الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Hospital Acquired Pneumonia is defined as pneumonia that occurs 48 hours or more after admission, which was not incubating at the time of admission, HAP may be managed in a hospital ward or in the intensive care unit (ICU) when the illness is more severe, Ventilator Acquired Pneumonia refers to pneumonia that arises more than 48–72 hours after endo tracheal intubation.
Health Care Associated Pneumonia includes any patient who was hospitalized in an acute care hospital for two or more days within 90 days of the infection; resided in a nursing home or long-term care facility; received recent intravenous antibiotic therapy, chemotherapy, or wound care within the past 30 days of the current infection; or attended a hospital or hemodialysis clinic.
Hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and healthcare-associated pneumonia (HCAP) remain important causes of morbidity and mortality despite advances in antimicrobial therapy, better supportive care modalities, and the use of a wide-range of preventive measures.
HAP, VAP, and HCAP may be caused by a wide spectrum of bacterial pathogens, may be poly microbial, and are rarely due to viral or fungal pathogens in immune competent hosts.
Fungal pathogens. Nosocomial pneumonia due to fungi, such as Candida species and Aspergillus fumigatus, may occur in organ transplant or immunocompromised, neutropenic patients, but is uncommon in immunocompetent patients.
Nosocomial Aspergillus species infections suggest possible airborne transmission by spores, and may be associated with an environmental source such as contaminated air ducts or hospital construction. By comparison, isolation of Candida albicans and other Candida species from endotracheal aspirates is common, but usually represents colonization of the airways, rather than pneumonia in immunocompetent patients, and rarely requires treatment with antifungal therapy.