Community acquired pneumonia & Hospital Acquired
Pneumonia
What qualifies as CAP?
-ambulatory/outpatients (outside of a healthcare setting)
-patients who are NOT residents of nursing homes or other long term facilities
-diagnosed if present within 48hrs of a hospital admission
What percent of cases is an unidentifiable cause of CAP?
40-60%
What bacteria accounts for 2/3 of CAP isolates?
S pneumoniae
What is the most common viral infection that progresses into CAP PNA?
Influenza
Sometiems causes compromise to lead to secondary bacterial infection
In 5% of CAP cases, what do providers find?
2+ pathogens
What do prevelance of pathogens depend on?
Geography, vaccination rates, season, and host risk factors
Other bacteria, atypical bacteria, viruses, and fungi based on epidemiologic risk
factors
CAP risk factors
1. Advanced age
2. Smoking
3. Alcoholism
4. Comorbidities
5. Aspiration
6. Immunosuppression
Why does smoking increase risk of CAP?
Inhibits mucociliary apparatus
What comorbidities increase risk of CAP?
Lung cancer
COPD
Bronchiectasis
Asthma
Who is at highest risk to aspirate and cause CAP?
1. Comatose patients, stroke patients
2. Chronic gingivitis or periodontitis
3. Alcohol and drug intoxication
Immunosuppression pts (HIV/AIDS) what kind of CAP do they get?
1. HIV AIDS: pneumocystisis Jiroveci****
-yeast like fungal organism
Previously called pneumocystisis carinii or PCP
Nosocomial definition
Originating in a hospital
Nosocomial pneumonia guidelines
1. Begins MORE than 48hrs after admission to hospital or other healthcare facility
2. Excludes any infection present within the first 48hrs of admission
3. Second most common and morbid hospital acquired infection
Pneumonia
What qualifies as CAP?
-ambulatory/outpatients (outside of a healthcare setting)
-patients who are NOT residents of nursing homes or other long term facilities
-diagnosed if present within 48hrs of a hospital admission
What percent of cases is an unidentifiable cause of CAP?
40-60%
What bacteria accounts for 2/3 of CAP isolates?
S pneumoniae
What is the most common viral infection that progresses into CAP PNA?
Influenza
Sometiems causes compromise to lead to secondary bacterial infection
In 5% of CAP cases, what do providers find?
2+ pathogens
What do prevelance of pathogens depend on?
Geography, vaccination rates, season, and host risk factors
Other bacteria, atypical bacteria, viruses, and fungi based on epidemiologic risk
factors
CAP risk factors
1. Advanced age
2. Smoking
3. Alcoholism
4. Comorbidities
5. Aspiration
6. Immunosuppression
Why does smoking increase risk of CAP?
Inhibits mucociliary apparatus
What comorbidities increase risk of CAP?
Lung cancer
COPD
Bronchiectasis
Asthma
Who is at highest risk to aspirate and cause CAP?
1. Comatose patients, stroke patients
2. Chronic gingivitis or periodontitis
3. Alcohol and drug intoxication
Immunosuppression pts (HIV/AIDS) what kind of CAP do they get?
1. HIV AIDS: pneumocystisis Jiroveci****
-yeast like fungal organism
Previously called pneumocystisis carinii or PCP
Nosocomial definition
Originating in a hospital
Nosocomial pneumonia guidelines
1. Begins MORE than 48hrs after admission to hospital or other healthcare facility
2. Excludes any infection present within the first 48hrs of admission
3. Second most common and morbid hospital acquired infection
