A Practical Approach to Hospital Acquired Pneumonia

Date: 14 Oct 2026 | Time: 1305 - 1325 | Venue: The NAK Auditorium, Academia (SGH Campus)

Track: Session 4.1 Healthcare-associated Infections

Speaker: 

Overview:

Pneumonia is a devastating illness in older people and 2nd commonest cause of death in Singapore. Hospital Acquired Pneumonia (HAP) typically occurs more than 48 hours after hospital admission and is not incubating at the time of admission.  Frailty is a state of reduced physiological responses and increased vulnerability, often resulting in poor outcomes both during and following an acute hospital admission.

Frailty is common in older patients with Community Acquired Pneumonia (CAP) and may be even more relevant in HAP given the risk factors such as advanced age, prolonged hospitalisation, poor swallow, bedbound status, and NG feeding identified in hospital audits, where HAP incidence rate was 1.1 per 1,000 patient days in a cohort of 375 geriatric admissions with radiological changes, which is in keeping with other international studies. HAP varies according to criteria used for diagnosis but aetiology over a 4-year period was predominantly aspiration but HAP is likely contributed by reduced immunological responses in older patients and exposure to more virulent pathogens during hospitalisation.

Prevention of HAP may be achieved with simple strategies within the ward environment, which is supported by the evidence base for ventilator associated pneumonia (VAP). A small RCT that evaluated efficacy of a multi-component interventions for HAP prevention in hospitalised older adults, utilized 30° head up positioning, oral care, and dysphagia screening using an adapted Toronto Bedside Swallowing Screening Test combined with routine influenza and pneumococcal vaccinations at discharge. Thes interventions increased mean time to next hospitalization due to respiratory infection (11.5 months vs. 9.5 months; P=0.049) and reduced risk of hospitalization due to respiratory infections within 1 year (18.6% vs. 34.4%; P=0.049) likely due to improved oral care and vaccination uptake. There was insufficient HAP to determine benefit in HAP prevention.

The presentation will cover a practical approach Hospital Acquired Pneumonia in a hospital setting.