hospital-acquired pneumonia

So it's kind of hard to differentiate whether it's that, I should say, not hospital acquired or institution acquired pneumonia versus a truly an aspiration pneumonia.

Yeah, there isn't like a specific test that you can do to say, yes, it's aspiration versus CAP or HAP.

It's also really not possible to differentiate between aspiration pneumonia, where you have a bacterial infection caused by the pathogens in your mouth or stomach, versus aspiration pneumonitis, which is the stomach acid itself causing irritation in the lung lining.

And you don't have bacteria that is causing problems, but you have similar hypoxia, things like that, shortness of breath caused by the lung tissue being damaged by stomach acid, not by a bacterial infection.

Right.

And so to remind the audience about what are those common...

CAP or HAP pathogens, we are looking at the Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, MSSA, which is the methicillin-sensitive Streptococcus aureus, or our atypicals like the Legionella, Chlamydia, and Mycoplasma.

And then if it's more of a hospital-acquired picture in terms of patients with nosocomial risk factors, we can still see the community pathogens, but we're also going to see things like MRSA, so methicillin-resistant staph aureus, pseudomonas, a bunch of other gram-negatives that like to be resistant to a lot of stuff, so like citrobacter, interbacter, And then we can also see kind of your more basic gram-negatives like E. coli and Klebsiella, but they can also develop resistance patterns and become things like multidrug-resistant, like carbapenemase-resistant enterobacteriaceae or ESBL-producing bacteria that degrade some of our more common antibiotics, and we need to use broader spectrum gram-negative coverage for those patients.