In 2009, a multicenter, prospective observational study in Italy determined that health care-associated pneumonia patients presented with more severe disease, experienced higher mortality rates, and had longer hospital lengths of stay than community-acquired pneumonia patients (Figure 2). Later that year, a single-center retrospective observational study of culture-positive and culture-negative community-acquired and health care-associated pneumonia patients in Japan found S.pneumoniae to be the most common pathogen in both groups; however, health care-associated pneumonia patients had an increased incidence of pneumonia secondary to Pseudomonas and MRSA.17 Compared to communityacquired pneumonia, mortality was again higher in health care-associated pneumonia.