Nosocomial Pneumonia Outside the Intensive Care Unit

Nosocomial pneumonia is the second most frequent cause of nosocomial infection. Most studies have been carried out in intensive care units with patients requiring mechanical ventilation or at high risk for developing nosocomial pneumonia. However, about half of the cases of nosocomial pneumonia occur outside intensive care unit and differ from ventilator-associated pneumonia in several aspects. Patients admitted in conventional hospital wards are not exposed to such aggressive maneuvers as those receiving mechanical ventilation. Moreover, changes in the oropharyngeal flora are probably delayed and the community flora persists longer in them. In addition, these patients are more susceptible to the pathogens present in the air and water environment. These facts suggest that the etiology and therapeutic approach in these 2 groups are not totally comparable.