Updated: 12/20/2018

Microbiology of Pneumonia

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 Bugs Causing Pneumonia
Bug
Neon.
<4 wks
Kids
<18 yrs
Adults
18-40
Adults
40-65
Elderly Nosoc. IC EtOH/
IVDA
CF Post-
viral
Atypical
S. aureus           X X X   X  
S. pneumoniae   X X X X     X    X  
Group B strep X                    
E. coli X                    
K. pneumoniae               X      
Serratia           X          
P. aeruginosa                 X    
H. influenzae       X X         X  
L. pneumophila                     X
Chlamydophila   X X               X
M. pneumoniae   X X X             X
CMV             X        
RSV   X                  
Parainfluenza X X                  
H. capsulatum                      
C. immitis                      
P. brasiliensis                      
C. neoformans                      
P. jiroveci             X        
  • Most common causes
    • typical
      • S. pneumoniae
        • causes 50-75% of community-acquired pneumonia!
    • atypical
      • Mycoplasma pneumoniae
      • Chlamydia pneumoniae
      • Legionella pneumophila
  • Additonal rules of thumb
    • older adults and elderly
      • anaerobic bacteria
      • viruses
      • Gram-negative rods
    • nosocomial
      • enteric Gram-negative rods
    • immunocompromised
      • enteric Gram-negative rods
      • fungi
      • viruses
    • aspiration pneumonia
      • normal mixed oral flora 
      • anaerobes 
  • Standard treatment
    • cephalosporin
      • cover Gram-positives
    • macrolide
      • cover atypical causes
  • Bronchitis
    • acute bronchitis is almost always due to a virus
  • Abbreviations
    • Neon. = neonates
    • Nosoc. = nosocomial infections
    • EtOH/IVDA = alcoholics/intravenous drug abusers
    • CF = cystic fibroris
    • IC = immunocompromised
 

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