Pnömoni
Özet
Pnomöniler hastaneye yatmayı en sık gerektiren ve hastane içi ölümlerin önde gelen nedenlerinden olan enfeksiyöz bir hastalıktır. Solunumsal ve dolaşımsal destek tedavinin yanında antimikrobiyal tedavi hastalığın seyrini belirleyen önemli unsurlardan birisidir. Sorumlu etkenin kan kültürü ve balgam kültüründe üreme oranının düşük olması nedeni ile hastalığın tedavisi öncelikle pnomoni etkenini aldığı yere göre belirlenir ve buna göre toplum kökenli, hastane kökenli veya sağlık bakımı ile ilişkili pnomöni olmak üzere sınıflanır. Bu yazıda pnomöniler genel hatlarıyla kısaca gözden geçirilmiş ve temel tedavi prensipleri ortaya konulmaya çalışılmıştır.
Referanslar
Jain S, Self WH, Wunderink RG, et al. Community-Acquired Pneumonia Requiring Hospitalization among U.S. Adults. N Engl J Med. 2015;373(5):415-427)
TUİK: Ölüm ve Ölüm Nedeni İstatistikleri 2019. 04.0.3.2023 tarihinde (https://data.tuik.gov.tr/Bulten/Index?p=Olum-ve-Olum-Nedeni-Istatistikleri-2019-33710 adresinden ulaşılmıştır)
Viasus D, Calatayud L, McBrown MV et al. Urinary antigen testing in community-acquired pneumonia in adults: an update. Expert Rev Anti Infect Ther. 2019;17(2):107-115
Musher DM, Abers MS, Bartlett JG. Evolving Understanding of the Causes of Pneumonia in Adults, With Special Attention to the Role of Pneumococcus. Clin Infect Dis. 2017;65(10):1736-1744
Jain S, Self WH, Wunderink RG, et al. Community-Acquired Pneumonia Requiring Hospitalization among U.S. Adults. N Engl J Med. 2015;373(5):415-427
Viasus D, Calatayud L, McBrown MV et al. Urinary antigen testing in community-acquired pneumonia in adults: an update. Expert Rev Anti Infect Ther. 2019;17(2):107-115
Varshochi M, Kianmehr P, Naghavi-Behzad M et al. Correspondence between hospital admission and the pneumonia severity index (PSI), CURB-65 criteria and comparison of their predictive value in mortality and hospital stay. Infez Med. 2013;21(2):103-110
Richards G, Levy H, Laterre PF et al. CURB-65, PSI, and APACHE II to assess mortality risk in patients with severe sepsis and community acquired pneumonia in PROWESS. J Intensive Care Med. 2011;26(1):34-40
Soyletir G, Altinkanat G, Gur D, et al. Results from the Survey of Antibiotic Resistance (SOAR) 2011-13 in Turkey. J Antimicrob Chemother. 2016;71 Suppl 1(Suppl 1):i71-i83
Marik PE. Aspiration pneumonitis and aspiration pneumonia. N Engl J Med 2001; 344:665-71
Bartlett JG. How important are anaerobic bacteria in aspiration pneumonia: when should they be treated and what is optimal therapy. Infect Dis Clin North Am 2013;27:149-55T
Niederman MS, Cilloniz C. Aspiration pneumonia. Rev Esp Quimioter. 2022;35 Suppl 1(Suppl 1):73-77
American Thoracic Society, Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med 2005; 171: 388–416.
Magill SS, Edwards JR, Bamberg W et al, Emerging Infections Program Healthcare-Associated Infections Antimicrobial Use Prevalence Survey Team. Multistate point-prevalence survey of health care-associated infections. N Engl J Med 2014; 370(13):1198–1208.
Ceylan E. Hastane Kökenli Pnömoniler. Harran Üniversitesi Tıp Fakültesi Dergisi 2006;3(2):53-61
Esperatti M, Ferrer M, Theessen A et al. Nosocomial pneumonia in the intensive care unit acquired by mechanically ventilated versus nonventilated patients. Am J Respir Crit Care Med. 2010; 182(12):1533–9.)
Çevik MA, Yılmaz GR, Erdinç FŞ, ark. Nöroloji Yoğun Bakım Ünitesinde mortalite ile ilişkili faktörler ve nozokomiyal enfeksiyonla mortalitenin ilişkisi. Yoğun Bakım Dergisi 2001;1:47-55
Papazian L, Klompas M, Luyt CE. Ventilator-associated pneumonia in adults: a narrative review. Intensive Care Med. 2020;46(5):888-906
Kalil AC, Metersky ML, Klompas M et al. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis 2016 63:e61–e111
Beardsley JR, Williamson JC, Johnson JW et al. Using local microbiologic data to develop institution-specific guidelines for the treatment of hospital-acquired pneumonia. Chest. 2006;130(3):787–93
Hong HL, Hong SB, Ko GB, et al. Viral infection is not uncommon in adult patients with severe hospital-acquired pneumonia. PLoS One2014; 9(4):e95865.
Chalmers JD, Rother C, Salih W, et al. Healthcare-associated pneumonia does not accurately identify potentially resistant pathogens: A systematic review and meta-analysis. Clin Infect Dis 2014;58:330e339
Referanslar
Jain S, Self WH, Wunderink RG, et al. Community-Acquired Pneumonia Requiring Hospitalization among U.S. Adults. N Engl J Med. 2015;373(5):415-427)
TUİK: Ölüm ve Ölüm Nedeni İstatistikleri 2019. 04.0.3.2023 tarihinde (https://data.tuik.gov.tr/Bulten/Index?p=Olum-ve-Olum-Nedeni-Istatistikleri-2019-33710 adresinden ulaşılmıştır)
Viasus D, Calatayud L, McBrown MV et al. Urinary antigen testing in community-acquired pneumonia in adults: an update. Expert Rev Anti Infect Ther. 2019;17(2):107-115
Musher DM, Abers MS, Bartlett JG. Evolving Understanding of the Causes of Pneumonia in Adults, With Special Attention to the Role of Pneumococcus. Clin Infect Dis. 2017;65(10):1736-1744
Jain S, Self WH, Wunderink RG, et al. Community-Acquired Pneumonia Requiring Hospitalization among U.S. Adults. N Engl J Med. 2015;373(5):415-427
Viasus D, Calatayud L, McBrown MV et al. Urinary antigen testing in community-acquired pneumonia in adults: an update. Expert Rev Anti Infect Ther. 2019;17(2):107-115
Varshochi M, Kianmehr P, Naghavi-Behzad M et al. Correspondence between hospital admission and the pneumonia severity index (PSI), CURB-65 criteria and comparison of their predictive value in mortality and hospital stay. Infez Med. 2013;21(2):103-110
Richards G, Levy H, Laterre PF et al. CURB-65, PSI, and APACHE II to assess mortality risk in patients with severe sepsis and community acquired pneumonia in PROWESS. J Intensive Care Med. 2011;26(1):34-40
Soyletir G, Altinkanat G, Gur D, et al. Results from the Survey of Antibiotic Resistance (SOAR) 2011-13 in Turkey. J Antimicrob Chemother. 2016;71 Suppl 1(Suppl 1):i71-i83
Marik PE. Aspiration pneumonitis and aspiration pneumonia. N Engl J Med 2001; 344:665-71
Bartlett JG. How important are anaerobic bacteria in aspiration pneumonia: when should they be treated and what is optimal therapy. Infect Dis Clin North Am 2013;27:149-55T
Niederman MS, Cilloniz C. Aspiration pneumonia. Rev Esp Quimioter. 2022;35 Suppl 1(Suppl 1):73-77
American Thoracic Society, Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med 2005; 171: 388–416.
Magill SS, Edwards JR, Bamberg W et al, Emerging Infections Program Healthcare-Associated Infections Antimicrobial Use Prevalence Survey Team. Multistate point-prevalence survey of health care-associated infections. N Engl J Med 2014; 370(13):1198–1208.
Ceylan E. Hastane Kökenli Pnömoniler. Harran Üniversitesi Tıp Fakültesi Dergisi 2006;3(2):53-61
Esperatti M, Ferrer M, Theessen A et al. Nosocomial pneumonia in the intensive care unit acquired by mechanically ventilated versus nonventilated patients. Am J Respir Crit Care Med. 2010; 182(12):1533–9.)
Çevik MA, Yılmaz GR, Erdinç FŞ, ark. Nöroloji Yoğun Bakım Ünitesinde mortalite ile ilişkili faktörler ve nozokomiyal enfeksiyonla mortalitenin ilişkisi. Yoğun Bakım Dergisi 2001;1:47-55
Papazian L, Klompas M, Luyt CE. Ventilator-associated pneumonia in adults: a narrative review. Intensive Care Med. 2020;46(5):888-906
Kalil AC, Metersky ML, Klompas M et al. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis 2016 63:e61–e111
Beardsley JR, Williamson JC, Johnson JW et al. Using local microbiologic data to develop institution-specific guidelines for the treatment of hospital-acquired pneumonia. Chest. 2006;130(3):787–93
Hong HL, Hong SB, Ko GB, et al. Viral infection is not uncommon in adult patients with severe hospital-acquired pneumonia. PLoS One2014; 9(4):e95865.
Chalmers JD, Rother C, Salih W, et al. Healthcare-associated pneumonia does not accurately identify potentially resistant pathogens: A systematic review and meta-analysis. Clin Infect Dis 2014;58:330e339
