Hospital-acquired pneumonia causes: Difference between revisions
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{{Hospital-acquired pneumonia}} | {{Hospital-acquired pneumonia}} | ||
'''Editor(s)-in-Chief:''' [[C. Michael Gibson, M.S., M.D.]] ; [[Philip Marcus, M.D., M.P.H.]] | '''Editor(s)-in-Chief:''' [[C. Michael Gibson, M.S., M.D.]] ; [[Philip Marcus, M.D., M.P.H.]] | ||
==Overview== | ==Overview== | ||
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===Ventilator-associated Pneumonia (VAP)=== | ===Ventilator-associated Pneumonia (VAP)=== | ||
*VAP has been classified into either early-onset pneumonia (EOP), if pneumonia develops within 96 hours of the patient’s admission to an ICU or intubation for mechanical ventilation, and late-onset pneumonia (LOP), if pneumonia develops after 96 hours of the patient’s admission to an ICU or intubation for mechanical ventilation. | *VAP has been classified into either early-onset pneumonia (EOP), if pneumonia develops within 96 hours of the patient’s admission to an ICU or intubation for mechanical ventilation, and late-onset pneumonia (LOP), if pneumonia develops after 96 hours of the patient’s admission to an ICU or intubation for mechanical ventilation. <ref> {{cite web|url=http://www.cdc.gov/hicpac/pdf/guidelines/HApneu2003guidelines.pdf |title=CDC GUIDELINES FOR PREVENTING HEALTH-CARE-ASSOCIATED PNEUMONIA, 2003}}</ref> | ||
* This categorization can be helpful to clinicians in initiating empiric antimicrobial therapy for cases of pneumonia, when the results of microbiologic diagnostic testing are not yet available. | * This categorization can be helpful to clinicians in initiating empiric antimicrobial therapy for cases of pneumonia, when the results of microbiologic diagnostic testing are not yet available. | ||
* EOP has been associated usually with non-multi-antimicrobial-resistant microorganisms such as Escherichia coli, [[Klebsiella]] spp., [[Proteus]] spp., [[S. pneumoniae]], [[H. influenzae]], and oxacillin-sensitive [[S. aureus]]. | * EOP has been associated usually with non-multi-antimicrobial-resistant microorganisms such as Escherichia coli, [[Klebsiella]] spp., [[Proteus]] spp., [[S. pneumoniae]], [[H. influenzae]], and oxacillin-sensitive [[S. aureus]]. | ||
Revision as of 20:32, 15 December 2014
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Hospital-acquired pneumonia Microchapters |
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Differentiating Hospital-Acquired Pneumonia from other Diseases |
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Hospital-acquired pneumonia causes On the Web |
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Directions to Hospitals Treating Hospital-acquired pneumonia |
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Risk calculators and risk factors for Hospital-acquired pneumonia causes |
Editor(s)-in-Chief: C. Michael Gibson, M.S., M.D. ; Philip Marcus, M.D., M.P.H.
Overview
The majority of cases related to various gram-negative bacilli (52%) and S. aureus (19%). Others are Haemophilus spp. (5%). In the ICU results were S. aureus(17.4%), P. aeruginosa (17.4%), Klebsiella pneumoniae and Enterobacter spp. (18.1%), and Haemophilus influenzae (4.9%). Viruses -influenza and respiratory syncytial virus and, in the immunocompromised host, cytomegalovirus- cause 10-20% of infections.
Causes[1]
Aerobic Gram Negative Pathogens
- Commonly polymicrobial
- Common microbial agents include:
Gram-Positive Pathogens
- Staphylococcus aureus
- Methicillin resistant staphylococcus aureus (common in patients with diabetes mellitus, head trauma, and in ICU)
Elderly Population
- S. aureus
- Enteric gram-negative rods
- Streptococcus pneumoniae
- Pseudomonas
Ventilator-associated Pneumonia (VAP)
- VAP has been classified into either early-onset pneumonia (EOP), if pneumonia develops within 96 hours of the patient’s admission to an ICU or intubation for mechanical ventilation, and late-onset pneumonia (LOP), if pneumonia develops after 96 hours of the patient’s admission to an ICU or intubation for mechanical ventilation. [2]
- This categorization can be helpful to clinicians in initiating empiric antimicrobial therapy for cases of pneumonia, when the results of microbiologic diagnostic testing are not yet available.
- EOP has been associated usually with non-multi-antimicrobial-resistant microorganisms such as Escherichia coli, Klebsiella spp., Proteus spp., S. pneumoniae, H. influenzae, and oxacillin-sensitive S. aureus.
- On the other hand, LOP has been associated with Pseudomonas aeruginosa, oxacillin-resistant S. aureus, and Acinetobacter spp-- strains that are usually multi-antibiotic-resistant.
References
- ↑ "Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia". American Journal of Respiratory and Critical Care Medicine. 171 (4): 388–416. 2005. doi:10.1164/rccm.200405-644ST. PMID 15699079. Retrieved 2012-09-12. Unknown parameter
|month=ignored (help) - ↑ "CDC GUIDELINES FOR PREVENTING HEALTH-CARE-ASSOCIATED PNEUMONIA, 2003" (PDF).