Bacterial pneumonia risk factors

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz

Overview

Bacterial pneumonia can affect individuals of any age, gender, or race and has minimal significance in relation to family history although those with underlying immunoglobulin defects have a higher likelihood of infection. It tends to affect men more often than women, and is more common in African Americans compared to Caucasians. Socioeconomic status is an important contributing factors and may explain the increased prevalence rate in low to middle-income nations.

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Risk Factors

Common risk factors in the development of bacterial pneumonia include:

• Age; Infants and geriatric patients greater than 65 years
• Comorbidities
  • Diabetes
  • Chronic kidney disease
  • COPD
  • Asthma
  • Lung cancer
• Underlying Genetic conditions
  • Cystic Fibrosis
  • X-linked Agammaglobulinemia
  • Selective IgA deficiency
  • Common variable immunodeficiency
• Smoking
• Excessive alcohol intake
• Post viral complication (often after an Influenza infection)
• Immunosuppresion (eg, HIV, use of corticosteroids that may be iatrogenic)
• Low socioeconomic status
• Males
• African Americans

Pneumonia in relation to other Drugs/ Other medications used:

• Atypical antipsychotics have been shown to increase the risk of pneumonia, especially in elderly individuals.
• Use of Acid Suppressing drugs (H2 blockers, proton pump inhibitors, and other antacids) may increase the risk of pneumonia.
• ACE inhibitors may be helpful in reducing the risk of pneumonia.

Risk Factors and specific bacterial microorganisms leading to Pneumonia:

Underlying Condition	Most Common Bacterial Microorganisms
Alcohol Abuse	Streptococcus Pneumoniae, oral anaerobes, Klebsiella Pneumoniae, Acinetobacter, Mycobacterium Tuberculosis
Aspiration	Oral anaerobes, Gram-negative enteric bacteria
COPD	Haemophilus Influenzae, Pseudomonas Aeruginosa, Legionella, Streptococcus Pneumoniae, Moraxella Catarrhalis
Endotracheal Obstrcution	Streptococcus Pneumoniae, oral flora anaerobes, Haemophilus Influenzae, Staphylococcus Aureus
Lung Abscess	Community-acquired MRSA , Mycobacterium Tuberculosis, oral anaerobes, Atypical Mycobacteria
HIV	Streptococcus Pneumoniae, Haemophilus Influenzae, Mycobacterium Tuberculosis
IV Drug Abuse	Staphylococcus Aureus, oral anaerobes, Mycobacterium Tuberculosis, Streptococcus Pneumoniae
Smoking	Haemophilus Influenzae, Pseudomonas Aeruginosa, Legionella, Streptococcus Pneumoniae, Moraxella Catarrhalis
Structural Lung Diseases	Pseudomonas Aeruginosa, Burkholderia Cepacia, Staphylococcus Aureus