Legionella Pneumophila Infection
Meera Chand, John Holton in Case Studies in Infection Control, 2018
Legionella spp. are found commonly in fresh water and soil. The number of bacteria in the source is a determining factor in the development of Legionnaires’ disease. Hospital-acquired outbreaks of Legionnaires’ disease have been reported repeatedly and are associated with potable water supplies rather than cooling towers. Many cases are not diagnosed because the signs and symptoms are nonspecific and many hospitals do not routinely test patients with hospital-acquired pneumonia. Detection of Legionella spp. in the water supply on routine testing increases the suspicion of Legionnaires’ disease and makes diagnosis more likely. Colonization of water supplies in large buildings is common, but showering is not a common means of transmission in hospitals. Most cases result from aspiration of oropharyngeal secretions and, hence, patients with chronic lung disease or recent surgery are most at risk.
Prevalence of Bacterial Infections in Respiratory Tract
K. Balamurugan, U. Prithika in Pocket Guide to Bacterial Infections, 2019
Klebsiella infections usually spread through the pathogenic bacteria via respiratory tract, which initially causes pneumonia or infection in the bloodstream (septicemia). Klebsiella can spread promptly and easily but not through the air. Healthcare locations are the most vulnerable places for Klebsiella infections, owing to the nature of trials that allow tranquil access of the pathogen into the body. Patients who are on ventilators or have catheters or surgery lesions are highly disposed to spreading this deadly nosocomial infection. Infection of K. pneumoniae occurs in the lungs, where they cause necrosis, inflammation, and hemorrhage within the lung tissue. This is caused by aspirating oropharyngeal microorganisms into the LRT. About 70% of hospitalized pneumonia cases can be detected as aspiration pneumonia (ASP) based on the description determined by Japanese hospital acquired pneumonia (HAP) and nursing and healthcare-associated pneumonia (NHCAP) guidelines (Teramoto et al. 2008; Kohno et al. 2013). Reports suggest that the ratio of ASP cases to the incidence of hospital-acquired pneumonia increases with age. ASP contains two pathological conditions: dysphagia-associated miss-swallowing and airspace infiltration with bacterial pathogens. Microaspiration of oropharyngeal matters is particularly communal in the elderly, including those who are affected after a stroke and may cause small penetrations to the lungs, which then develop into ASP (Kikuchi 1994; Teramoto 2009; Shimada et al. 2014). Occurrence of pneumonia among outpatients in communication with the healthcare system such as hospitals is characterized as healthcare-associated pneumonia. The incidence of ASP is high in very elderly patients and those with healthcare-associated pneumonia (Teramoto et al. 2009).
Moxifloxacin
M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson in Kucers’ The Use of Antibiotics, 2017
Limited data on plasma pharmacokinetics in intensive care patients are available (Pletz et al., 2010; Leone et al., 2004; Stass et al., 2006; Kees et al., 2013). Generally these studies report increased clearance compared with healthy volunteers. Kees et al. (2013) reported pharmacodynamic evaluation showing good probability for clinical success for community-acquired pneumonia, but called for caution in the treatment of hospital-acquired pneumonia unless a highly susceptible pathogen is proven (Kees et al., 2013).
An unusual case of peritonitis following a caesarean delivery
Published in Alexandria Journal of Medicine, 2018
Ahmed Gado, Hesham Badawi, Ahmed Karim
There were serious postoperative complications following exploratory laparotomy: severe bronchopneumonia, wound infection, severe anemia and hypoalbuminemia. Bronchopneumonia and wound infection are common postoperative complications. Both occur at days 3–5. Pneumonia accounts for a 2.7% to 3.4% of complications among surgical patients.12 In the post-operative setting, hospital-acquired pneumonia is the predominant type.13 Surgical site infections are the third most frequently reported healthcare associated infection.14 Surgical site infections can be caused for a variety of factors.14 Common pathophysiologic factors to all surgical site infections can be broken down into two general categories: immune dysfunction (intrinsic factors); environmental and external factors related to the operation itself (extrinsic factors).14 Anemia and hypoalbuminemia are associated with sepsis.15–17 Sepsis alters RBC morphology and membrane composition and both contribute to the development of anemia in septic patients.15,16 Severe anemia often occurs in sepsis. 14 An association between a low serum albumin and infection has been found in intensive care unit patients and serum albumin has been noted to be low in sepsis (below 2.0 g/100 ml).17 Many reports have been published on surgical and caesarean delivery infection prevention.18,19
The epidemiology and healthcare costs of community-acquired pneumonia in Ontario, Canada: a population-based cohort study
Published in Journal of Medical Economics, 2023
Ryan O’Reilly, Hong Lu, Jeffrey C. Kwong, Allison McGeer, Teresa To, Beate Sander
For inpatient episodes, we included two alternative definitions to identify exposed subjects (Supplementary Appendix 2). The first alternative definition (“sensitive definition”) expanded the inpatient CAP episodes to include hospitalizations where pneumonia was coded as either the most responsible diagnosis or a pre-admission comorbidity. This provided the most sensitive definition, as it included the broadest range of CAP hospitalizations. The second alternative definition (“tailored definition”) adopted a narrower approach and included all hospitalizations where pneumonia was either (1) the most responsible diagnosis or (2) was a secondary diagnosis with a most responsible diagnosis of related complications including sepsis, meningitis, respiratory failure, acute respiratory distress syndrome (ARDS), empyema, or chronic obstructive pulmonary disease (COPD) exacerbation/infection. In all definitions, we excluded subjects for whom pneumonia was classified as a post-admission comorbidity to limit the inclusion of hospital-acquired pneumonia. In these alternative definitions, we also expanded the considered ED visits to include COPD with lower respiratory tract infections or exacerbations as long as there was a concomitant pneumonia code.
Lipid emulsion for acute organophosphate insecticide poisoning – a pilot observational safety study
Published in Clinical Toxicology, 2019
Bharath A. Chhabria, Ashish Bhalla, Nusrat Shafiq, Susheel Kumar, Deba Prasad Dhibar, Navneet Sharma
There was no significant difference with respect to requirement of mechanical ventilation between the two groups at presentation. However, the duration of mechanical ventilation was significantly lower in the study group with the mean of 1.95 days versus 6.27 days (p = .01). The total duration of hospitalization also was significantly lower in the cases compared to the controls with a mean of 4.78 days versus 10.73 days (p = .01). There was no significant difference in the mortality (p = .84). Five patients (12.5%) in the study group and 11 patients (13.8%) in the control group succumbed during the course of hospital stay. The most common cause of death was sepsis and septic shock in both the groups. The occurrence of ventilator associated pneumonia/hospital acquired pneumonia was significantly lower in the study group (p = .01). Three cases (7.5%) and 21 controls (26.3%) developed hospital-acquired respiratory infections.
Related Knowledge Centers
- Bacterial Pneumonia
- Fever
- Pneumonia
- Urinary Tract Infection
- Viral Pneumonia
- Leukocytosis
- Hospital
- Community-Acquired Pneumonia
- Hospital-Acquired Infection
- Intensive Care Unit