Nosocomial Pneumonias

Nosocomial Pneumonias

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Pneumonia that develops within 48 hours after hospital admission?
Pneumonia in patients NOT in an acute care facility but with 2 or more risk factors for MDR pathogens
Pneumonia that develops within 48 hours after intubation?
Risk factor for MDR: Hospitalization for greater than 2 days in the past _____ days
Risk factor for MDR: ABX use in the past ______ days
Risk factors for MDR pathogens is the main risk factor for which type of pneumonia?
For diagnosis: Criteria #1
For diagnosis: Fever greater than _____˚F
For diagnosis: Leukocytosis or _______
For diagnosis: _________ pulmonary secretions
A score greater than ________ on the Clinical Pulmonary Infection Score (CPIS) is suggestive of pneumonia?
Endotracheal aspirate threshold = 10^___ cfu/mL
Bronchoalveolar lavage threshold = 10^___ cfu/mL
Protected specimen brush threshold = 10^___ cfu/mL
Because quantitative thresholds aren't always accurate in the presence of recent antibiotic changes, use a _____ fold lower threshold if ABX regiment changed w/in 72 hours
Early onset is less than how many days after onset
Late onset is more than how many days after onset?
For the next few pathogens, say whether it is for early onset, late onset, or both: S. pneumoniae
H. influenzae
S. aureus
Enteric GNRs
P. aerugenosa
If a patient aspirated, which group of pathogens are at risk of causing pneumonia?
Which pathogen is more likely in patients with immunosuppressive conditions, diabetes, ESRD, or in hospital water supply?
Recommended dosing for nosocomial pneumonia: Cefepime (use sig codes., space between number and units)
Imipenem (2 dosing methods separated by or)
Zosyn (could also use prolonged infusion regiment)
Gentamicin or tobramycin
vancomycin target trough (micrograms/ml)
A patient with diabetes, head trauma, ICU admission, and institution with a high rate in this type of pathogen is at risk for an infection with this pathogen?
Azithromycin should be added to the regimen for which infection if a fluoroquinolone isn't already being used
If a patient is suspected of having a MRSA infection, vancomycin or ______ should be added to the regimen
Try to reduced treatment duration to ____-______ days
If infected with P. aeruginosa or Acinetobacter app, treat for _____ days

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