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Editorials |

Health-Care–Associated Pneumonia : A New Therapeutic Paradigm

Kumiko Hiramatsu, MD; Michael S. Niederman, MD
Author and Funding Information

Affiliations: Mineola, NY
 ,  Dr. Hiramatsu is Visiting Scholar, Division of Pulmonary and Critical Care Medicine, Winthrop-University Hospital, and is affiliated with the Fourth Department of Internal Medicine, Nippon Medical School, Tokyo, Japan. Dr. Niederman is affiliated with the Department of Medicine, Division of Pulmonary and Critical Care Medicine, Winthrop-University Hospital.

Correspondence to: Michael S. Niederman, MD, Chairman, Department of Medicine, Winthrop-University Hospital, 222 Station Plaza N, Suite 509, Mineola, NY 11501; e-mail: mniederman@winthrop.org



Chest. 2005;128(6):3784-3787. doi:10.1378/chest.128.6.3784
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Patients residing in long-term care facilities, and individuals who have recently been hospitalized or who have come in contact with the health-care environment (eg, therapy in a dialysis center) are an expanding part of our population. In 1990, approximately 1.6 million people resided in nursing homes, but this number is expected to reach 5.3 million in 2030.12 In this population, infection is more common than in individuals residing in the community, and lower respiratory tract infection, including pneumonia, is the second most common infection.34 In the nursing home population, the median rate of pneumonia is 365 per 1,000 persons, compared to 34 per 1,000 persons in those over 75 years of age who live in the community.4 When a resident of a long-term care facility requires transfer to the hospital for the treatment of infection, pneumonia is the most common cause, and 10 to 18% of all admissions to the hospital for pneumonia are among nursing home residents.4

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