Pneumonia HAP

Question 1

If it occurs within 4-5 days of admission it is more likely to be CAP bacteria, what about the type of bacteria after this point?

Answer 1

More likely to be Gram negative such as pseudonomas, Klebsiella, MRSA

Question 2

What factors predispose an individual to HAP?

Answer 2

Reduced defences (corticosteroid therapy, diabetes), aspiration of nasopharyngeal or gastric secretions (NG intubation, immobility, GORD), bacteria in lower resp tract (intubation, ventilators), bacteraemia (sepsis, cannula infection)

Question 3

When should HAP be considered?

Answer 3

Any patient developing g a persistant fever above 38 degrees, purulant sputum, raised WBC, new shadowing on CXR

Question 4

Management is?

Answer 4

Same as CAP but antibiotics differ. Instead cefotaxime, gentamicin, meropenem and flucloxacillin.

Question 5

Mortality is roughly what?

Answer 5

30%

Question 6

What is HAP?

Answer 6

Pneumonia that occurs at least 2 days after admission to hospital