JOURNAL REPORT: NEONATAL PNEUMONIA

Journal Report: Community Acquired Pneumonia

Ronilyn A. Alvarez
Saint Louis University

JOURNAL REPORT: NEONATAL PNEUMONIA

Pneumonia is an important cause of neonatal infection and accounts for significant morbidity and
mortality, especially in developing countries. Community Acquired Pneumonia (CAP) is defined as the
acquisition of pneumonia outside of the hospital environment. It remains a major cause of morbidity and
mortality in developing countries and is estimated to be the cause of death in 4 million children under the
age of 5 annually. Pneumonia can occur when pathogenic microbes invade the lower respiratory tract. The
most common routes of infection are inhalation of airborne pathogens, aspiration of gastric,
oropharyngeal or nasopharyngeal secretions or via the bloodstream from other sites. In previously well
individuals, pneumonia may present with a 12 day history of cough, fever, dyspnea, fatigue, rigors and
pleuritic pain. The article entitled Neonatal community-acquired pneumonia: Pathogens and treatment
aims to analyze the bacterial pathogens and drug sensitivities for neonatal community-acquired
pneumonia. It is anticipated that this knowledge will contribute to the establishment of appropriate
antibiotic therapies for these infections. The article also discusses that gram positive bacteria such as S.
pneumoniae and Staphylococcus are the most prevalent pathogens of CAP in developed countries. All
patients aged below 28 days, admitted to the hospital and met the definition of CAP were included in the
study. Seven hundred sixty sputum samples from newborns with community-acquired pneumonia were
cultured to determine microbial organisms present and their drug sensitivities. The results show that Of
the 760 specimens, 425 grew pathogens for a 55.9% positive rate. Among the 425 positive cultures, 278
grew gram-negative organisms, 142 grew gram-positive organisms, while 5 grew fungus. The most
common gram-negative organisms were Escherichia coli, Klebsiella pneumoniae and Hemophilus
influenzae, while the most common gram-positive organisms were Staphylococcus aureus,
Staphylococcus epidermidis and Staphylococcus haemolyticus. To the gram-negative organisms, the most
sensitive drugs were meropenem, imipenem and amikacin, while to the gram-positive ones were
vancomycin, teicoplanin and quinupristin/dalfopristin.
The case I have handled was neonatal pneumonia and it was not identified if it was hospital acquired
or community acquired. I chose this article because there might be possibility that the patient could have
acquired the pneumonia in the community where he has been living. There are also numerous CAP cases
in the Philippines but I have only found limited available articles regarding this matter. The article
discusses that although gram positive bacteria are the most prevalent pathogens of CAP, the researcher
adds that gram negative bacteria also contributes to the causes of CAP and most antibiotic therapies
showed high levels of antibiotic resistance in gram negative bacilli. Appropriate antibiotic choice is the
key to reduce the spread of infection and the production of resistant microbial strains. Being a nurse,
practicing appropriate measures in addressing different types of pneumonia would decrease the of
morbidity and mortality rate especially in pediatric patients. In the Philippines, the first line treatment
would be antibiotics addressing pneumonia but proper antibiotic choice would be more appropriate to
properly address the microorganism present in the illness. Current techniques may have insufficient
sensitivity to detect all relevant pathogens. Even in large research centers, the approach to the
investigation of pediatric and neonatal CAP is inconsistent. Hence, most cases are treated without a
causative agent being isolated. With this frequent use of antibiotics, including those with a broad
spectrum, the rate of drug resistance is increasing. The article discusses that widespread and prolonged
use of potent antibiotics results in microbial resistance which is a cause of concern. Using the correct
antibiotics for certain infections will not only save the lives of patients but also help decrease the
development and progression of antibiotic resistance.

JOURNAL REPORT: NEONATAL PNEUMONIA

Wang, H., et al. (2010). Neonatal community-acquired pneumonia: Pathogens and
treatment. [PDF document]. Retrieved from
http://content.ebscohost.com/ContentServer.asp?T=P&P=AN&K=55203717&S=R&D=a9h