LECTURE OVERVIEW.
• Acute/ Chronic LRTI (focus on pneumonia)
• Clinical manifestations, associated microorganisms and treatment of community
acquired pneumonia (CAP) and hospital acquired pneumonia (HAP)
• Streptococcus pneumoniae: virulence factors
• Case study: pneumococcal pneumonia –specimens, common diagnostic procedures,
health and safety issues
• Treatment
• Pneumococcal vaccination
LOWER RESPIRATORY TRACT INFECTIONS ACUTE/CHRONIC.
acute lower respiratory tract.
acute- comes on very quickly
not something that lasts for a long period of times.
rapidly comes and rapidly progresses.
pneumonia is an acute respiratory tract infection.
chronic takes a long time to progress and treat.
tuberculosis- caused by mycobacterium tuberculosis.
Very easily transmissible from active patient to people who are immunocompromised.
Active disease, is very severe- treatment is very extensive.
People are infected with TB for life.
Aspergilosis is caused by the fungus aspergillus fumigatis and tends to impact people who
are immunocompromised.
So there immune system cant clear the aspergilus spores so they get the formation and
growth of aspergillus fungal plaques within the lungs.
People who have cystic fibrosis get chronic infections which can last years and are difficult
to treat. Such as mycobacterium absence.
PNEUMONIA.
• Definition: an acute LRTI associated with recently developed radiological signs.
Infection of the lungs due to bacteria, viruses and fungi
• May be acquired in the community (CAP) or in the hospital (HAP); associated risk
factors
• Approximately 30,000 people die due to pneumonia in the UK per annum
• May present with either TYPICAL or ATYPICAL symptoms
• May be caused by several organisms therefore accurate identification is essential to
ensure appropriate antimicrobial therapy
• Bacteria that cause typical and atypical pneumonia tend to be different.
, • Aspiration pneumonia
• Recurrent pneumonia
• CAP- is where you develop pneumonia in the next few days without acquiring it from
the hospital. This means that you have acquired pneumonia from a community
setting. And you bring this into the hospital setting.
• HAP- if you have been hospitalized for over 48 hrs and you develop pneumonia this
is classed as hospital acquired pneumonia.
• Aspiration pneumonia- occurs with people with Alzheimer’s and lewy body disease,
they forget to swallow, so you get a reflux of gastric juices and saliva that gets
inhaled as a consequence you get aspiration pneumonia.
• People who are lying down for long periods of time such as in a hospital bed can
suffer with this, common in the elderly especially those with cognitive decline and
neurodegenerative disorders.
• Recurrent pneumonia- persistent pneumonia that keeps coming back
COMMUNITY ACQUIRED PNEUMONIA.
• Every year, 0.5% to 1% of UK adults will have CAP (approx. 320,000 – 640,000
people)
• Mainly seasonal: Autumn / Winter
• CAP is diagnosed in 5 to 12% of patients presenting to their GP with symptoms of
LRTI
-22 to 42% admitted to hospital (approx.100,000 patients)
-5 to14% die in hospital
-50% of deaths occur in patients 84 years or more
SIGNS AND SYMPTOMS OF TYPICAL PNEUMONIA.
Predominantly respiratory; most common in elderly; may occur spontaneously in young
adults
Signs Symptoms
cough fever
cyanosis muscle aches
tachypnoea Shakes / rigors
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