Pneumonia or Lung Infection is a Respiratory Tract Infection
Although pneumonia is commonly found in children, did you know that pneumonia is also frequently found in the elderly, especially those with underlying or chronic diseases? Pneumonia is caused by respiratory tract infections, which can be bacterial, viral, or fungal. The common pathogens are shown in the table below.
|
Age |
Common Causative Pathogens |
| Newborn – 3 months | Mostly bacterial pathogens such as Escherichia coli, Streptococcus pneumoniae, Staphylococcus aureus, group B Streptococcus. It may also be caused by viruses or Chlamydia trachomatis. |
| 3 months – 5 years | Usually viral pathogens such as Respiratory syncytial virus, and bacterial pathogens such as Streptococcus pneumoniae and Haemophilus influenzae. |
| Over 5 years | Mostly Mycoplasma pneumoniae, Streptococcus pneumoniae. Respiratory syncytial virus or Chlamydia pneumoniae may also be found. |
However, most cases are caused by bacteria called pneumococcus. The body acquires the infection through the respiratory tract. Generally, pneumonia or lung infection is often a complication following influenza.
Pneumonia is found in about 8-10% of patients with acute respiratory infections. It is the leading cause of death from infections in children under 5 years old. There are two main causes: infectious pneumonia and non-infectious pneumonia. Infectious pneumonia is more common. Pneumonia can be classified in many ways. Currently, it is commonly classified based on the environment where pneumonia occurs: community-acquired pneumonia (CAP) and hospital-acquired pneumonia (nosocomial pneumonia or HAP) for the benefit of diagnosis and treatment from the start.
- Community-acquired pneumonia refers to pneumonia caused by infection occurring outside the hospital, excluding pneumonia that develops within 2 weeks after hospital discharge.
- Hospital-acquired pneumonia refers to pneumonia caused by infection occurring after the patient has been hospitalized for at least 48-72 hours.
|
Environment |
Common Causative Pathogens in Different Environments |
| Community-acquired pneumonia | Usually bacterial pathogens such as Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Legionella spp. |
| Early hospital-acquired pneumonia (Hospitalized 2-5 days) |
Bacterial pathogens such as Methicillin-sensitive Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae, Klebsiella spp., Enterobacter spp., Escherichia coli, Proteus spp., Serratia marcescens. |
Severity of Pneumonia
Pneumonia or lung infection in the elderly can be life-threatening, especially in patients with weakened immune systems. If complications such as bloodstream infection or respiratory failure occur, it can lead to death. Pneumonia in the elderly is therefore more serious than in the general population due to complications that make treatment difficult.
Elderly at Risk of Pneumonia
- Age 65 and older
- Having underlying diseases such as heart disease, diabetes, chronic respiratory diseases, chronic obstructive pulmonary disease, chronic asthma, cirrhosis
- Immunocompromised individuals such as patients receiving chemotherapy, cancer patients, those on regular dialysis, patients with immunodeficiency diseases, or those on immunosuppressive drugs
- Individuals without a spleen or with non-functioning spleen
- Regular smokers
Symptoms of Pneumonia
Typically, symptoms include cough, sputum, shortness of breath, nausea, vomiting, fatigue, difficulty breathing, and high fever. Symptoms may last only 1-3 days or up to 1 week. However, in the elderly, symptoms may be less clear, such as lethargy or fever without cough. Therefore, it is necessary to closely observe pneumonia symptoms in the elderly. Without prompt treatment or if the body is weak, complications such as pneumonia, respiratory failure, bloodstream infection, or even death may occur. The mortality rate in elderly patients with this disease is as high as 50% due to complications that make treatment difficult.
Treatment of Pneumonia Symptoms
Pneumonia caused by bacterial infection requires patients to take antibiotics or receive injections. Symptoms usually improve within 2-3 days after medication. If pneumonia is caused by a virus, symptoms are less severe than bacterial infections. You may only need sufficient rest and drink plenty of fluids. However, elderly patients with pneumonia should see a doctor because they may develop complications.
Simple Self-Care to Prevent Pneumonia
- Get enough rest, exercise regularly, avoid close contact or exposure to people with colds or early cold symptoms.
- Avoid touching the nose, mouth, and eyes when having a cold, and wash hands regularly because influenza viruses may contaminate these areas and spread infection. Therefore, handwashing is very important.
- Eat a balanced diet with all five food groups to maintain good health and build immunity to prevent the body from becoming weak and susceptible to infections.
Why is Vaccination Better for Preventing Pneumonia?
Although pneumonia symptoms can be treated and cured with antibiotics, bacterial resistance to drugs is increasing, making treatment more difficult and complex. Preventing the disease before it occurs is best. Vaccination with the pneumococcal vaccine (IPD) is another effective way to prevent pneumonia, especially for the elderly aged 65 and over. They should receive the IPD vaccine to prevent IPD and pneumonia caused by pneumococcus. As age increases, immunity decreases, making infections easier to occur. Immunity can be built by receiving the newly developed, highly effective IPD vaccine, which provides good protection for the elderly.
Currently, there are 2 types of vaccines:
- Conjugate vaccine (13-valent pneumococcal conjugate vaccine: PCV-13)
The pneumococcal conjugate vaccine (PCV-13) protects against 13 types of bacteria that cause severe infections. Indications for conjugate vaccine administration in adults and the elderly include individuals at risk of pneumonia or pneumococcal infections or those who may have severe complications if infected with pneumococcus. The vaccine is approved for children aged 6 weeks to 5 years, except the 13-valent vaccine which is approved for at-risk groups and those aged 65 and older. - Polysaccharide vaccine (Polysaccharide: PPV23) protects against 23 types of bacteria that cause infections and pneumonia. It is indicated for adults with risk factors and elderly people over 65 years old.
References
*Epidemiology Division, Department of Disease Control, Ministry of Public Health
*Infectious Diseases Society of Thailand
