Pneumonia is common across all age groups but it is a leading cause of death among the old and immunosupressed. There are two broad classifications, community acquired pneumonia (CAP) and hospital acquired pneumoniae (HAP).
pneumonia can be caused by the flue, COVID-19 or many other infectious agents. Health providers make a distinction between viral pneumonia and bacterial pneumonia. Viral pneumonia follows on from a cold or flue that persists. Bacterail pneumonia is caused by bacteria and may be accompanied by a mucus-y cough, high fever and severe chest paints.
Community acquired pneumonia (CAP):
CAP is infectious pneumonia in a person who has not been recently hospitalized. It is the most common type of pneumonia. Causes of CAP include gram positive bacteria such as Streptococcus pneumoniae and staphylococcus aureus. Gram negative bacteria causes include Haemophilus influenza, Klebsiella pneumonia, Escherichia coli, Pseudomonas aeruginosa, and Moraxella catarrhalis. These bacteria often live in the stomach or intestines and may enter the lungs if vomit is inhaled. Atypical bacterial causes include Chlamydophila pneumoniae, Mycoplasma pneumonia (also called “walking pneumonia which is less severe), and Legionella pneuophila. Viral causes include influenza, respitory syncytial virus (RSV), adenovirus, and parainfluenza. Viruses account for about 20% of pneumonia according to some studies.
Hospital acquired pneumoniae (HAP):
HAP also called nosocomial pneumonia is acquired during or after hospitalization for another illness or procedure with an onset 72 hours after admission. Hospital acquired microorganisms can include resistant bacteria such as , Pseudomonas, Enterobacter, and Serratia. Because individuals with HAP are immunosuppressed to start with, this type of infection is typically more deadly then CAP. Nationwide, about 6% of hospitals have problems with “superbugs” known as carbapenem-reistant bacteria such as Klebsiella pneumonia. For example, the NIH in 2011 had such an outbreak which killed 11 of their patients. 6 of the patients had immune systems weakened by cancer and drugs given after organ transplants.
Symptoms: Pneumonia is an inflammatory condition of the lung which is often is characterized by air sacs (alveoli) filling with fluid. Symptoms of pneumonia include cough, chest pain, fever, and difficulty breathing. Other symptoms include coughing up blood, blueness of the skin, nausea, vomiting, and joint pains.
Specific Types of Bacteria that cause Pneumoniae
Klebsiella species cause a wide range of diseases including pneumonia, urinary tract infections (UTIs), bloodstream infections and sepsis. These infections are particularly a problem among neonates, elderly and immunocompromised individuals. Klebsiella is also responsible for a significant number of community-acquired infections. A defining feature of these infections is their morbidity and mortality, and the Klebsiellastrains associated with them are considered hypervirulent. lebsiella species are ubiquitously found in nature including water, soil and animals, and they can colonise medical devices and the healthcare environment See Pessoa
–Klebsiella pneumonia is a type of Gram-negative bacteria that can cause different types of healthcare-associated infections, including pneumonia, bloodstream infections, wound or surgical site infections, and meningitis. Increasingly, Klebsiella bacteria have developed antimicrobial resistance. See CDC
The capsular polysaccharide and type 1 fimbriae are two of the major surface-located virulence properties associated with the pathogenesis of Klebsiella pneumoniae. The capsule is an elaborate polysaccharide matrix that encases the entire cell surface and provides resistance against many host defense mechanisms. See Klemm
Carbapenem-resistant (CR) Klebsiella pneumoniae has emerged as an urgent public health threat in many industrialized countries worldwide, including the United States. Infections caused by CR K. pneumoniae are difficult to treat because these organisms are typically resistant to multiple antibiotics, and the patients have significant comorbidities. Notably, there is high (∼50%) mortality among individuals with bacteremia caused by CR K. pneumoniae. See Deleo
Treatment:
Symptoms of pneumonia needs immediate medical attention. Treatment includes antibiotics. If a patient’s condition does not improve or if there is doubt about the diagnosis, a culture of the sputum may be tested.
Many people with pneumonia need antibiotics even if an infectio had a viral origin becasue a bacterial infection may have set in.
A vaccine against Streptococcus pneumoniae is available and is recommended for all adults over 65. A repeat vaccine may be required after 5- 10 years. Influenza vaccines should be given at the same time.
Complications:
Ventilator-associated pneumonia (VAP): is a frequent complication in patients requiring mechanical ventilation with an incidence rate of 10-25% and a crude mortality ranging from 10% to 40%. M