Lecture - Microbiology Of Pneumonia Flashcards Preview

Block 3 - Resp > Lecture - Microbiology Of Pneumonia > Flashcards

Flashcards in Lecture - Microbiology Of Pneumonia Deck (23):
1

When is testing for microbiology in pneumonia beneficial?

- more severe cases
- if unusual pathogen is more likely
- sensitivity/specificity
- if results would influence therapy

2

Less invasive non sterile site for microbiologic diagnosis

- sputum
- urine
- nasopharyngeal aspirate
- nasopharyngeal swab
- nasal washings

3

More invasive normally sterile site for microbiologic diagnosis

- venepuncture
- bronchoscopy
- lung biopsy
- seldom done: transtracheal aspirate, lung puncture

4

Test and causative organism for microbiologic diagnosis: bacteria

- strep pneumonia
- others (H. Influenzae, staph aureus)

- Culture: sputum, blood, pleural fluid

5

Test and causative organisms for microbiologic diagnosis: atypical agents

- Mycoplasma
- legionella
- chlamydia

- Serology, urine antigen detection, PCR

6

Test and causative organism for microbiologic diagnosis: viruses

- influenza, RSV


- immunofluorescence, PCR

7

Test and causative organism for microbiologic diagnosis: uncommon

- TB, immune compromised patients

- special procedures and tests

8

Examination of sputum

- prompt processing
- screen lower airways
- do before antibiotics

9

Problems in sputum examination

- not available in children under 7-8
- 10-30% adults non productive cough at time of presentation
- 15-30% adults pre treated
- antibiotics - eradicate SP, HI, promote staph, GNB

10

Specomem collection: Blood

- invasive
- age
- use

- minimally
- all
- culture, serology

11

Specimen collection: pleural fluid

- invasive
- age
- use

- a bit more invasive
- all
- gram stain, biochemistry, culture

12

Lung aspirate:

- invasive?
- age
- use

- very
- all
- full spectrum

13

Lung biopsy

- invasive
- age
- use

- most invasive
- all
- full spectrum and histology

14

Respiratory specimen collection - uncontaminated sites

- transtracheal aspirate
- bronchoscopy
- urine antigen
- nasopharyngeal swab
- nasopharyngeal aspirate
- Elisa
- PCR

15

Nasopharyngeal aspirate

- mostly for viruses and pertussis
- mostly in children
- multiplex test

16

Bronchoalveolar lavage

- PCR especially used for TB but also applicable to fungi and other pathogens

17

Interpretation of PCR

- multoples tests more common
- false positives can occur
- multiple infections can be identified

18

Incidence of pneumnia by age

-most common in infancy and old age

- disparity bw indifgenous and non indigenous community. That increases with age

19

Age specific causes of pneumonia in otherwise healthy children

- less than 2 years
- over two years
- all ages

- less than 2 years: resp virus most important, mycoplasma uncommon
- over 2 years: viruses decrease, mycoplasma increases
- all ages: pneumococcus remains important

20

Impact of pneumococcal vaccine on pneumonia in Australia

- pneumococcal vaccine reduces rate of pneumonia only in children
- but the vaccine reduces deaths in both age and children

21

Changes in adult pneumonia between 1980 and 2008

- less pneumococcus
- blood culture down from 13% to 6% positive
- resistant staph emerging
- gram negatives associated with long term care and co morbidities
- mycoplasma associated with

22

Major pathogens in patients

- S pneumonia
- M pneumonia
- Resp viruses
- C pneumonia
- H influenza

23

Major pathogens in patients >60 yo or coexisting disease

- S pneumonia
- resp viruses
- H influenza
- Aerobic GNB
- S aureaus

Decks in Block 3 - Resp Class (44):