Introduction

The term "nosocomial pneumonia" broadly covers all infections occurring 48 hours or more after hospital admission excluding any infection incubating at the time of admission, and has also been called hospital acquired pneumonia. Intensive care unit (ICU) acquired pneumonia (occurring within 48 hours of admission to the ICU) and ventilator associated pneumonia (occurring within 48 hours of starting mechanical ventilation) are also included in the broader term "nosocomial pneumonia". The development of nosocomial pneumonia remains a major problem in the ICU with most studies reporting an incidence of between 9% and 45%,^1-19 depending on the groups of patients being studied, the definition of nosocomial pneumonia, and the criteria used to diagnose it. It has been shown that nosocomial pneumonia acquired in the ICU markedly increases the length of hospital stay^{12 16 20 21} and the costs of hospital care.^21 22 Mortality rates may also be increased,^{3 5 7 16 17 19 23} although it is not entirely clear whether all deaths from nosocomial . . . [Full text of this article]