to help identify patients at higher risk of infection with multidrug resistant pathogens, such as patients with recent hospital admissions, residence in long-term care facilities, recent IV antibiotic use, or significant immunosuppression, however this term may soon be retired(1, 2)

IDSA/ATS 2016 guidelines do not include designation of HCAP, as that definition is neither sensitive nor specific for the identification of patients at risk for infections with multi-drug resistant (MDR) organisms warranting broad empiric antimicrobial therapy

previously reported poor clinical outcomes associated with HCAP as compared to community acquired pneumonia believed to be predominantly related to age and medical comorbidities rather than infection with MDR organisms

(Dynamed)

HOSPITALIZADO POR MAIS DE 2 DIAS A MENOS DE 90 DIAS

RESIDENTE EM CASA DE SAUDE OU ASILO

ATB EV, QUIMIOTERAPIA OU TTO DE ESCARA HA MENOS DE 30 DIAS

EM HEMODIALISE