Pneumonias relacionadas com a assistência à saúde: epidemiologia, patogenia, fatores de risco, evolução, diagnóstico, tratamento e prevenção

Abstract

Pneumonia is the second most common healthcare-associated infection (HAI) in hospital settings and the leading one among patients admitted to intensive care units (ICUs), primarily represented by ventilator-associated pneumonia (VAP) in these units. Its occurrence is associated with prolonged hospital stays, increased morbidity and mortality, and elevated hospital costs. The objective of this work was to carry out a narrative review of the literature on hospital-acquired pneumonia. A bibliographic search was carried out focusing on the past 8 years. Sources included books, theses, dissertations, scientific journals, and articles available in databases such as Scielo, LILACS, PubMed, Medline, and ScienceDirect, which allowed obtaining information focusing on epidemiology, pathogenesis, risk factors, progression, diagnosis, treatment, and prevention of healthcare-associated pneumonia. Pneumonia has a global incidence, predominantly affecting males and individuals with comorbidities. These infections can affect people of all ages, particularly those over 50, and may be caused by various microorganisms, including Streptococcus pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, Staphylococcus aureus, and enterobacteria such as Klebsiella pneumoniae, Escherichia coli, among others. Diagnosis involves clinical, radiological, and laboratory assessments. Initial treatment is empirical, using broad-spectrum antimicrobials, which are later adjusted based on the results of antimicrobial susceptibility testing to target the specific isolated microorganism. The importance of hospital-acquired pneumonia, especially VAP in ICUs, is clear, making more and better epidemiological studies, research into easier and lower-cost strategies for its prevention, and ongoing training of healthcare professionals to improve patient outcomes.