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{{Bacterial pneumonia}}
{{Bacterial pneumonia}}


'''Editor-In-Chief:''' [[User:C Michael Gibson|C. Michael Gibson, M.S., M.D.]] [Mailto:charlesmichaelgibson@gmail.com| <nowiki>[1]</nowiki>]; '''Associate Editor(s)-in-Chief:''' Arooj Naz<br />
'''Editor-In-Chief:''' [[User:C Michael Gibson|C. Michael Gibson, M.S., M.D.]] [Mailto:charlesmichaelgibson@gmail.com| <nowiki>[1]</nowiki>]; '''Associate Editor(s)-in-Chief:''' [[User:AroojNaz|Arooj Naz, M.B.B.S]]


==Overview==
==Overview==
Bacterial pneumonia may be due to a variety of underlying causes. The microorganisms responsible are divided into ''Typical'' and ''Atypical''. ''Typical'' bacteria often result in a classic pneumonia whereas ''atypical'' bacteria lead to a much milder presentation often referred to as "walking pneumonia". These patients appear near normal but have extensive findings on chest x-ray.
Bacterial pneumonia may be due to a variety of underlying causes. The microorganisms responsible are divided into typical and atypical. Typical bacteria often result in a classic pneumonia whereas atypical bacteria lead to a much milder presentation often referred to as "[[walking pneumonia]]". These patients appear near normal but have extensive findings on chest x-ray. Apart from typical and atypical classifications, [[bacterial pneumonia]] can be categorized based on demographics by differentiating into neonates (<4 weeks old), toddlers (2 - 4 years), children (4 weeks - 18 years), adults (18 - 65 years), and the elderly (>65 years). Underlying characteristics may also help determine the specific cause. These include alcoholics, those at risk of [[aspiration]], [[cystic fibrosis]], [[intravenous drug users]], and those that are [[immunocompromised]] or at risk of [[nosocomial pneumonia]]. 


==Causes==
==Causes==


===Microorganisms===
===According to Microorganisms===
{| class="wikitable"
{| class="wikitable"
|+
!Typical  Pneumonia<ref name="pmid30020693">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume=  | issue=  | pages=  | pmid=30020693 | doi= | pmc= | url= }} </ref>
!Typical  Pneumonia <ref name="pmid30020693">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume=  | issue=  | pages=  | pmid=30020693 | doi= | pmc= | url= }} </ref>
!Atypical  Pneumonia
!Atypical  Pneumonia <ref name="pmid30020693">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume=  | issue=  | pages=  | pmid=30020693 | doi= | pmc= | url= }} </ref>
|-
|-
|''[[Streptococcus pneumoniae]]''
|''[[Streptococcus pneumoniae]]''
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|
|
|}
|}
 
===According to Demographics===
===Causes of Nosocomial and Ventilator Associated Pneumonia===
<ref name="pmid30571062">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume=  | issue=  | pages=  | pmid=30571062 | doi= | pmc= | url= }} </ref>
 
*''[[Staphylococcus aureus]] (MRSA)''
*''[[Streptococcus]] species''
*''[[Pseudomonas aeruginosa]]''
*''[[Escherichia coli]]''
*''[[Klebsiella]] pneumoniae''
*''[[Enterobacter]]'' species
*''[[Acinetobacter spp|Acinetobacter]]'' species
 
===Demographics===
{| class="wikitable"
{| class="wikitable"
|+
!Age Group
!Age Group
!Most common organism
!Most common organism
|-
|-
|Neonates (<4 weeks old)
|[[Neonates]] (<4 weeks old) <ref name="pmid2107797">{{cite journal| author=Webber S, Wilkinson AR, Lindsell D, Hope PL, Dobson SR, Isaacs D| title=Neonatal pneumonia. | journal=Arch Dis Child | year= 1990 | volume= 65 | issue= 2 | pages= 207-11 | pmid=2107797 | doi=10.1136/adc.65.2.207 | pmc=1792235 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2107797  }} </ref><ref name="pmid27569107">{{cite journal| author=Nguyen TK, Tran TH, Roberts CL, Graham SM, Marais BJ| title=Child pneumonia - focus on the Western Pacific Region. | journal=Paediatr Respir Rev | year= 2017 | volume= 21 | issue=  | pages= 102-110 | pmid=27569107 | doi=10.1016/j.prrv.2016.07.004 | pmc=7106312 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27569107  }} </ref>
|''[[Group B streptococci]], [[Escherichia coli]]'' <ref name="pmid2107797">{{cite journal| author=Webber S, Wilkinson AR, Lindsell D, Hope PL, Dobson SR, Isaacs D| title=Neonatal pneumonia. | journal=Arch Dis Child | year= 1990 | volume= 65 | issue= 2 | pages= 207-11 | pmid=2107797 | doi=10.1136/adc.65.2.207 | pmc=1792235 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2107797  }} </ref>, ''[[Listeria monocytogenes]]'' <ref name="pmid27569107">{{cite journal| author=Nguyen TK, Tran TH, Roberts CL, Graham SM, Marais BJ| title=Child pneumonia - focus on the Western Pacific Region. | journal=Paediatr Respir Rev | year= 2017 | volume= 21 | issue=  | pages= 102-110 | pmid=27569107 | doi=10.1016/j.prrv.2016.07.004 | pmc=7106312 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27569107  }} </ref>
|''[[Group B streptococci]],'' ''[[Escherichia coli]],'' ''[[Listeria monocytogenes]]''
|-
|-
|Toddlers (2 - 4 years)
|[[Toddler|Toddlers]] (2 - 4 years) <ref name="pmid27569107" />
|''[[Streptococcus pneumoniae]], [[Haemophilus influenzae]], [[Moraxella catarrhalis]]'' <ref name="pmid27569107">{{cite journal| author=Nguyen TK, Tran TH, Roberts CL, Graham SM, Marais BJ| title=Child pneumonia - focus on the Western Pacific Region. | journal=Paediatr Respir Rev | year= 2017 | volume= 21 | issue=  | pages= 102-110 | pmid=27569107 | doi=10.1016/j.prrv.2016.07.004 | pmc=7106312 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27569107  }} </ref>
|''[[Streptococcus pneumoniae]],'' ''[[Haemophilus influenzae]],'' ''[[Moraxella catarrhalis]]''
|-
|-
|Children (4 weeks - 18 years)
|[[Children]] (4 weeks - 18 years) <ref name="pmid27569107" />
|''[[Streptococcus pneumoniae]],'' ''[[Mycoplasma pneumoniae]], [[Haemophilus influenzae]]'' <ref name="pmid27569107">{{cite journal| author=Nguyen TK, Tran TH, Roberts CL, Graham SM, Marais BJ| title=Child pneumonia - focus on the Western Pacific Region. | journal=Paediatr Respir Rev | year= 2017 | volume= 21 | issue=  | pages= 102-110 | pmid=27569107 | doi=10.1016/j.prrv.2016.07.004 | pmc=7106312 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27569107  }} </ref>
|''[[Streptococcus pneumoniae]],'' ''[[Mycoplasma pneumoniae]],'' ''[[Haemophilus influenzae]]''
|-
|-
|Adults (18 - 65 years)
|[[Adult|Adults]] (18 - 65 years) <ref name="pmid32461392">{{cite journal| author=Eshwara VK, Mukhopadhyay C, Rello J| title=Community-acquired bacterial pneumonia in adults: An update. | journal=Indian J Med Res | year= 2020 | volume= 151 | issue= 4 | pages= 287-302 | pmid=32461392 | doi=10.4103/ijmr.IJMR_1678_19 | pmc=7371062 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32461392  }} </ref>
|[[Streptococcus pneumoniae|''Streptococcus pneumoniae'']], ''[[Staphylococcus aureus]],'' ''[[Haemophilus influenzae]], [[Klebsiella]], [[Pseudomonas aeruginosa]], [[Legionella]], [[Mycoplasma pneumoniae]], [[Chlamydia pneumoniae]]'' <ref name="pmid32461392">{{cite journal| author=Eshwara VK, Mukhopadhyay C, Rello J| title=Community-acquired bacterial pneumonia in adults: An update. | journal=Indian J Med Res | year= 2020 | volume= 151 | issue= 4 | pages= 287-302 | pmid=32461392 | doi=10.4103/ijmr.IJMR_1678_19 | pmc=7371062 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32461392  }} </ref>
|[[Streptococcus pneumoniae|''Streptococcus pneumoniae'']], ''[[Staphylococcus aureus]],'' ''[[Haemophilus influenzae]],'' ''[[Klebsiella]],'' ''[[Pseudomonas aeruginosa]],'' ''[[Legionella]],'' ''[[Mycoplasma pneumoniae]],'' ''[[Chlamydia pneumoniae]]''
|
|-
|-
|Elderly (>65 years)
|[[Elderly]] (>65 years) <ref name="pmid28916385">{{cite journal| author=Henig O, Kaye KS| title=Bacterial Pneumonia in Older Adults. | journal=Infect Dis Clin North Am | year= 2017 | volume= 31 | issue= 4 | pages= 689-713 | pmid=28916385 | doi=10.1016/j.idc.2017.07.015 | pmc=7127502 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28916385  }} </ref>
|[[Streptococcus pneumoniae|''Streptococcus pneumoniae'']], ''[[Staphylococcus aureus]],'' ''[[Haemophilus influenzae]], [[Legionella]], Gram Negative Rods ([[Escherichia coli]], [[Klebsiella]], [[Enterobacter]] species, [[Pseudomonas aeruginosa]])'' <ref name="pmid28916385">{{cite journal| author=Henig O, Kaye KS| title=Bacterial Pneumonia in Older Adults. | journal=Infect Dis Clin North Am | year= 2017 | volume= 31 | issue= 4 | pages= 689-713 | pmid=28916385 | doi=10.1016/j.idc.2017.07.015 | pmc=7127502 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28916385  }} </ref>
|[[Streptococcus pneumoniae|''Streptococcus pneumoniae'']], ''[[Staphylococcus aureus]],'' ''[[Haemophilus influenzae]],'' ''[[Legionella]], Gram Negative Rods ([[Escherichia coli]], [[Klebsiella]], [[Enterobacter]] species, [[Pseudomonas aeruginosa]])''
|}
|}


 
===According to Specific Groups===
<br />
{| class="wikitable"
!Group Description
!Most common organism
|-
|[[Alcoholic|Alcoholics]] <ref name="WikidocPneumonia"><nowiki>{{</nowiki>https://www.wikidoc.org/index.php/Pneumonia_risk_factors<nowiki>}} </nowiki></ref><ref name="ClinicalInfectiousDiseases"><nowiki>{{</nowiki>https://academic.oup.com/cid/article/44/Supplement_2/S27/372079<nowiki>}} </nowiki></ref>
|''[[Streptococcus pneumoniae|Streptococcus Pneumoniae]], Oral [[anaerobes]],'' ''[[Klebsiella pneumoniae|Klebsiella Pneumoniae]],'' ''[[Acinetobacter spp|Acinetobacter]]''
|-
|[[Aspiration]] <ref name="WikidocPneumonia" /><ref name="ClinicalInfectiousDiseases" />
|''Oral [[anaerobes]], [[Pseudomonas aeruginosa]], Gram-Negative Rods ([[Escherichia coli]], [[Klebsiella]], [[Enterobacter]] species)''
|-
|[[Cystic fibrosis]] <ref name="WikidocPneumonia" /><ref name="ClinicalInfectiousDiseases" />
|''[[P. aeruginosa|Pseudomonas Aeruginosa]],'' ''[[Burkholderia cepacia|Burkholderia Cepacia]],'' ''[[S. aureus|Staphylococcus Aureus]]''
|-
|[[Immunocompromised]] <ref name="WikidocPneumonia" /><ref name="ClinicalInfectiousDiseases" />
|''[[S. pneumoniae|Streptococcus Pneumoniae]],'' ''[[H. influenzae|Haemophilus Influenzae]]''
|-
|[[Intravenous drug users]] <ref name="WikidocPneumonia" /><ref name="ClinicalInfectiousDiseases" />
|''[[S. aureus|Staphylococcus Aureus]], Oral [[anaerobes]],'' ''[[S. pneumoniae|Streptococcus Pneumoniae]]''
|-
|[[Nosocomial]] (hospital acquired) <ref name="pmid30571062">{{cite journal| author=| title=StatPearls | journal= | year= 2021 | volume=  | issue=  | pages=  | pmid=30571062 | doi= | pmc= | url= }} </ref>
|''[[Staphylococcus aureus]] (MRSA),'' ''[[Streptococcus]] species,'' ''[[Pseudomonas aeruginosa]], Gram-Negative Rods ([[Escherichia coli]], [[Klebsiella]], [[Enterobacter]] species),'' ''[[Acinetobacter spp|Acinetobacter]]'' species
|-
|Postviral <ref name="pmid28159155">{{cite journal| author=Prasso JE, Deng JC| title=Postviral Complications: Bacterial Pneumonia. | journal=Clin Chest Med | year= 2017 | volume= 38 | issue= 1 | pages= 127-138 | pmid=28159155 | doi=10.1016/j.ccm.2016.11.006 | pmc=5324726 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28159155  }} </ref>
|''[[Staphylococcus aureus]],'' ''[[Streptococcus pneumoniae|Streptococcus Pneumoniae]]''
Less likely to be ''[[Haemophilus influenzae]]''
|}


==References==
==References==
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[[Category:Pneumonia|Pneumonia]]
[[Category:Pneumonia|Pneumonia]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
 
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz, M.B.B.S

Overview

Bacterial pneumonia may be due to a variety of underlying causes. The microorganisms responsible are divided into typical and atypical. Typical bacteria often result in a classic pneumonia whereas atypical bacteria lead to a much milder presentation often referred to as "walking pneumonia". These patients appear near normal but have extensive findings on chest x-ray. Apart from typical and atypical classifications, bacterial pneumonia can be categorized based on demographics by differentiating into neonates (<4 weeks old), toddlers (2 - 4 years), children (4 weeks - 18 years), adults (18 - 65 years), and the elderly (>65 years). Underlying characteristics may also help determine the specific cause. These include alcoholics, those at risk of aspiration, cystic fibrosis, intravenous drug users, and those that are immunocompromised or at risk of nosocomial pneumonia.

Causes

According to Microorganisms

Typical Pneumonia[1] Atypical Pneumonia
Streptococcus pneumoniae Legionella
Staphylococcus aureus Mycoplasma pneumoniae
Haemophilus influenzae Chlamydia pneumoniae
Listeria monocytogenes Chlamydia psittaci
Group A streptococci Chlamydia Trachomatis
Moraxella catarrhalis
Anaerobes and aerobic gram-negative bacteria

According to Demographics

Age Group Most common organism
Neonates (<4 weeks old) [2][3] Group B streptococci, Escherichia coli, Listeria monocytogenes
Toddlers (2 - 4 years) [3] Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis
Children (4 weeks - 18 years) [3] Streptococcus pneumoniae, Mycoplasma pneumoniae, Haemophilus influenzae
Adults (18 - 65 years) [4] Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Klebsiella, Pseudomonas aeruginosa, Legionella, Mycoplasma pneumoniae, Chlamydia pneumoniae
Elderly (>65 years) [5] Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Legionella, Gram Negative Rods (Escherichia coli, Klebsiella, Enterobacter species, Pseudomonas aeruginosa)

According to Specific Groups

Group Description Most common organism
Alcoholics [6][7] Streptococcus Pneumoniae, Oral anaerobes, Klebsiella Pneumoniae, Acinetobacter
Aspiration [6][7] Oral anaerobes, Pseudomonas aeruginosa, Gram-Negative Rods (Escherichia coli, Klebsiella, Enterobacter species)
Cystic fibrosis [6][7] Pseudomonas Aeruginosa, Burkholderia Cepacia, Staphylococcus Aureus
Immunocompromised [6][7] Streptococcus Pneumoniae, Haemophilus Influenzae
Intravenous drug users [6][7] Staphylococcus Aureus, Oral anaerobes, Streptococcus Pneumoniae
Nosocomial (hospital acquired) [8] Staphylococcus aureus (MRSA), Streptococcus species, Pseudomonas aeruginosa, Gram-Negative Rods (Escherichia coli, Klebsiella, Enterobacter species), Acinetobacter species
Postviral [9] Staphylococcus aureus, Streptococcus Pneumoniae

Less likely to be Haemophilus influenzae

References

  1. ↑ "StatPearls". 2021. PMID 30020693.
  2. ↑ Webber S, Wilkinson AR, Lindsell D, Hope PL, Dobson SR, Isaacs D (1990). "Neonatal pneumonia". Arch Dis Child. 65 (2): 207–11. doi:10.1136/adc.65.2.207. PMC 1792235. PMID 2107797.
  3. ↑ 3.0 3.1 3.2 Nguyen TK, Tran TH, Roberts CL, Graham SM, Marais BJ (2017). "Child pneumonia - focus on the Western Pacific Region". Paediatr Respir Rev. 21: 102–110. doi:10.1016/j.prrv.2016.07.004. PMC 7106312 Check |pmc= value (help). PMID 27569107.
  4. ↑ Eshwara VK, Mukhopadhyay C, Rello J (2020). "Community-acquired bacterial pneumonia in adults: An update". Indian J Med Res. 151 (4): 287–302. doi:10.4103/ijmr.IJMR_1678_19. PMC 7371062 Check |pmc= value (help). PMID 32461392 Check |pmid= value (help).
  5. ↑ Henig O, Kaye KS (2017). "Bacterial Pneumonia in Older Adults". Infect Dis Clin North Am. 31 (4): 689–713. doi:10.1016/j.idc.2017.07.015. PMC 7127502 Check |pmc= value (help). PMID 28916385.
  6. ↑ 6.0 6.1 6.2 6.3 6.4 {{https://www.wikidoc.org/index.php/Pneumonia_risk_factors}}
  7. ↑ 7.0 7.1 7.2 7.3 7.4 {{https://academic.oup.com/cid/article/44/Supplement_2/S27/372079}}
  8. ↑ "StatPearls". 2021. PMID 30571062.
  9. ↑ Prasso JE, Deng JC (2017). "Postviral Complications: Bacterial Pneumonia". Clin Chest Med. 38 (1): 127–138. doi:10.1016/j.ccm.2016.11.006. PMC 5324726. PMID 28159155.

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