 | Nosocomial Pneumonia |
 melanie writes "Nosocomial Pneumonia is the leading cause of death due to hospital acquired infection-mortality ranges from 20-25%. Highest risk of infection is associated with mechanical ventilation, but the majority of infections still occur outside of the ICU. Aspiration is felt to play a central role in the pathogenesus, 45% of healthy people aspirate while asleep and this statistic rises with severely ill patients. 75% of severely ill hospitalized patients will become colonized with gram negative bacteria within 48 hours of admission. Normally the upper gastrointestinal tract and stomach are near sterile, however in the face of illness, stress, medications and enteric feedings will alter the gastric pH allowing colonization.
Frequently infections are polymicrobial with gram negative predominating. Pseudomonas-17%, Staph aureus-16%, Enterobacteriaceae-11%, Klebsiella-7%, E.Coli-6%, H.Influenza-6%, Serratia marcescens-5% and Acinetobacter emerging with significant prevalence depending on individual centers.
Risk factors: Age > 70, chronic lung disease, depressed consciousness, large volume aspitation, chest surgery, NG tube, H2 blocker, transport, previous antibiotic exposures, fall/winter hospitalizations, mechanical ventilation. Semire*****bent positioning has been show in intubated patients to decrease the number of infections but not to decrease morality.
Diagnosis relies in sputum, gram stain, leukocytosis, gram stain, and clinical findings."
|
|
|
|
| |
| Related Links |  |
| Article Rating | |
| Options | |
|
