Hospital_Acquired_Pneumonia_Presentation_with_XRays.pptx

Everything you want to know about pneumonia

1. Hospital Acquired Pneumonia (HAP) Definition, Anatomy, Pathophysiology, Pharmacology, Treatment & Criteria

2. Definition & Epidemiology - Pneumonia developing ≥48 hours after hospital admission - Not incubating at time of admission - 2nd most common nosocomial infection - High morbidity & mortality, esp. in ICU patients

3. Relevant Anatomy - Respiratory tract: nasal cavity → trachea → bronchi → alveoli - Normal defense: mucociliary clearance, alveolar macrophages - Intubation & impaired clearance increase risk

4. Pathophysiology - Aspiration of colonized oropharyngeal secretions - Impaired host defenses in hospitalized patients - Biofilm formation on endotracheal tubes - Inflammatory response → alveolar consolidation

5. Risk Factors - Mechanical ventilation (>48h) - Prolonged hospitalization - Broad-spectrum antibiotic use - Immunosuppression - Advanced age, chronic illness

6. Clinical Features & Diagnosis - Fever, purulent sputum, leukocytosis - New/progressive infiltrate on chest X-ray - Hypoxemia - Diagnostic tools: sputum culture, BAL, blood culture

7. Distinguishing Criteria - HAP: ≥48h after admission - CAP: community onset, before 48h - VAP: pneumonia after ≥48h of mechanical ventilation - HCAP: healthcare-associated (dialysis, nursing home, etc.)

8. Microbiology - Gram-negative bacilli: Pseudomonas, Klebsiella, E. coli - Gram-positive: MRSA - Polymicrobial in ICU cases - MDR pathogens are common

9. Pharmacology - Empiric therapy: cover Pseudomonas & MRSA if risk present - Beta-lactams (piperacillin-tazobactam, cefepime) - Carbapenems (meropenem) - Vancomycin/linezolid (MRSA coverage) - Aminoglycosides (synergistic use)

10. Treatment Protocol - Initial empiric broad-spectrum antibiotics - Tailor based on culture results - Duration: 7–10 days (shorter if good response) - Supportive care: oxygen, fluids, physiotherapy

11. Complications & Prognosis - Lung abscess, empyema - Sepsis, multiorgan failure - Mortality higher in ICU and MDR infections

12. Prevention Strategies - Hand hygiene & infection control - Elevation of head of bed (30–45°) - Oral care with chlorhexidine - Minimizing ventilator days - Judicious antibiotic use

13. Summary - HAP: pneumonia ≥48h after admission - Pathophysiology: aspiration, impaired defenses - MDR organisms frequent - Early recognition + empiric therapy essential - Prevention reduces incidence & mortality

14. Chest X-rays in Hospital Acquired Pneumonia Image 1: HAP X-ray Image 2: HAP X-ray Image 3: HAP X-ray Image 4: HAP X-ray