Nosocomial pneumonia

Question 1

ventilator assisted pneumonia are separated into what two lists ?

Answer 1

any infection that occurs after 48 hours inthehopsital

put into early onset and late onset
early onset - antibiotic susceptible
late onset antibiotic resistant
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early onset /non multi drug resistant
strep pneumonia
homophilus influenza

enterobacteria
escheria coli
klebsiella

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last onset and multi drug resistant
p auriginosa = MOST COMMON
(bronchiectasis and corticosteroids)

MRSA =MOST COMMON
(diabetes and chronic renal failure)

Question 2

increased risk factor of hospital acquired pneumonia ?

Answer 2

invasive procedures
usually ventilator assisted pneumonia
endotracheal intubation

endoscopy

central venous line

urinary catheterrs

Question 3

risk factors for multi drug resistance in nosocomial pneumonia ?

Answer 3

antibiotic therapy within last 3 months

in the shoptalk for more than 5 days

resistant bacteria in hospitall

nursing home dwellers

on hemodilaysis

Question 4

what re the three factors important in pathogenesis of ventilator assisted pneumonia ?

Answer 4

colonisation of oropharynx

aspiration of this microorganisms to the lower respiratory tract

Question 5

what is the clinical manifestation of NOSOCOMICAL PNEUMONIA ?

Answer 5

abc samosa before

blood culture

sputum culture

bronchoscopy protected specimen brush

broncho alveolar lavage

Question 6

what is the treatmnet management ?

Answer 6

early onset infections , previously no antibiotics received
and absence of MDR

mono therapy of ceftriaxone , levofloxacin
co - amoxiclav

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patients with early onset recently received antibiotics
and risk factor for mar

third gen cephalosporin - ceftriaxone

fluroquinilones
peperacillin tazobactam

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when the causative agent is p aeurginosa

piperacillin tazobactum / meropenem + macrolide/ doxycylin / fluroquinilones

or cephalosporins (cefepime) and aminoglycoside (gentamicin)

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if mrsa
linezolid and vancomycin