PNEUMONIA

An infection that involves a complex set of steps, beginning with initial contact with a pathogenic
microorganism and culminating in the invasion of the lower respiratory tract. This infection can be
acquired in the community or within the hospital setting, and can be transmitted by aspirated or
inhaled microorganisms.

PNEUMONIA:Types By Location

Hospital-acquired pneumonia (HAP): This type of bacterial pneumonia is acquired during a

hospital stay. It can be more serious than other types, because the bacteria involved may be more
resistant to antibiotics.

Community-acquired pneumonia (CAP): This refers to pneumonia that is acquired outside of a

medical or institutional setting.

PNEUMONIA :Types by germ

Bacterial Pneumonia: The most common cause of bacterial pneumonia is Streptococcus

pneumoniae. Chlamydophila pneumonia and Legionella pneumophila can also cause bacterial
pneumonia.

Viral Pneumonia : Respiratory viruses are often the cause of pneumonia, especially in young
children and older people. Viral pneumonia is usually not serious and lasts for a shorter time than
bacterial pneumonia.

Mycoplasma Pneumonia : Mycoplasma organisms are not viruses or bacteria, but they have traits
common to both. Mycoplasmas generally cause mild cases of pneumonia, most often in older children
and young adults.

Fungal Pneumonia : Fungi from soil or bird droppings can cause pneumonia in people who inhale
large amounts of the organisms. They can also cause pneumonia in people with chronic diseases or
weakened immune systems.

Types How They are Acquired

Aspiration pneumonia: This type of pneumonia occurs when you inhale bacteria into your lungs
from food, drink, or saliva. This type is more likely to occur if you have a swallowing problem or if
you become too sedate from the use of medications, alcohol, or some types of illicit drugs.

Ventilator-associated pneumonia (VAP): When people who are using a ventilator get pneumonia,
it’s called VAP.

Epidemiology

Pneumonia is responsible for 16% of death in young children worldwide, mostly occurring in
impoverished countries with limited access to healthcare system. In more affluent societies
pneumonia is rarely fatal, it leads however to substantial morbidity.

Pneumonia is the number one killer of infectious diseases

According to the latest WHO data published in 2017 Influenza and Pneumonia Deaths in Philippines
reached 75,970 or 12.27% of total deaths. The age adjusted Death Rate is 115.96 per 100,000 of
population ranks Philippines #24 in the world.
 Clinical Manifestations

Cough (sputum);Fever; Dyspnea;Headache;Hemoptysis;Chest pain

Pneumonia Causing Microbes

Bacteria

 Streptococcus pneumoniae (pneumococcus)

A Gram-positive bacterium that is responsible for the majority of community-acquired pneumonia. It

is a commensal organism in the human respiratory tract, meaning that it benefits from the human
body, without harming it. However, infection by pneumococcus may be dangerous, causing not only
pneumonia, but also bronchitis, otitis media, septicemia, and meningitis.

S. pneumoniae is alpha-hemolytic, meaning that it can break down red blood cells through the
production of hydrogen peroxide (H2O2). The production of H2O2 by the bacterial infection can also
cause damage to DNA, and kill cells within the lungs

 Haemophilus influenzae

A type of bacterium that grows in the upper airways of adults and children, normally without causing
any disease. Haemophilus influenzae type b, known as Hib for short, is one of 6 types that have been
described.

Haemophilus influenzae type b can cause some serious life-threatening conditions, including
meningitis (inflammation of the lining of the brain and spinal cord) and epiglottitis (inflammation of
the epiglottis — the small cartilage at the base of your tongue that closes off your voice box when you
eat or drink). Since widespread vaccination, however, Hib is not a common cause of either of these
conditions.

 Staphylococcus aureus (S. aureus or “staph”)

S. aureus has long been recognized as one of the most important bacteria that cause disease in
humans. It is the leading cause of skin and soft tissue infections such as abscesses (boils), furuncles,
and cellulitis. Although most staph infections are not serious, S. aureus can cause serious infections
such as bloodstream infections, pneumonia, or bone and joint infections.

 Mycoplasma pneumonia (MP)

A contagious respiratory infection that spreads easily through contact with respiratory fluids. It can
cause epidemics.

known as an atypical pneumonia and is sometimes called “walking pneumonia.” It spreads quickly in
crowded areas, such as schools, college campuses, and nursing homes. When an infected person
coughs or sneezes, moisture containing the MP bacteria is released into the air. Uninfected people in
their environment can easily breathe the bacteria in.

 Chlamydia pneumoniae

A type of bacteria that can cause lung infections, such as pneumonia. C. pneumoniae is one of the
causes of community-acquired pneumonia (lung infections developed outside of a hospital). However,
not everyone who is exposed to C. pneumoniae develops pneumonia.
These lung infections are spread in the same way as many other respiratory diseases. They are
passed from person to person directly through coughs or sneezes and indirectly from germs on hands
or other objects. The number of these infections peaks in school-aged children between 5 and 15
years of age.

 L. Pneumophila

a Gram-negative, none capsulated, aerobic bacillus with a single, polar flagellum often characterized
as being a coccobacillus. It is aerobic and unable to hydrolyze gelatin or produce urease. It is also
nonfermentive. L. pneumophila is neither pigmented nor does it auto fluoresce. It is oxidase- and
catalase-positive, and produces beta-lactamase. L. pneumophila colony morphology is gray-white
with a textured, cut-glass appearance; it also requires cysteine and iron to thrive. It grows on yeast
extract in "opal-like" colonies.

Pneumonia Causing Microbes

Virus

 Influenza

It is a highly contagious viral infection that is one of the most severe illnesses of the winter season.
Influenza is spread easily from person to person, usually when an infected person coughs or sneezes.

Influenza is a common cause of pneumonia, especially among younger children, the elderly, pregnant
women, or those with certain chronic health conditions or who live in a nursing home. Most cases of
flu never lead to pneumonia, but those that do tend to be more severe and deadly.

Pneumonia Causing Microbes

Fungi

 Histoplasmosis

Infection by a fungus found in the droppings of birds and bats in humid areas. It is not serious if
confined to the lungs but can be fatal if spread throughout the body.

 Blastomycosis

Enters the body through the lungs and causes a lung infection, usually pneumonia. From the lungs,
the fungus can spread to other areas of the body including your skin, bones, joints and central
nervous system. This disease is rare and more commonly affects people involved with outdoor
activities.

Gram-positive pathogens

The most common Gram-positive pathogens isolated from patients with HAP include S. aureus
(methicillin-sensitive and methicillin-resistant),Streptococcus species, and Streptococcus
pneumoniae. Gram-positivepathogens account for 20 to 30% of HAP cases.

How is Pneumonia diagnosed?

 Chest X-ray
This test takes pictures of internal tissues, bones, and organs, including the lungs.

 Blood Test
 This test may be used to see whether infection is present and if infection has spread to the
bloodstream (blood cultures). Arterial blood gas testing checks the amount of oxygen in your
bloodstream.

 Sputum Culture
This test is done on the material that is coughed up from the lungs and into the mouth. It’s
often used to see if there’s an infection in the lungs.
 Pulse Oximetry
An oximeter is a small machine that measures the amount of oxygen in the blood. A small
sensor is taped or clipped onto a finger. When the machine is on, a small red light can be seen
in the sensor. The test is painless and the red light does not get hot.
 Bronchoscopy
This is direct exam of the bronchi (the main airways of the lungs) using a flexible tube (called
a bronchoscope). It helps to evaluate and diagnose lung problems, assess blockages, and take
out samples of tissue and/or fluid for testing,
 Pleural Fluid Culture
In this test, a sample of a fluid sample is taken from the pleural space. This is the space
between the lungs and chest wall. A long, thin needle is put through the skin between the ribs
and into the pleural space. Fluid is pulled into a syringe attached to the needle. It is sent to the
lab where it’s tested to find out which bacteria is causing the pneumonia.

Can pneumonia be prevented?

-In many cases, pneumonia can be prevented.

• Pneumonia vaccine
-The first line of defense against pneumonia is to get vaccinated. Ask your doctor about
the two pneumonia vaccines, which can help protect against bacterial pneumonia. Pneumonia
can often be a complication of the flu, so be sure to also get an annual flu shot.

Two types of pneumonia vaccines are available in the United States.

Prevnar 13: This vaccine is effective against 13 types of pneumococcal bacteria. The Centers for
Disease Control and Prevention (CDC) recommends this vaccine for:
• babies and children under the age of 2
• adults ages 65 years or older
• people between ages 2 and 65 years with chronic conditions that increase their
risk of pneumonia
Pneumovax 23: This vaccine is effective against 23 types of pneumococcal bacteria. The CDC
recommends it for:
• adults ages 65 years or older
• adults ages 19–64 years who smoke
• people between ages 2 and 65 years with chronic conditions that increase their
risk of pneumonia
• Other prevention tips:
• In addition to vaccination, there are other things you can to avoid pneumonia:
• If you smoke, try to quit. Smoking makes you more susceptible to respiratory infections,
especially pneumonia.
• Wash your hands regularly with soap and water.
• Cover your coughs and sneezes, and dispose of used tissues promptly.
• Maintain a healthy lifestyle to strengthen your immune system. Get enough rest, eat a healthy
diet, and get regular exercise.