Surveillance for Nosocomial Pneumonia

Compared to most hospitalized patients, rates of nosocomial pneumonia are 10- to 20-fold higher in intensive care unit patients, and 7- to 21-fold higher in the intubated patients (4-6). Therefore, intubated patients in intensive care should be a major focus of surveillance for nosocomial pneumonia. Unit- 

Three categories of data comprise the usual information collected on a patient with a nosocomial pneumonia demographic, clinical, and laboratory. Information describing important risk factors for infection should also be collected, but only if it will be analyzed and used by the hospital personnel. Corresponding denominator data should also be collected so that infection rates can be calculated. 

For the numerator of a nosocomial pneumonia rate, accurate and consistent case finding of nosocomial pneumonia in the population under study is needed. Consistent definitions for case finding are essential. Therefore, it is imperative that there be available a uniform set of criteria that define nosocomial pneumonia. The most widely used definitions currently in use are the definitions used by National Nosocomial Infection Surveillance (NNIS) system hospitals, the complete version of which was published in Hospital Epidemiology and Infection Control in 1996. The current definition for nosocomial pneumonia is shown on Table 1. 

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Rales or dullness to percussion on physical examination of chest and any of the 

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Once the CQI program is implemented, ongoing surveillance provides the data with which to measures its effectiveness (17). A standardized case definition should be used to ensure comparability between different abstractors. The CDC definition (Table 4) for nosocomial pneumonia is commonly used. The case definition differs for ventilated versus nonventilated patients and it depends on the age of the patient (18). Interinstitutional rates cannot be compared without standardization of the case definition. Surveillance for nosocomial pneumonia has typically been the domain of the hospital epidemiology and infection control department. It is a fundamental part of the specialized function of infection control practitioners (19,20). 

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