HAP and VAP

Question 1

pathogenesis of HAP and VAP is related to

Answer 1

the number and virulence of micro-organisms entering the lower respiratory tract and the response of the host

Question 2

primary route of infection of the lungs is

Answer 2

microaspiration of oragnisms colonising the oropharyngeal tracts

Question 3

T/F the near sterility of the stomach and upper GI is disrupted by alterations in gastric pH due to illness, meds, enteric feeding

Answer 3

true

Question 4

common pathogens of HAP

Answer 4

aerobic gram negatic bacilli (E. coli, K. pneumonia, Enterobacter, P. aeruginosa, Acinetobacter) and gram positive cocci (S. aureus, MRSA, Streptococcus species)

Question 5

MDR is defined as

Answer 5

resistance to at least 2,3,4 or 8 of the antibiotics typically used to treat infections with these organisms

Question 6

panresistance is

Answer 6

the gram negative organisms with diminished susceptibility to all of the antibitics recommended for empiric treatment of VAP

Question 7

risk factors for MDR pathogens

Answer 7

prolonged hospitalisation and recent exposure to antibiotics

Question 8

dx of HAP VAP

Answer 8

a new lung infitrate AND clinical evidence that the infiltrate is of infectious origin (including the new onset of fever, purulent suptum, leukocytosis, and decline in oxygenation)

Question 9

When to use CT in VAP/HAP dx

Answer 9

in pts with normal chest x ray who have clinical symptoms of pneumonia; to help ID a target lobe for sampling

Question 10

when to take samples

Answer 10

prior to initiation of antibiotics or change in antibiotic therapy

Question 11

how to sample for suspected VAP

Answer 11

the lower respiratory tract should be sampled and peripheral blood cultures should be sent