What is the role of bacteria in aspiration pneumonia and chemical pneumonitis?

Updated: Aug 15, 2018
  • Author: Justina Gamache, MD; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Answer

Answer

Nosocomial bacterial pneumonia caused by aspiration is common, and the major pathogens involved are hospital-acquired florae through oropharyngeal colonization (eg, enteric gram-negative bacteria, staphylococci). Selection and colonization of gram-negative organisms in the oropharynx, sedation, and intubation of the patient's airways are important pathogenetic factors in nosocomial pneumonia.

Because of the relative sterility of normal gastric contents, bacteria do not play an important role in the early stages of the disease. This does not hold true in patients with gastroparesis or small-bowel obstruction or in those using antacids (proton pump inhibitors [PPIs], histamine 2-receptor antagonists). Regardless of the bacterial load of the inoculum, bacterial superinfection may occur after the initial chemical injury.


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