emcardioНеотложная кардиология и кардиоваскулярные рискиEmergency Cardiology and Cardiovascular Risks journal2616-633XБелорусский государственный медицинский университетemcardio-218Research ArticleМастер-классMaster-classНозокомиальная пневмония: современные подходы к диагностике и лечениюNosocomial pneumonia: modern approaches to diagnosis and treatmentАнтоновичЖ. В.AntanovichZh. V.Учреждение образования «Белорусский государственный медицинский университет»Belarusian State Medical University20191111202532626635Copyright © Антонович Ж.В., 20252025Антонович Ж.В.Antanovich Z.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://emcardio.bsmu.by/jour/article/view/218

Нозокомиальная пневмония (НП) является второй по частоте внутрибольничной инфекцией и основной причиной смерти от внутрибольничных инфекций у критически больных пациентов. Большинство случаев НП вызывается аэробными грамотрицательными бактериями (P. aeruginosa, E. coli, K. pneumoniae, Acinetobacter spp.) и грамположительными кокками (S. aureus). С практической точки зрения для назначения адекватной стартовой антибактериальной терапии (АБТ) целесообразна стратификация пациентов в зависимости от сроков развития НП и наличия факторов риска (ФР) полирезистентных возбудителей (ПРВ). ПРВ чаще выделяются у пациентов с тяжёлыми хроническими заболеваниями и ФР развития НП. Для диагностики НП и определения ее тяжести используют диагностические критерии и клиническую шкалу оценки инфекции легких (Clinical Pulmonary Infection Score – CPIS). Исход лечения пациента с НП зависит от уровня знаний врача и максимально быстрого назначения адекватной стартовой эмпирической АБТ, представленной в современных рекомендациях, с учетом локальных данных о преобладающих в отделении возбудителях и их резистентности.

Nosocomial pneumonia (NP) is the second most common nosocomial infection and the main cause of death from nosocomial infections in critically ill patients. Most cases of NP are caused by aerobic gramnegative bacteria (P. aeruginosa, E. coli, K. pneumoniae, Acinetobacter spp.) and gram-positive cocci (S. aureus). From a practical point of view, in order to prescribe adequate initial antibacterial therapy (ABT) it is advisable to stratify patients depending on timing of the NP development and presence of risk factors (RF) for multidrug-resistant (MDR) pathogens. MDR pathogens are more often excreted in patients with severe chronic diseases and RF for the development of NP. Diagnostic criteria and Clinical Pulmonary Infection Score (CPIS) are used to diagnose NP and determine its severity. The outcome of treatment of patient with NP depends on the doctor’s level of knowledge and the most rapid administration of an adequate initial empiric ABT, presented in guidelines, taking into account local data on pathogens prevailing in the department and their resistance.

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The authors declare that there are no conflicts of interest present.