Term
|
Definition
| acquired in more than 48 hours after admission |
|
|
Term
|
Definition
| acquired 48-72 hours after endotrachial |
|
|
Term
HCAP is # _ in hospital acquired infections
mortality % |
|
Definition
|
|
Term
| HAP increases hospital stay by _ days |
|
Definition
|
|
Term
| Most significant predisposing factor for HAP |
|
Definition
|
|
Term
| what are other predisposing factors for HAP? |
|
Definition
severity of illness
length of hosp stay
supine
coma
ARDS
prior ABX |
|
|
Term
| what is the difference in the clinical presentation of CAP vs HAP |
|
Definition
purulent sputum
Lab tests:
leukopenia or leukocytosis |
|
|
Term
| when do you get culutures for for HAP? and from where? |
|
Definition
before 1st ABX
endotrachial aspriates or sputum |
|
|
Term
| what is the MAIN thing to remember at the cultures |
|
Definition
|
|
Term
| endotrachial aspirates/sputum culutes give _ % neg rate only under what circumstance |
|
Definition
| 94- ABX hasnt changed in last 72 hours |
|
|
Term
| what 2 things do the culutres grow |
|
Definition
the causative org
non causative (candida, enterococcus) |
|
|
Term
| what are the 2 general methofs for getting specimen for cultures |
|
Definition
transtracheal
fiberoptic bronchoscopy |
|
|
Term
| what are teh 2 forms of fiberoptic bronchoscopy |
|
Definition
|
|
Term
| difference btwm BAL and SPB |
|
Definition
| BAL is more invasive and can give quantitiate |
|
|
Term
| what is the gold stanadard of diagnosis for HAP |
|
Definition
|
|
Term
| when do you perform the gold standard of diagnosis |
|
Definition
| pediatics or immunosuppressed when don't know pathogen |
|
|
Term
| if ABX have changed in 72 hours what do you to determine diagnosis |
|
Definition
| reduce threshold by ten so don't get false negatives |
|
|
Term
| what are the pathogens in early onset pneumonia |
|
Definition
k. pneumonia,
s. pneumonia
H. influenza
e coli
proteus
MSSA |
|
|
Term
| what are the pathogens of late onset pneumonia |
|
Definition
MRSA
Pseudomonas
ESBL producing K. pnuemonia
Legionella
Acetinobacter |
|
|
Term
| when do you use broad spectrum ABX for HAP |
|
Definition
|
|
Term
what is the 5th gen Ceph
what is it good for?
not good for? |
|
Definition
Ceftobiprole
HA-MRSA, pseudomonus, PRSP
Acetinobacter- EBSL prod pathogens |
|
|
Term
| when do you revaluate patient |
|
Definition
|
|
Term
| what specifically on the CBC do you look at when re evaluating |
|
Definition
|
|
Term
how long before you cna discontinue ABX?
what types of pathogens needs a longer treatment |
|
Definition
8 days
non-fermenting G- (acetinobacter, psuedomonas) |
|
|
