Complications of oropharyngeal dysphagia: aspiration pneumonia.
The incidence and prevalence of aspiration pneumonia (AP) are poorly defined. They increase in direct relation with age and underlying diseases. The pathogenesis of AP presumes the contribution of risk factors that alter swallowing function and predispose to the oropharyngeal bacterial colonization. The microbial etiology of AP involves Staphylococcus aureus, Haemophilus influenzae and Streptococcus pneumoniae for community-acquired AP and Gram-negative aerobic bacilli in nosocomial pneumonia. It is worth bearing in mind the relative unimportance of anaerobic bacteria in AP. When we choose the empirical antibiotic treatment, we have to consider some pathogens identified in oropharyngeal flora. Empirical treatment with antianaerobics should only be used in certain patients. According to some known risks factors, the prevention of AP should include measures in order to avoid it.
Servei de Cures Intensives, Hospital de Mataró, Universitat Autònoma de Barcelona, CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Barcelona, Spain.
Jordi
J
Almirall
Mateu
M
Cabré
Pere
P
Clavé
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000150:complications* / Q000188:drug therapy; D003428:Cross Infection / Q000188:drug therapy / Q000209:etiology; D003679:Deglutition; D003680:Deglutition Disorders / Q000150:complications* / Q000382:microbiology; D006801:Humans; D010614:Pharynx / Q000382:microbiology*; D011015:Pneumonia, Aspiration / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D053120:Respiratory Aspiration / Q000209:etiology*; D012307:Risk Factors
D000900:Anti-Bacterial Agents