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Pneumonia Causative Organism By: Yomna mamdouh Pharm D student Definition of Pneumonia : It’s an respiratory disease characterized by inflammation of the lung parenchyma (excluding the bronchi) with congestion caused by,bacteria, virus,fungi or irritants. Classification of pneumonia :(clinically) Pneumonia Community Acquired Pneumonia Pneumonia in Immunocompromised patients Hospital Acquired Pneumonia Community Acquired Pneumonia Community-acquired pneumonia : Refers to pneumonia acquired outside of hospitals or extended-care facilities. Community Acquired Pneumonia Epidemiology: 4-5 million cases annually ~500,000 hospitalizations ~45,000 deaths Mortality 2-30% Probably highest incidence occur in ages between 25-65 yrs Bartlett. CID 1998;26:811-38 Incidence 1400 1171 1207 1200 1000 1071 898 800 684 600 # of cases # in 400 1000s 200 83 0 <5 5 to 18-24 25-44 45-64 >65 17 AGE Causative Organism in community acquired pneumonia Streptococcus pneumoniae (most common cause of CAP) Hemophilus influenzae Chlamydia pneumoniae Mycoplasma pneumoniae Legionella spp. Staphylococcucs aureus Viruses (e.g. adenoviruses, influenza viruses, metapneumovirus, HIV and parainfluenza virus) Frequency Pathogen Cases (%) Streptococcus pneumoniae 20-60 Haemophilus influenzae 3-10 Staphylococcus aureus 3-5 Legionella species 2-8 Mycoplasma pneumoniae 1-6 Chlamydia pneumoniae 4-6 Viruses 2-15 Hospital acquired pneumonia It describes pneumonia acquired during hospitalization. It develops after 48 hours admission in hospital. It’s neither detected nor incubated at admission. Ventilator-associated pneumonia (VAP) is defined as pneumonia that occurs after 48-72 hours of endotracheal intubation. Types by origin: 1.Endogenous: Caused by organism that are present as normal flora of the patient. e.g. Staphylococcus aureus 2. Exogenous: Caused by organisms acquiring by exposure to hospital personnel, medical devices or hospital environment. Causative Organism in Hospital acquired pneumonia Aerobic gram positive cocci bacteria Methicillin-resistant Staphylococcus aureus (MRSA) Aerobic gram-negative bacilli bacteria Pseudomonas aeruginosa Klebsiella pneumoniae Acinetobacter species e.g.(Acinetobacter baumannii) Escherichia coli Enterobacteriaceae Pneumonia in Immuno compromised patients Pneumonia in the immunocompromised host involves infection and inflammation of the lower respiratory tract. Regardless of the reason for altered immune function, pneumonia carries a high mortality rate in immunocompromised patients. Causative Organism of pneumonia in immunocompromised patients Bacteria Viruses Fungi Other Chlamydia pneumoniae Cytomegalovirus (CMV) Aspergillus spp. Pneumocystis carinii Pseudomonas aeruginosa Herpes zoster virus Cryptosporidium spp. Mycobacterium Respiratory syncytial Candidia Mycobacterium tuberculosis tuberculosis virus Streptococcus pneumoniae Picornaviruses Fusarium Haemophilus influenzae Adenoviruses Cryptococcus Pneumocystis carinii, has been classified to be the most causative organism of pneumonia in people with compromised immune systems, such as those with AIDS or undergoing cancer treatment. Differences: The spectrum of potential pathogens associated with HAP differs from that of CAP and in immunocompromised patients. In Hospital acquired pneumonia Common pathogens include aerobic gram-negative bacteria (e.g., Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli) rarely causes community-acquired pneumonia. In Immuno compromised patients pneumonia is caused by either bacteria, Viruses or fungi. THANK YOU