World Pneumonia Day 2022: How genetic factors increase the risk of pneumonia

World Pneumonia Day 2022: How genetic factors increase the risk of pneumonia

World Pneumonia Day is celebrated annually on November 12 to raise awareness about pneumonia and advocate for global action to protect against, help prevent, and effectively treat respiratory disease. The day aims to generate action to fight against pneumonia. It was created by the Stop Pneumonia Initiative in 2009 to raise awareness of the toll of pneumonia, one of the leading causes of childhood death worldwide. Pneumonia is the biggest infectious killer of adults and children in the world and claimed 2.5 million lives, including 672,000 children under the age of five, in 2019.

Pneumonia is a serious infection of one or both lungs caused by bacteria, viruses or fungi, which causes the air cells to fill with pus and other fluids.

According to experts, genetic factors can directly or indirectly increase the risk of pneumonia.

How genetic factors can lead to pneumonia

Host genetic factors can directly or indirectly lead to pneumonia either by increasing the risk of infection or increasing the severity, Dr Rohit Kumar Garg, Consultant, Department of Infectious Diseases, Amrita Hospital, Faridabad, told ABP Live. He added that some lung diseases such as cystic fibrosis, asthma and bronchiectasis are due to underlying genetic factors and lead to repeated lung infections. Bronchiectasis is a condition in which the airways in the lungs are damaged, making it difficult to clear mucus. Cystic fibrosis is a life-threatening, inherited disease that damages the lungs and digestive system, affecting the cells that produce mucus, sweat, and digestive juices.

“Genetic conditions that affect the host’s immune response also increase the risk of infections,” Dr. Garg added. For example, complement factor deficiency increases the risk of pneumococcal infection. The complement system in the human body is made up of a large number of distinct plasma proteins that induce a series of inflammatory reactions to help the host fight infection. Deficiency of these proteins is responsible for community acquired pneumonia (CAP), which occurs in a community setting.

Genetic diseases such as cystic fibrosis and primary ciliary dyskinesia make a person more likely to get pneumonia, Dr. Dixit Thakur, Pulmonary and Critical Care Consultant, Artemis Lite Hospital, New Delhi, told ABP Live.

Pneumonia is one of the serious manifestations of SARS-CoV-2 infection

Symptoms of Covid-19 pneumonia usually begin about five to seven days after infection with SARS-CoV-2, Dr Garg said. Symptoms include fever, cough, difficulty breathing, and low oxygen saturation, among others.

SARS-CoV-2 causes mild symptoms like sore throat, runny nose and dry cough, but severe infection with the virus affects lung parenchyma, leading to pneumonia, Dr Thakur said.

Different types of pneumonia

The most common and useful way to categorize pneumonia is based on context, Dr. Garg said. Depending on the context, pneumonia can be classified into community-acquired pneumonia (CAP) and nosocomial pneumonia (PN). CAP refers to infection acquired outside of hospital settings while NP refers to infection caused in hospital settings.

“Other ways to categorize pneumonia include causative organism (bacteria, virus, fungi, parasites), immune status (immunocompetent or immunocompromised), and clinico-pathology (bronchopneumonia, lobar or interstitial pneumonia),” added the Dr. Garg.

“These categorizations help us decide on management, considering the most likely possibilities,” he explained.

For example, the most common causative organisms of CAP include typical bacteria such as Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus, atypical bacteria such as Legionella spp., Mycoplasma pneumoniae, and Chlamydia pneumoniae, and viruses such as the virus influenza, SARS CoV -2, other coronaviruses, adenoviruses and respiratory syncytial virus, among others. Atypical bacteria are those that are not stained by Gram stain. This means that they are neither gram-positive nor gram-negative.

“Common pathogens for NP include bacteria such as Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas spp. and Acinetobacter spp., among others. In immunocompromised hosts, pneumonia can be caused by tuberculosis, fungal pathogens, Pneumocystis jirovecii, etc. in addition to other common causes,” Dr. Garg said.

Pneumonia risk factors

Children under five are more prone to pneumonia than others. “The most common risk factors for pneumonia include smoking, comorbidities (diabetes, chronic heart disease, chronic lung disease), immunocompromised conditions (cancer, HIV, steroid use, chemotherapy drugs), alcohol consumption, vaccination status (for common preventable infections) and some special epidemiological exposures to particular organisms (exposure to birds, bat and bird droppings, contaminated water),” Dr. Garg said.

Stroke patients are also prone to pneumonia, Dr. Thakur said.

Can pneumonia be completely treated?

Pneumonia can be treated completely, experts say. “Pneumonia is completely treatable with a course of antimicrobial agents. The principles of pneumonia management are common to all types of patients. The choice of treatment options depends on the probable (or confirmed) cause and certain conditions such as severe illness, kidney disease, liver disease and other ongoing medications In recent years there has been a disturbing change in the profile of causative organisms and the pattern of antibiotic resistance This change has made it difficult to treat multidrug-resistant microbes with available antimicrobial agents,” Dr. Garg said.

“Pneumonia can be completely treated, but treating it earlier works better. If someone has symptoms, they should get tested immediately. If the person sees a doctor as soon as symptoms appear, the chances of getting treatment are higher. However, in some cases, such as in the case of multi-resistant bacteria or extremely drug-resistant bacteria, there are chances that pneumonia cannot be treated and can also be fatal,” said Dr. Thakur .

Diseases that pneumonia can cause

Pneumonia can lead to several short- and long-term complications, Dr. Garg said. “These can be due to the pneumonia itself, comorbidities and/or hospitalization. Some of the short-term complications include disease progression (severe illness, sepsis, respiratory failure, death), other hospital-related infections, myocardial infarction, cardiac arrhythmias, heart failure, pulmonary embolism and stroke. Long-term complications include worsening lung function or lung disease (eg, COPD), risk of recurrent lung infections, and progression/increased risk of diseases such as diabetes, heart disease and strokes,” Dr. Garg said.

Foods and lifestyle habits to prevent pneumonia and keep lungs healthy

A can prevent illnesses like pneumonia through simple measures such as following a healthy lifestyle with a balanced and nutritious diet, and avoiding smoking and unhealthy foods. “Certain foods, especially those high in antioxidants (eg, apples, berries, tomato products) or fiber (eg, beans, lentils, whole grains) are particularly beneficial for promoting healthy digestion. lung health.In addition to vaccination, people with chronic lung disease (such as COPD) also benefit from pulmonary rehabilitation programs.Finally, it is essential that in the event of illness, we consult an expert and avoid the self-use of antibiotics (without medical prescription), to prevent the emergence of drug resistance,” said Dr Garg.

Dr. Thakur said one should lead a normal and healthy life, eat home-cooked foods and avoid fatty and processed foods. People should exercise regularly and practice yoga. More importantly, children should be vaccinated in time to prevent pneumonia.

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