Hospital-acquired Pneumonia

Microbiology:

Core pathogens (if no previous antibiotics):

  • Strep.pneumoniae, Haem.influenzae, Staph.aureus (MSSA)
  • Sensitive enteric Gram-negative bacilli

Additional pathogens to consider in certain circumstances:

  • Legionella

In immunocompromised patients or if there are features suggesting atypical infection. If suspected contact Medical Microbiologist

  • Pseudomonas aeruginosa

In immunocompromised patients, those recently on ICU, prior broad-spectrum antibiotic use or structural lung disease

  • Anaerobes

Note: Standard treatment provides adequate cover for aspiration pneumonia

  • MRSA

Risk of MRSA if previous stay on ICU, inpatient on ward with endemic MRSA, patients on prior antibiotic therapy (especially quinolones) or patient from Nursing Home.