Aspiration Pneumonia

Clinical Microbiology and Antimicrobial Chemotherapy. 2008; 10(3):216-234

​ Avdeev S.N.
aspiration pneumonia anaerobic infections review
Section
Diseases and Pathogens
Type
Journal article
Publication
Clinical Microbiology and Antimicrobial Chemotherapy. 2008; 10(3):216-234

Abstract

Aspiration is defined as accidental entry of oropharyngeal secretions or gastric juice (endogenous substances) or water, food (exogenous substances) into the lower respiratory tract. The clinical response to aspiration is dependent on the interplay between the characteristics of the aspirate and those of the host. Aspiration syndromes are classified into three sets of disorders: (1) aspiration pneumonitis; (2) airway mechanical obstruction caused by foreign bodies; and (3) aspiration pneumonia. Conditions which predispose to aspiration include decreased level of consciousness, neurologic diseases, swallowing disturbance, esophageal diseases, tube feeding, tracheal intubation, poor oral condition, etc. The microbiology of aspiration pneumonia is intimately tied to the predominantly anaerobic flora of the oropharyngeal cavity. The recent reports of a more virulent aerobic pathogen profile in ICU patients however, suggests that such severely ill individuals may have a different bacteriology. Antibiotic therapy should be based on an assessment of the severity of illness, where the infection was acquired (community versus hospital), and the presence or absence of risk factors for gram-negative rod colonization. Therapy options include b-lactam/b-lactamase inhibitor combinations, carbapenem antibiotics, b-lactam antibiotics in combination with clindamycin or metronidazole, moxifloxacin.

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