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Microbiology > Pneumonia > Flashcards

Pneumonia Flashcards

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Biology 101 flashcards
1
Q

What is the globla % of deaths caused by pneumonias

A

7%

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2
Q

What is the gold standard for diagnosing of pneumonia

A

New consolidation on CXR

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3
Q

What is the genearl incidence of pneumonia

A

5-11 per 1000

40% need hospitalising –> of these up to 14% mortality

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4
Q

What are hte most common cause of pneumonia

A

Strep Pneumonia (36%)
H. Influenzae (10.2%)
In almost 50% no oragnism is idneetified

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5
Q

What are common causative organisms in COPD

A

H. Influenzae and M. Cattarhalis

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6
Q

What are common causative organisms in Aspiration

A

Gram -ve bacilli and anaerobes

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7
Q

What are common causative organisms in nursing homes

A

S. Aureus and aspiration

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8
Q

What are common causative organisms in diabetes

A

Bacterial pneucomococcal

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9
Q

What are the pathogenesis of S. Pneumoniae

A

Few toxins –> pneuloysin is most imporatnt

Causes marked host inflammatory response –> tissue damage

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10
Q

What percentage of us are colonised by s. pneumoniae

A

5-10%, but increases in winter

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11
Q

What is the role of the spleen in protecting against s. pneumoniae

A

Protects against enapsulated s. pneumoniae –> if asplenic give abx prohophylaxis

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12
Q

What is the first line for CAP

A

Amoxicillin –> however increasing resistance is being seen in S. pneumoniae

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13
Q

How is resistance to macroldes being seen in CAP

A

ermB- altered binding pocket at ribosome

ermA - efflux pump

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14
Q

What type of organisms is H . influenzae

A

Gram -ve cocco-bacilli, encapsulated or non-encapsulated

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15
Q

What % of H. Influenzae produce beta-lactamase

A

20%

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16
Q

When do you generally get s. aureus pneumonia

A

FOllowing infleunca

17
Q

Who is M. catarrhalis pneumonia more common in

A

Those with underlying chronic lung disease e.g. COPD

18
Q

Who is enterbactericeae more common in

A

More common in elderly

May get haemorrhogic pneumonia

19
Q

What may make you think its an atypical pneumonia

A

Doesnt respond to beta lactams
unusualy appearance on CXR –> i.e. patchy shadowing rather than lobar consolidation
Fastidious organism –> difficult to grow

20
Q

What do we give to cover atypical pneumonia organisms

A

A macrolide i.e. clarithromycin

21
Q

Who does mycoplasma usually affect

A

Young males

22
Q

Incubation and symtpomas of mycoplasma

A

2-3 week incubation; flu-like prodrome followed by pneumonia
Usually mild disaese with a more dramatic CXR than clinical picture

Epidemics occur every 3-4 years
May get immune problems following e.g. SJS

23
Q

What type of organism is Legionell

A

Gram -ve coccovacilli

24
Q

How do you get legionella

A

Naturally lives in water –> acquired via the inhalation of contaminated aerosols
Outbreaks in hospitals a hotels

Espescially occurs in summer due to prfering tepid water and people hliday

25
Q

What are the advancatges of reaching a microiological diagnosis

A

Enables the use of more narrow spectrum agents
Decreases the devlopment of resistance
May enable pathogen idenfications
Epidemiological reasons

26
Q

What are the methods of microbiological diagnosis

A

Blood Culture
Sputum Culture
Bronchoscopy
Urinary antigen detection

27
Q

What is the precalince of HAP

A

0.5-1% of patients

VAP has a mortality of up to 75% if due to an MDR organisms

28
Q

What are risk factosr for HAP

A 
Sedation
Intubation
Poor cough reflex
Long term hospital stay
Vomiting
Impaired swallowing
29
Q

What are the causes of early onset HAP

A

community organists

30
Q

What are the causes of late onset HAP

A

1) Gram -ve fermenters e.g. gut commensal –> E. Coli etc
2) Gram -ve non-fermenters e.g. P. Aureginosa and Acinetbacter
3) Gram +ves, S. aureus
4) Others: Anaerobes, Legionalla, Virsues

31
Q

Why can endotracheal tube placement cause problems

A

Local trasuma can increase coloinisation and decrease bacterial clearance
Secretions can pool and leak into the LRt and the ET cuff
Inhalation of contaminated aerosols
Biolfilm formation
Bacteria transported to LRT during swalloing

32
Q

What infection control measures can we do to prevent pneumonia

A 
Screening swabs
Side Rooms
Hand Washing
Cleaning of Equipment
PPE
barrier nurse
Screen other patients
Dedicated Nurse
33
Q

Preventative measure of pneumonia for VAP

A

Disinfection of equipment
No routine chanigng of equipment
Sterile insertion and suctioning
Nurse head up to prevent secretions pooling
‘Sedation canvations’
Extubate ow wean as soon as clnically safe
Selective decontamination –> controversial

Microbiology (14 decks)

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