Hospital-acquired and ventilator-associated pneumonia

John G. Bartlett, M.D., Paul G. Auwaerter, M.D.
Hospital-acquired and ventilator-associated pneumonia is a topic covered in the Johns Hopkins ABX Guide.

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PATHOGENS

  • S. aureus: MRSA > MSSA
  • Gram negative bacilli: Klebsiella,Enterobacter,E. coli, Pseudomonas aeruginosa, S. maltophilia,Acinetobacter spp. and others
    • Most recent dreaded: carbapenem-resistant enterobacteriaceae (CRE), multidrug resistant Pseudomonas and Acinetobacter
  • Legionella spp: may arise from institutional water/heating/cooling, consider nosocomial epidemic
  • Anaerobes (aspiration rarely cultured due to need for uncontaminated specimen sources)
  • Viruses: influenza, RSV, parainfluenza

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PATHOGENS

  • S. aureus: MRSA > MSSA
  • Gram negative bacilli: Klebsiella,Enterobacter,E. coli, Pseudomonas aeruginosa, S. maltophilia,Acinetobacter spp. and others
    • Most recent dreaded: carbapenem-resistant enterobacteriaceae (CRE), multidrug resistant Pseudomonas and Acinetobacter
  • Legionella spp: may arise from institutional water/heating/cooling, consider nosocomial epidemic
  • Anaerobes (aspiration rarely cultured due to need for uncontaminated specimen sources)
  • Viruses: influenza, RSV, parainfluenza

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