Epidemiology 6th leading cause of death in U.s Number one among the infectious diseases 5.6 million patients annually in US Incidence 5-10/1,000/year Mortality in OPD patients 1-5%, but Inpatients 25%, ICU50-60% 202l/1/21 Dr HU Bijie
2021/1/21 Dr.HU Bijie 6 Epidemiology • 6th leading cause of death in U.S. • Number one Among the infectious diseases • 5.6 million patients annually in US • Incidence 5~10/1,000/year • Mortality in OPD patients 1-5 %, but Inpatients 25%, ICU 50-60%
Classification of respiratory tract infections Upper respiratory Definition Pharyngitis Otitis media Epiglotitis Pneumonia is the Laryngitis inflammation of lower Airway infections Acute bronchitis respiratory tracts including Acute exacerbation of chronic bronchitis alveoli, interstitial tissues, Cystic fibrosis and broncioles by the Parenchymal Infections microorganisms, chemical Preumonia Lung abscess Tuberculosis irritations or by an immunological process 202l/1/21 Dr HU Bijie Empyema
2021/1/21 Dr.HU Bijie 7 Definition • Pneumonia is the inflammation of lower respiratory tracts including alveoli, interstitial tissues, and broncioles by the microorganisms, chemical irritations or by an immunological process
Classifications Terminology Mild. moderate. severe Lobar vs interstitial Infections vs. noninfections Bacterial, viral, fungal, parasitic Primary vs Secondary P Community Acquired pneumonia Nosocomial Pneumonia a Ventilator Associated pneumionia Typical vs Atypical Immune compromised vs. Normalimmunity 202l/1/21
2021/1/21 Dr.HU Bijie 8 Classifications & Terminology • Mild, moderate, severe • Lobar vs interstitial • Infections vs. noninfections • Bacterial, viral, fungal, parasitic • Primary vs. Secondary • Community Acquired Pneumonia Nosocomial Pneumonia Ventilator Associated Pneumionia • Typical vs. Atypical • Immune compromised vs. Normal immunity
Key bacterial Pathogens of CAP A Global Meta-Analysis Other 12% S pneumoniae Legionella spp 66% 4% M. pneumoniae H. influenzae Study cohorts: N= 127 2% Total patients: N= 33,148 Total patients reporting data: N=6866 202l/1/21 Dr HU Bijie Fine MJ et al. JAMA 1996: 275(2): 134-41
2021/1/21 Dr.HU Bijie 9 Key Bacterial Pathogens of CAP: A Global Meta-Analysis Fine MJ et al. JAMA 1996; 275(2):134-41. • Study cohorts: N = 127 • Total patients: N = 33,148 • Total patients reporting data: N = 6866 S. pneumoniae 66% Other 12% Legionella spp. 4% M. pneumoniae 7% H. influenzae 12%
Causative pathogens in 5,961 adults admitted to hospital with CAP identified in 26 prospective studies from 10 European countries s pneumoniae C pneumoniae Viral Mycoplasma pneumoniae Legionella sp H influenzae G-neg enterobacteria C psittaci Coxiella burnetii Staph aureus M catarrhalis Other 15202530 202l/1/21 Dr Ht Bijie Woodhead M. chest 1998: 183S-187S
2021/1/21 Dr.HU Bijie 10 Causative pathogens in 5,961 adults admitted to hospital with CAP identified in 26 prospective studies from 10 European countries 0 5 1 0 1 5 2 0 2 5 3 0 S pneumoniae C pneumoniae Viral Mycoplasma pneumoniae Legionella sp H influenzae G-neg enterobacteria C psittacii Coxiella burnetii Staph aureus M catarrhalis Other Woodhead M. Chest 1998;183S-187S