HEALTHCARE-ASSOCIATED PNEUMONIAS: EPIDEMIOLOGY, PATHOGENESIS, RISK FACTORS, EVOLUTION, DIAGNOSIS, TREATMENT AND PREVENTION
DOI:
https://doi.org/10.47820/recima21.v7i1.7401Keywords:
Healthcare-associated infections, hospital-acquired pneumonia, ventilator-associated pneumonia, intensive care unitsAbstract
Pneumonia is the second most common healthcare-associated infection (HAI) in hospital settings and the most common in intensive care units (ICUs). 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 ventilator-associated pneumonia 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.
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References
AI-OMARI, B. et al. Systematic review of studies investigating ventilator associated pneumonia diagnostics in intensive care. BMC Pulmonary Medicine, v. 21, n. 196, 2021. DOI: https://doi.org/10.1186/s12890-021-01560-0. DOI: https://doi.org/10.1186/s12890-021-01560-0
ALNIMIR, A. Antimicrobial Resistance in Ventilator-Associated Pneumonia: Predictive Microbiology and Evidence Based Therapy. Infectious Diseases Therapy, v. 12, n. 6, p.1527–1552, 2023. DOI: https://doi.org/10.1007/s40121-023-00820-2. DOI: https://doi.org/10.1007/s40121-023-00820-2
ALVARES, F. A. Pneumonia associada à ventilação mecânica: incidência, etiologia microbiana e perfil de resistência aos antimicrobianos. Revista De Epidemiologia E Controle De Infecção, v. 11, n. 4, 2022. DOI: https://doi.org/10.17058/reci.v11i4.16781. DOI: https://doi.org/10.17058/reci.v11i4.16781
ALVES, J. N. B. et al. Pneumonia em pacientes hospitalizados por traumas sob tratamento intensivo / Pneumonia in patients hospitalized for trauma under intensive care. Revista de Enfermagem UFPE on line, Recife, v. 15, n. 1, 2021. DOI: 10.5205/1981-8963.2021.245951. DOI: https://doi.org/10.5205/1981-8963.2021.245951
ANVISA. Critérios diagnósticos de infecções relacionadas à assistência à saúde. Brasília: Anvisa, 2017.
ARAÚJO, A. M. et al. Assistência de enfermagem na prevenção de pneumonia associada à ventilação mecânica: revisão integrativa / Nursing assistance in preventing pneumonia associated with mechanical ventilation: integrative review. Journal of Nursing and Health, v. 11, n. 3, 2021. DOI: https://doi.org/10.15210/jonah.v11i3.17637
BASSI, E. et al. Association of antimicrobial use and incidence of hospital-acquired pneumonia in critically ill trauma patients with pulmonary contusion: an observational study. Brazilian Journal of Anesthesiology, v. 74, n.3, 744454, 2024. DOI: https://doi.org/10.1016/j.bjane.2023.07.011. DOI: https://doi.org/10.1016/j.bjane.2023.07.011
BLOT, S. et al. Healthcare-associated infections in adult intensive care unit patients: changes in epidemiology, diagnosis, prevention and contributions of new technologies. Intensive & Critical Care Nursing, v. 70, p.103227, 2022. Elsevier BV. DOI: 10.1016/j.iccn.2022.103227. DOI: https://doi.org/10.1016/j.iccn.2022.103227
BUSTOS, I. G. Transforming Microbiological Diagnostics in Nosocomial Lower Respiratory Tract Infections: Innovations Shaping the Future. Diagnostics, v. 15, n. 3, p. 265, 2025. DOI: https://doi.org/10.3390/ diagnostics15030265. DOI: https://doi.org/10.3390/diagnostics15030265
CAMPOS, C. G. P. et al. Análise dos critérios diagnósticos de pneumonia associada à ventilação mecânica: estudo de coorte. Revista Brasileira de Enfermagem, v. 74, n. 6, 2021. DOI: https://doi.org/10.1590/0034-7167-2019-0653. DOI: https://doi.org/10.1590/0034-7167-2019-0653
CANDEL, F. J. Ten Issues for Updating in Community-Acquired Pneumonia: An Expert Review. Journal of Clinical Medicine, v. 12, n. 21, 6864, 2023. DOI: https:// doi.org/10.3390/jcm12216864. DOI: https://doi.org/10.3390/jcm12216864
CARREÑO, E. R. et al. Study of risk factors for healthcare-associated infections in acute cardiac patients using categorical principal component analysis (CATPCA). Sci Reports, v. 12, n. 1, p. 12-28, 2022. DOI:10.1038/s41598-021-03970-w. DOI: https://doi.org/10.1038/s41598-021-03970-w
CECCATTO, A. et al. Prediction of ventilator-associated pneumonia outcomes according to the early microbiological response: a retrospective observational study. European Respiratory Journal, v. 59, n.4, 2100620, 2022. DOI: 10.1183/13993003.00620-2021. DOI: https://doi.org/10.1183/13993003.00620-2021
CHEN, C. et al. Clinical outcome of nosocomial pneumonia caused by Carbapenem resistant gram negative bacteria in critically ill patients: a multicenter retrospective observational study. Scientific Reports, v. 12, n. 7501, 2022. DOI: https://doi.org/10.1038/s41598-022-11061-7. DOI: https://doi.org/10.1038/s41598-022-11061-7
CLSI – Clinical and Laboratory Standards Institute. Performace Standards for AntimicrobialSusceptibilityTesting. 28th ed. CLSI supplement M100. Wayne, PA: Clinical and Laboratory Standards Institute, 2018.
COLANERI, M. et al. Incidence, microbiology and mortality of ventilation-associated pneumonia in a large Italian cohort of critically ill patients. Results from the PROSAFE project. Clinical Microbiology and Infection, 2025. DOI: https://doi.org/10.1016/j.cmi.2025.05.026. DOI: https://doi.org/10.1016/j.cmi.2025.05.026
COSTA, A. L. M. et al. Manejo da pneumonia associada à ventilação mecânica na unidade de terapia intensiva. Brazilian Journal of Health Review, Curitiba, v. 7, n. 4, p. 01-19, 2024. DOI:10.34119/bjhrv7n4-018. DOI: https://doi.org/10.34119/bjhrv7n4-018
CUSTÓDIO, N. S. et al. Antibiotic stewardship and nosocomial infection prevention in critically ill patients: a quality improvement program. Revista da Associação Médica Brasileira, v. 70, n. 5, e20231282, 2024. DOI: https://doi.org/10.1590/1806-9282.20231282
DA ROCHA GASPAR, M. D. et al. Impact of evidence-based bundles on ventilator -associated pneumonia prevention: A systematic review. The Journal of Infection in Developing Countries, v. 17, n. 2, p. 194-201, 2023. DOI: 10.3855/jidc.12202. DOI: https://doi.org/10.3855/jidc.12202
DONGOL, S. et al. Epidemiology, etiology, and diagnosis of health care acquired pneumonia including ventilator-associated pneumonia in Nepal. PLoS ONE, v. 16, n. 11, e0259634, 2021. DOI: https://doi.org/10.1371/journal. pone.0259634. DOI: https://doi.org/10.1371/journal.pone.0259634
EDGINTON, S. et al. Methods for determination of optimal positive end-expiratory pressure: a protocol for a scoping review. BMJ Open, v. 13, e071871, 2023. DOI: 10.1136/ bmjopen-2023-071871. DOI: https://doi.org/10.1136/bmjopen-2023-071871
European Centre for Disease Prevention Control. Healthcare-associated infections acquired in intensive care units. In E.C.D.C. Annual Epidemiological Report for 2020. ECDC: Stockholm, Sweden, 2024.
EUZÉBIO, D. M. et al. Perfil epidemiológico das infecções relacionadas à assistência à saúde em Unidade de Terapia Intensiva no período de 2019 a 2020. Research, Society and Development, v. 10, n. 17, e2101724926, 2021. DOI: http://dx.doi.org/10.33448/rsd-v10i17.24926. DOI: https://doi.org/10.33448/rsd-v10i17.24926
FAGUNDES, A. P. F. S. et al. Indicadores de infecção relacionados à assistência à saúde em um hospital de urgência e trauma / Indicators of infection related to health care in an emergency and trauma hospital. Revista Científica da Escola Estadual de Saúde Pública de Goiás “Cândido Santiago”. 2023. DOI: https://doi.org/10.22491/2447-3405.2023.V9.9c1
FALLY, M. et al. Unravelling the complexity of ventilator-associated pneumonia: a systematic methodological literature review of diagnostic criteria and definitions used in clinical research. Critical Care, v. 28, n. 214, 2024. DOI: https://doi.org/10.1186/s13054-024-04991-3. DOI: https://doi.org/10.1186/s13054-024-04991-3
FERREIRA, J. C. et al. Orientações práticas de ventilação mecânica baseadas em evidências: sugestões de duas sociedades médicas brasileiras. Jornal Brasileiro de Pneumologia, v. 51, n. 1, e20240255, 2025. DOI: https://dx.doi.org/10.36416/1806-3756/e20240255. DOI: https://doi.org/10.62675/2965-2774.20250242-pt
FONSECA, B. et al. Microrganismos bucais no desenvolvimento da pneumonia aspirativa por ventilação mecânica em pacientes de unidade de terapia intensiva - Revisão de literatura. Revista UNINGÁ Review, v.30, n.2, pp.37-43, 2017.
GAJIC, I. et al. Antimicrobial Susceptibility Testing: A Comprehensive Review of Currently Used Methods. Antibiotics, v. 11, n. 4, 427, 2022. DOI: https://doi.org/10.3390/ antibiotics11040427. DOI: https://doi.org/10.3390/antibiotics11040427
GAMAZO, J. J.; CANDEL, F. J.; CASTILLO, J. G. Nosocomial pneumonia: Current etiology and impact on antimicrobial therapy. Revista Española de Quimioterapia, v. 36 (Suppl. 1), p. 9-14, 2023. DOI:10.37201/req/s01.03.2023. DOI: https://doi.org/10.37201/req/s01.03.2023
GENANEH, W. et al. Health care-associated infections and associated factors among adult patients admitted to intensive care units of selected public hospitals, Addis Ababa, Ethiopia. International Journal of Africa Nursing Sciences, 2023. DOI: https://doi.org/10.1101/2023.12.05.23299476
GIULIANO, K. K.; BAKER, D.; QUINN, B. The epidemiology of nonventilator hospital acquired pneumonia in the United States. American Journal of Infection Control, v. 46, n. 3, p. 322–327, 2018. DOI: 10.1016/j.ajic.2017.09.005. DOI: https://doi.org/10.1016/j.ajic.2017.09.005
GOLDMAN, L; SCHAFER, A. I. Goldman Cecil Medicina. 26. ed. Rio de Janeiro: GEN, 2022.
GONÇALVES, A. C. S; PIUBELLO, S. M. N; DANSKI, M. T. R. Medidas preventivas de pneumonia associada à ventilação mecânica em pacientes na unidade de terapia intensiva. Enfermagem em Foco, v. 15, e-202471, 2024. DOI: https://doi.org/10.21675/2357-707X.2024.v15.e-202471. DOI: https://doi.org/10.21675/2357-707X.2024.v15.e-202471
GUNALAN, A. et al. Early- vs Late-onset Ventilator-associated Pneumonia in Critically Ill Adults: Comparison of Risk Factors, Outcome, and Microbial Profile. Indian Journal of Critical Care Medicine, v. 27, n. 6, p. 411–415, 2023. DOI: 10.5005/jp-journals-10071-24465. DOI: https://doi.org/10.5005/jp-journals-10071-24465
HALAT, D. H; MOUBARECK, C. A. Hospital-acquired and ventilator-associated pneumonia caused by multidrug-resistant Gram-negative pathogens: Understanding epidemiology, resistance patterns, and implications with COVID-19 [version 2; peer review: 2 approved]. F1000Research, v. 12, n. 92, 2024. DOI: 10.12688/f1000research.129080.1. DOI: https://doi.org/10.12688/f1000research.129080.2
HALILI, A. et al. Prevention of ventilator-associated pneumonia by a nose care program combining with oral care among patients hospitalized in intensive care units: a single-blind randomized controlled trial. Medicina Clínica Práctica, v. 7, n.1, 2024, 100401, ISSN 2603-9249. DOI: https://doi.org/10.1016/j.mcpsp.2023.100401. DOI: https://doi.org/10.1016/j.mcpsp.2023.100401
HOWROYD, F. et al. Ventilator-associated pneumonia: pathobiological heterogeneity and diagnostic challenges. Nature Communications, v. 15, n. 1, 6447, 2024. DOI: 10.1038/s41467-024-50805-z. DOI: https://doi.org/10.1038/s41467-024-50805-z
JITMUANG, A. A multiplex pneumonia panel for diagnosis of hospital acquired and ventilator-associated pneumonia in the era of emerging antimicrobial resistance. Frontiers in Cellular and Infection Microbiology, v.12, 977320, 2022. DOI: 10.3389/fcimb.2022.977320. DOI: https://doi.org/10.3389/fcimb.2022.977320
JONES, W. S. et al. Diagnosing ventilator-associated pneumonia (VAP) in UK NHS ICUs: the perceived value and role of a novel optical technology. Diagnostic and Prognostic Research v. 6, n. 5, 2022. DOI: https://doi.org/10.1186/s41512-022-00117-x. DOI: https://doi.org/10.1186/s41512-022-00117-x
KLOMPAS, M. Strategies to prevent ventilator-associated pneumonia, ventilator-associated events, and nonventilator hospital-acquired pneumonia in acute-care hospitals: 2022 Update. Infection Control & Hospital Epidemiology, v.43, n. 6, p. 687–713, 2022. DOI: https://doi.org/10.1017/ice.2022.88. DOI: https://doi.org/10.1017/ice.2022.88
KOWALSKA-KROCHMAL, B.; DUDEK-WICHER, R. The Minimum Inhibitory Concentration of Antibiotics: Methods, Interpretation, Clinical Relevance. Pathogens, v. 10, n. 2, 165, 2021. DOI: https://doi.org/10.3390/ pathogens10020165. DOI: https://doi.org/10.3390/pathogens10020165
KUMAR, R. et al. Prevalence of hospital-acquired infection among patients with acute neurological conditions in the ICU. Journal of Clinical Neuroscience, v.134, 111072, 2025. DOI: https://doi.org/10.1016/j.jocn.2025.111072
LEAL, M. A; FREITAS-VILELA, A. A. de. Custos das Infecções Relacionadas à assistência em saúde em uma Unidade de Terapia Intensiva. Revista Brasileira de Enfermagem, v. 74, n. 1, 2021.
LEAL, R. S; NUNES, C. P. Pneumonia associada à ventilação mecânica nas unidades de terapia intensiva. Revista de Medicina de Família e Saúde Mental, v. 1, n. 1, 2019.
LEITE, R. F.; SILVA, B. M. Perfil epidemiológico e análise clínica de pacientes com pneumonia associada à ventilação mecânica em um hospital de ensino. Revista Ciências em Saúde, v. 8, n. 3, 2018. DOI: 10.21876/rcsfmit.v8i3.766. DOI: https://doi.org/10.21876/rcsfmit.v8i3.766
LI, J. et al. External validation and application of risk prediction model for ventilator–associated pneumonia in ICU patients with mechanical ventilation: A prospective cohort study. International Journal of Medical Informatics, v. 199, 105910, 2025. DOI: https://doi.org/10.1016/j.ijmedinf.2025.105910. DOI: https://doi.org/10.1016/j.ijmedinf.2025.105910
LI, J. et al. Prediction models for the risk of ventilator-associated pneumonia in patients on mechanical ventilation: A systematic review and meta-analysis. American Journal of Infection Control, v. 52, p. 1438–1451, 2024. DOI: https://doi.org/10.1016/j.ajic.2024.07.006
LI, Y. et al. The global epidemiology of ventilator-associated pneumonia caused by multi-drug resistant Pseudomonas aeruginosa: A systematic review and meta-analysis. International Journal of Infectious Diseases v.139, p.78–85, 2024. DOI: https://doi.org/10.1016/j.ijid.2023.11.023
LOCATELLI, C. K. et al. Cuidados de enfermagem ao paciente com pneumonia bacteriana associada à ventilação mecânica: uma revisão integrativa. Revista Enfermagem Atual In Derme, v. 98, n. 4, e024405, 2024.
MACHADO, L. G. et al. The burden of healthcare-associated infections in Brazil: multi-hospital point prevalence using a matched case-control study. São Paulo Medical Journal, v. 143, n. 2, e2023307, 2025. DOI: 10.1590/1516-3180.2023.0307.R1.03072024. DOI: https://doi.org/10.1590/1516-3180.2023.0307.r1.03072024
MARTINEZ-REVIEJO, R. et al. Prevention of ventilator-associated pneumonia through care bundles: A systematic review and meta-analysis. Journal of Intensive Medicine, v. 3, p. 352–364, 2023. DOI: https://doi.org/10.1016/j.jointm.2023.04.004
MATTA, A. C. G. et al. Análise dos custos de eventos adversos infecciosos em saúde. Acta Paulista de Enfermagem, v. 35, eAPE01187, 2022. DOI: http://dx.doi.org/10.37689/acta-ape/2022AO01187. DOI: https://doi.org/10.37689/acta-ape/2022AO01187
MAWZI, S.; BLYDENSTEIN, S. A.; MUKANSI, M. Ventilator-associated pneumonia in an academic intensive care unit in Johannesburg, South Africa. African Journal of Thoracic and Critical Care Medicine, v. 29, n. 4, 10.7196, 2023. DOI: 10.7196/AJTCCM.2023.v29i4.154. DOI: https://doi.org/10.7196/AJTCCM.2023.v29i4.154
MEIJERINK, C. I. et al. Análise do perfil dos pacientes e fatores relacionados às infecções relacionadas à assistência à saúde por bactérias multirresistentes da UTI de um hospital do Sul do Brasil. Research, Society and Development, v. 11, n. 16, e379111638127, 2022. DOI: 10.33448/rsd-v11i16.38127. DOI: https://doi.org/10.33448/rsd-v11i16.38127
MIRON, M. et al. Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia: A Literature Review. Microorganisms, v. 12, n. 1, 213, 2024. DOI: https://doi.org/10.3390/microorganisms12010213. DOI: https://doi.org/10.3390/microorganisms12010213
MOREIRA, B. F. et al. Principais intervenções de enfermagem na prevenção da pneumonia associada à ventilação mecânica: revisão integrativa / Main nursing interventions in the prevention of ventilator- associated pneumonia: integrative review. Revista Ciência Plural, v. 10, n. 2, p. 1-20, 2024. DOI: https://doi.org/10.21680/2446-7286.2024v10n2ID31059. DOI: https://doi.org/10.21680/2446-7286.2024v10n2ID31059
MOISE, P. A. et al. Collective assessment of antimicrobial susceptibility among the most common Gram-negative respiratory pathogens driving therapy in the ICU. JAC Antimicrobial Resistance, 2021. DOI: 10.1093/jacamr/dlaa129. DOI: https://doi.org/10.1093/jacamr/dlaa129
MODI, A. R; KOVACS, C. S. Hospital-acquired and ventilator-associated pneumonia: Diagnosis, management, and prevention. Cleveland Clinic Journal of Medicine, v. 87, n.10, 2020. DOI: 10.3949/ccjm.87a.19117. DOI: https://doi.org/10.3949/ccjm.87a.19117
MUMTAZ, H. et al. Ventilator associated pneumonia in intensive care unit patients: a systematic review. Annals of Medicine & Surgery, v.85, n.6, p.2932–2939, 2023. DOI: https://doi.org/10.1097/MS9.0000000000000836
NAUE, C. R. et al. Prevalência e perfil de sensibilidade antimicrobiana de bactérias isoladas de pacientes internados em Unidade de Terapia Intensiva de um hospital universitário do Sertão de Pernambuco. Semina: Ciências Biológicas e da Saúde, v. 42, n. 1, p. 15-28, 2021. Universidade Estadual de Londrina. DOI: 10.5433/1679-0367.2021v42n1p15. DOI: https://doi.org/10.5433/1679-0367.2021v42n1p15
NASCIMENTO, G. M. et al. Application of ventilator-associated events (VAE) in ventilator-associated pneumonia (VAP) notified in Brazil (IMPACTO MR-PAV): a protocol for a cohort study. BMJ Open, v.13, n.12, e076047, 2023. DOI:10.1136/bmjopen-2023-076047. DOI: https://doi.org/10.1136/bmjopen-2023-076047
NASCIMENTO, G. M. et al. Ventilator-associated events criteria in the assessment of Ventilator-Associated Pneumonia (IMPACTO MR-PAV): A prospective cohort. Brazilian Journal of Infectious Diseases v.29, n.4, 2025. DOI: 10.1016/j.bjid.2025.104543 DOI: https://doi.org/10.1016/j.bjid.2025.104543
NASCIMENTO, I. B. C; IENKE, L. T; TAQUES, T. I. Perfil epidemiológico de pacientes com pneumonia associada à ventilação mecânica de um hospital escola. Revista De Epidemiologia E Controle De Infecção, v.14, n.2, 2024 DOI: https://doi.org/10.17058/reci.v14i2.19087. DOI: https://doi.org/10.17058/reci.v14i2.19087
NASCIMENTO, L. C. G. B. et al. Resistência bacteriana no tratamento de pneumonia em pacientes de unidades hospitalares: uma revisão sistemática. Research, Society and Development, v. 11, n. 13, e25111334930, 2022. DOI: https://doi.org/10.33448/rsd-v11i13.34930
NISAR, O. et al. Clinical and Etiological Exploration of VentilatorAssociated Pneumonia in the Intensive Care Unit of a Developing Country. Cureus, v.15, n.10, e47515, 2023. DOI 10.7759/cureus.47515. DOI: https://doi.org/10.7759/cureus.47515
OLIVEIRA, R. M. C. et al. Estimating the savings of a national project to prevent healthcare-associated infections in intensive care units. Journal of Hospital Infection, v.143, p.8-17, 2024. DOI: 10.1016/j.jhin.2023.10.001. DOI: https://doi.org/10.1016/j.jhin.2023.10.001
PAPAZIAN, L; KLOMPAS, M; LUYT, C. E. Ventilator-associated pneumonia in adults: a narrative review. Intensive Care Medicine, v. 46, p.888–906, 2020. DOI: https://doi.org/10.1007/s00134-020-05980-0. DOI: https://doi.org/10.1007/s00134-020-05980-0
PEREIRA, P. P. S. et al. Fatores de risco para infecções relacionadas à assistência à saúde em Unidades de Terapia Intensiva. Revista de Enfermagem da UFPI, v.12, n.1, 2023. DOI: 10.26694/reufpi.v12i1.3806. DOI: https://doi.org/10.26694/reufpi.v12i1.3806
PLATA-MENCHACA, E. P; FERRER, R. Current treatment of nosocomial pneumonia and ventilator-associated pneumonia. Revista Española de Quimioterapia, v.35, (Suppl. 3), p.25-29, 2022. DOI:10.37201/req/s03.06.2022. DOI: https://doi.org/10.37201/req/s03.06.2022
Power BI report n. d. https://app.powerbi.com/view?r=eyJrIjoiMDRmZWJiM jAtYTdkZC00NzE4LWEzMTgtODk5ZDZjODg3YjZkIiwidCI6ImI2N2FmMjNmLWMzZ jMtNGQzNS04MGM3LWI3MDg1ZjVlZGQ4MSJ9.
PRIETO-ALVARADO, D. E. Risk factors and outcomes of ventilator-associated pneumonia in patients with traumatic brain injury: A systematic review and meta-analysis. Journal of Critical Care v. 85, 154922, 2025. DOI: https://doi.org/10.1016/j.jcrc.2024.154922
QUILLICI, M. C. B. et al. Gram-negative bacilli bacteremia: a 7 year retrospective study in a referral Brazilian tertiary-care teaching hospital. Journal of Medical Microbiology, v. 70, n. 1, p. 1-10, 2021. Microbiology Society. DOI:10.1099/jmm.0.001277. DOI: https://doi.org/10.1099/jmm.0.001277
RANZANI, O. T. et al. Diagnostic accuracy of Gram staining when predicting staphylococcal hospital-acquired pneumonia and ventilator-associated pneumonia: a systematic review and meta-analysis. Clinical Microbiology and Infection, v.26, n.11, p.1456-1463, 2020. DOI: https://doi.org/10.1016/j.cmi.2020.08.015. DOI: https://doi.org/10.1016/j.cmi.2020.08.015
RENTSCHLER, S.; KAISER, L.; DEIGNER, H.-P. Emerging Options for the Diagnosis of Bacterial Infections and the Characterization of Antimicrobial Resistance. International Journal of Molecular Sciences, v.22, n.1, 2021, 456. DOI: https://doi.org/ 10.3390/ijms22010456. DOI: https://doi.org/10.3390/ijms22010456
RICKARD, D; KABIR, M. A; HOMAIRA, N. Machine learning-based approaches for distinguishing viral and bacterial pneumonia in paediatrics: A scoping review. Computer Methods and Programs in Biomedicine, v.268, 2025, 108802. DOI: https://doi.org/10.1016/j.cmpb.2025.108802. DOI: https://doi.org/10.1016/j.cmpb.2025.108802
RIDER, A. C; FRAZEE, B. W. Community-Acquired Pneumonia. Emergency Medicine Clinics of North America, v.36, n.4, p. 665-683 2018. DOI: 10.1016/j.emc.2018.07.001. DOI: https://doi.org/10.1016/j.emc.2018.07.001
SANTOS, M. S. et al. Fatores de risco para pneumonia associada à ventilação mecânica: Revisão de escopo. Research, Society and Development, v. 11, n. 5, e33111528126, 2022. DOI: http://dx.doi.org/10.33448/rsd-v11i5.28126. DOI: https://doi.org/10.33448/rsd-v11i5.28126
SÃO PAULO. Secretaria da Saúde. Dados IRAS. São Paulo: Governo do estado de São Paulo n.d. Disponível em: https://www.saude.sp.gov.br/cve-centro-de-vigilancia-epidemiologica-prof.-alexandre-vranjac/areas-de-vigilancia/infeccao-hospitalar/dados-iras. Acesso em: 20 jun. 2025.
SILVA, C. M. et al. Relação entre pneumonia associada à ventilação mecânica e a permanência em unidade de terapia intensiva. Revista Nursing, v.24, n.283, p.6677-6688, 2021. DOI: https://doi.org/10.36489/nursing.2021v24i283p6677-6688
SILVA, D. D; BARROS, M. C; SILVA, L. S. R. Controle de infecção hospitalar na unidade de terapia intensiva: Uma revisão integrativa. Revista Nursing, v.25, n.294, p.8970-8975, 2022. DOI: https://doi.org/10.36489/nursing.2022v25i294p8970-8981
TANZARELLA, E. S. Antimicrobial De-Escalation in Critically Ill Patients. Antibiotics, v.13, n.4, 375, 2024. DOI: https://doi.org/10.3390/ antibiotics13040375. DOI: https://doi.org/10.3390/antibiotics13040375
TARIQ, A. et al. Risk factors and outcomes of inadequate empirical antibiotic therapy in ventilator-associated pneumonia: a systematic review and meta-analysis. Annals of Medicine & Surgery, v.87, n.6, p.3786–3793, 2025. DOI: 10.1097/MS9.0000000000003289 DOI: https://doi.org/10.1097/MS9.0000000000003289
WALTER, J. et al. Healthcare-associated pneumonia in acute care hospitals in European Union/European Economic Area countries: an analysis of data from a point prevalence survey, 2011 to 2012. Euro Surveillance, v.23, n.32, 1 DOI: https://doi.org/10.2807/1560-7917.ES.2018.23.32.1700843
WANG, M. et al. Associations Between Antithrombosis and Ventilator-Associated Events, ICU Stays, and Mortality Among Mechanically Ventilated Patients: A Registry-Based Cohort Study. Frontiers in Pharmacology, v.13, 891178, 2022. DOI: 10.3389/fphar.2022.891178. DOI: https://doi.org/10.3389/fphar.2022.891178
WEINER-LASTINGER, L. M. et al. Antimicrobial-resistant pathogens associated with adult healthcare-associated infections: Summary of data reported to the National Healthcare Safety Network, 2015–2017. Infection Control and Hospital Epidemiology, v.41, n.1, p.1–18, 2020. DOI: https://doi.org/10.1017/ice.2019.296
VIDAL-CORTÉS, P. et al. Difficult-to-Treat Pseudomonas aeruginosa Infections in Critically Ill Patients: A Comprehensive Review and Treatment Proposal. Antibiotics, v.14, 178, 2025. DOI: 10.3390/antibiotics14020178. DOI: https://doi.org/10.3390/antibiotics14020178
XU, E. et al. Nosocomial Pneumonia in the Era of Multidrug-Resistance: Updates in Diagnosis and Management. Microorganisms, v.9, n.3, 534, 2021. DOI: https://doi.org/10.3390/ microorganisms9030534. DOI: https://doi.org/10.3390/microorganisms9030534
ZARAGOZA, R. et al. Update of the treatment of nosocomial pneumonia in the ICU. Critical Care, v.24, n.383, 2020. DOI: 10.1186/s13054-020-03091-2. DOI: https://doi.org/10.1186/s13054-020-03091-2
ZHANG, X. et al. Association Between Medication Use and Hospital-Acquired Infections: A Multicentre Case–Control Study. Journal of Hospital Infection, v.160, n.46, 2025. DOI: https://doi.org/10.1016/j.jhin.2025.03.001. DOI: https://doi.org/10.1016/j.jhin.2025.03.001
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