What is institutional-acquired pneumonia (IAP), and what are the risk factors for healthcare-associated pneumonia (HCAP)?

Updated: Sep 30, 2020
  • Author: Justina Gamache, MD; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Institutional-acquired pneumonia (IAP) includes HCAP and nursing home–associated pneumonia (NHAP).

HCAP is defined as pneumonia that develops in the outpatient setting or within 48 hours of admission to a hospital in patients with increased risk of exposure to MDR bacteria as a cause of infection. Risk factors for exposure to MDR bacteria in HCAP include the following:

  • Hospitalization for two or more days in an acute care facility within 90 days of current illness

  • Exposure to antibiotics, chemotherapy, or wound care within 30 days of current illness

  • Residence in a nursing home or long-term care facility

  • Hemodialysis at a hospital or clinic

  • Home nursing care (infusion therapy, wound care)

  • Contact with a family member or other close person with infection due to MDR bacteria

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