Community acquired pneumonia & Hospital Acquired Pneumonia
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
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