{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T05:33:04Z","timestamp":1767159184138,"version":"build-2238731810"},"reference-count":24,"publisher":"Cambridge University Press (CUP)","issue":"10","license":[{"start":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T00:00:00Z","timestamp":1420156800000},"content-version":"unspecified","delay-in-days":5937,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[1998,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The most common route of entry of pathogens into the lung in patients managed in the intensive-care unit is aspiration of contaminated oropharyngeal secretions or gastric contents. In intubated patients, the risk of this type of infection is particularly high. Knowledge of specific risk factors for specific microorganisms, along with the origin of acquisition (primary endogenous, secondary endogenous, or exogenous), will permit a more rational and effective method of prevention. Attributable mortality is highly dependent on the institution of a correct initial antibiotic choice, as well as the interaction between the virulence of the pathogen responsible and host defenses. However, survival in these patients is determined primarily by the degree of severity at the time of pneumonia diagnosis and the response to initial therapy. As a consequence, the number of preventable deaths is likely to be much smaller than the total. Therapy requires both supportive and specific measures. When diagnostic information becomes available, it permits the rescue of some patients with inadequate therapy or simplifies the spectrum of the empirical therapy. Initial antibiotic choice should be based on expected etiologic pathogens, while knowledge of local microbial epidemiology and susceptibility patterns is crucial.<\/jats:p>","DOI":"10.1086\/647729","type":"journal-article","created":{"date-parts":[[2009,9,16]],"date-time":"2009-09-16T14:17:23Z","timestamp":1253110643000},"page":"795-797","source":"Crossref","is-referenced-by-count":24,"title":["Mortality as an Outcome in Hospital-Acquired Pneumonia"],"prefix":"10.1017","volume":"19","author":[{"given":"Jordi","family":"Rello","sequence":"first","affiliation":[{"name":"Hospital de Sabadell"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordi","family":"Valles","sequence":"additional","affiliation":[{"name":"Hospital de Sabadell"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2015,1,2]]},"reference":[{"key":"S0195941700005580_bib022","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.150.6.7952612"},{"key":"S0195941700005580_bib023","doi-asserted-by":"publisher","DOI":"10.1378\/chest.108.6.1655"},{"key":"S0195941700005580_bib016","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199401000-00013"},{"key":"S0195941700005580_bib012","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1993.03510160083034"},{"key":"S0195941700005580_bib003","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1086\/646946","article-title":"Mortality attributable to nosocomial infections in the ICU","volume":"15","author":"Fagon","year":"1994","journal-title":"Infect Control Hosp Epidemiol"},{"key":"S0195941700005580_bib018","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199107000-00005"},{"key":"S0195941700005580_bib001","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1164\/ajrccm.154.1.8680705","article-title":"Effect of ventilator-associated pneumonia on mortality and morbidity","volume":"154","author":"Papazian","year":"1996","journal-title":"Am J Respir Crit Care Med"},{"key":"S0195941700005580_bib009","first-page":"24","article-title":"Microbial causes of ventilator-associated pneumonia","volume":"11","author":"Rello","year":"1996","journal-title":"Semin Respir Infect"},{"key":"S0195941700005580_bib002","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199711000-00026"},{"key":"S0195941700005580_bib014","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1378\/chest.100.2.439","article-title":"Incidence, etiology and outcome of nosocomial pneumonia in mechanically ventilated patients","volume":"100","author":"Rello","year":"1991","journal-title":"Chest"},{"key":"S0195941700005580_bib019","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/0002-9343(93)90060-3","article-title":"Nosocomial pneumonia in ventilated patients: a cohort study evaluating attributable mortality and hospital stay","volume":"94","author":"Fagon","year":"1993","journal-title":"Am J Med"},{"key":"S0195941700005580_bib015","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1136\/thx.47.6.465","article-title":"Nosocomial pneumonia in the intensive care unit: mechanisms and significance","volume":"47","author":"A'Court","year":"1992","journal-title":"Thorax"},{"key":"S0195941700005580_bib007","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1378\/chest.104.4.1230","article-title":"Impact of previous antimicrobial therapy on the etiology and outcome of ventilator-associated pneumonia","volume":"104","author":"Rello","year":"1993","journal-title":"Chest"},{"key":"S0195941700005580_bib008","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/23.5.973"},{"key":"S0195941700005580_bib004","volume-title":"Proceedings of a Conference on the Future of Sepsis Research","year":"1996"},{"key":"S0195941700005580_bib013","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1093\/oxfordjournals.aje.a115245","article-title":"Hospital-acquired pneumonia attributable mortality and morbidity","volume":"129","author":"Leu","year":"1989","journal-title":"Am J Epidemiol"},{"key":"S0195941700005580_bib011","first-page":"792","article-title":"Risk factors for pneumonia and fatality in patients receiving continuous mechanical ventilation","volume":"133","author":"Craven","year":"1986","journal-title":"Am Rev Respir Dis"},{"key":"S0195941700005580_bib020","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1009340"},{"key":"S0195941700005580_bib024","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1378\/chest.104.4.993b","article-title":"Mortality and ventilator-associated pneumonia. 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