PATHOPHYSIOLOGY AND RESPIRATORY DISEASES

Hospital-acquired pneumonia is the type of pneumonia that arises over 48 hours subsequent to admission and with no any antecedent symptoms of infection during admission in hospital.

PATHOPHYSIOLOGY

Microbiology

Hospital-acquired pneumonia in Patients who have no previous antibiotic contact tends to resemble community-acquired pneumonia. The commonly popular pathogens include Enterobactera-ciea, Streptococcus pneumonia Haemophilus influenza, Staphyloccous aureus and methicillin-sensitive. Patients who had latest antibiotic contact are vulnerable to these organisms.

Gram-Positive Bacteria

The frequent gram-positive cocci resulting to pneumonia in admitted patients are

S aureus and S pneumonia. S pneumonia inhabits the upper airways and is a popular contributory organism of Hospital-acquired pneumonia. S aureus regularly takes possession of the higher airways, mainly the nasal passages

Gram-Negative Bacteria

Early occurring HAP is linked to Hemophilus influenza and gram-negative bacilli, for example, Enterobacteraciae . Enterobacteraciae are such as Klebsiella spp, Echerichia coli, and Enterobacter spp.

DIAGNOSIS

Bacteriologic Evaluation

The bacteriologic analysis of pneumonia entails sampling the minor airways to locate quantitative cultures. The Blind tracheobronchial aspiration or (TBAS) is a known to be a noninvasive method achieved by inserting a stretchy catheter inside of the distal trachea through the endotracheal tube. Samples are gotten and placed for quantitative culture. Here, characteristic diagnosis threshold of pneumonia is development of greater than 10 colony growing units for every milliliter. This method has the benefit of being comparatively noninvasive and provides a separate bacterial load to ascertain the pneumonia diagnosis.

Clinical Evaluation

The diagnosis for Hospital-acquired pneumonia, involves clinical aspects, for example fever and leukocytosis, in addition to radiological criterion, and persistent fresh analysis on chest radiograph. Radiology, two or more serial chest radiographs and Cavitations are undertaken.

Signs and symptoms and among others include fever  greater than 38 degrees Celcius in absence of additional recognizable causes and fresh occurrence of purulent sputum, or alteration in sputum character, or risen respiratory Secretions.  Others are Rales breath sounds and leukocytosis (greater than 12,000 WBC/µL)

References

Lipsett, A., & Kieninger, N. (2009). Hospital-Acquired Pneumonia: Pathophysiology, Diagnosis, and Treatment. Retrieved July 3, from http://www.sld.cu/galerias/pdf/sitios/anestesiologia/hospital_acquired_pneumonia.pdf