Pneumonia And Covid Infection

Pneumonia and Covid infection

Introduction

Pneumococcal infection associated with assisted mechanical ventilation is making the second infectious complication in the hospital, and occupies first in intensive medicine services, therefore, its risk is increased by the presence of the artificial airway. Pneumonia associated with ventilation affects up to 50% of patients, according to their admission pathology, enter the ICU, and presents an incidence density that varies between 10 and 20 episodes per thousand days of mechanical ventilation, with a daily riskbetween 1 to 3. 

Developing

This risk is higher in the first days, and is especially high in patients admitted to a coma, where it can be diagnosed up to 50% of patients. Base diseases and conditions that increase the risk of pneumonia associated with ventilation

Diagnosis

For diagnosis we can use non -invasive or invasive techniques. Within non -invasive techniques the most important is the blood culture that has an independent prognostic value and high specificity, the practice of two serial blood cultures extracted in different places and culture of the pleural fluid is always recommended if its presence is objective. It tells us that the sputum study is not very profitable, although it can be useful in the NN not admitted to the ICU.

Treatment

In most cases, antibiotic treatment must be administered initially empirically. It is essential that it is established as quickly as possible, given the high mortality that pneumonia can behave, especially if antibiotic therapy is not adequate.

Moreover, for a correct choice of treatment, different factors must be taken into account, such as hospital bacterial flora, antibiotic resistances, previous treatments and factors inherent to the host that can predispose to one or the other microorganism. 

In addition, if the infection was acquired in the ICU there are two probable added difficulties: the possible high degree of resistance of germs, especially in patients who have received antibiotics, and on the other hand, the polymicrobial etiology present in many of these pneumonies. Finally, any empirical treatment should comply with microbiological results when available. Your treatment. Thus, for the choice of treatment it is advisable to classify different groups of patients, according to three clinical criteria:

1. Gravity of pneumonia in two categories: not serious and serious
2. Presence or absence of specific risk factors for certain microorganisms,
3. The duration of hospitalization or period of time elapsed from admission to the beginning of pneumonia.

conclusion

On the other hand, it shows us the detection of legionela antigens in urine for serotype I is sensitive, specific and not influenced by antibiotic treatment. Therefore, the antigen detection of S may also be useful. Urine pneumonia. In mechanically ventilated patients it is always advisable to obtain samples by endotracheal aspirate in the analysis will require that, in all these cases of quantitative crops, it will allow distinguishing between those potentially pathogenic microorganisms that are colonizing or that are causing infection.

Bibliography

• Diaz E, Lorente L, Valles J, Rello J. Pneumonia associated with mechanical ventilation. Med Intensive. 2010; 34 (5): 318–24.
• Pulosur.net. [cited on December 4, 2020].