Management + Prevention Bacterial Immunocompromised Flashcards
Factors affecting Innate system- Primary (2)
Complement deficiencies
Phagocyte cell deficiencies
Factors affecting Innate system- Secondary (6)
Burns Trauma Major surgery Catheterization Foreign bodies (shunts, prosthesis) Obstruction
Factors affecting Adaptive systems- Primary (3)
T cell defects
B cell deficiencies
Severe combined immunodeficiency
Factors affecting Adaptive systems- Secondary (6)
Malnutrition Infectious diseases Neoplasm Irradiation Chemotherapy Splenectomy
What do Burns damage? (3)
Body’s mechanical barriers, Neutrophil function, and immune response
What are the major pathogens in Burn wound infections?
Aerobe, Facultative anaerobe, Fungi
Pseudoneumonas aeruginosa and staphylococcus aureus
—-> Ecthyma gangrenosum
How to treat Burn wound infection? (2)
Aminoglycoside + Beta-lactam (ceftazidime)
Carbapenem (Imipenem)
What causes traumatic injury and surgical wound infections?
S.aureus
What causes Catheter-associated infection of urinary tract?
GNB- Endogenous bacteria or cross-infection
What causes intravenous and peritoneal dialysis catheter infections?
Staphylococci (most common)
GNB
Candida
What causes infection of plastic devices in situ? E.g. Prosthetic Heart Valve
S.epidermidis
What causes infection in Leukemia?
Due to lack of circulating neutrophils that follows bone marrow failure
When is septicemia more common?
After exposure to chemotherapy
What is the Neutrophil count for Neutropenia?
< 0.5 x 10^9 neutrophils/L
When do prolonged periods of Neutropenia occur?
After bone marrow transplantation
What is length of Neutropenia for a fungal infection?
> 21 days
Which infective organisms are more common is the early periods of Neutropenia?
E.coli, P.auerginosa, Staphylococci, Sreptococci, Enterococci
How long do solid organ transplant infections take to occur?
3-4 months
Solid Organ Transplant infection- Drugs (2)
Cytotoxic Drugs —> Suppress CMI and Humoral Immunity
High doses Corticosteroids —> Suppress inflammatory response
Causes of Infection in Neutropenic patients - Gram-positive (7)
S. aureus Coagulase-negative staphylococci Streptococci Listeria Nocardia asteroids Mycobacterium tuberculosis Mycobacterium avium-intracellulare
Causes of infection in Neutropenic patients - Gram-negative (6)
E.coli Klebsiella pneumoniae Other Enterobacteriacae Pseudoneumonas aeruginosa Bacteroids fragilis Other anaerobes
Causes of Infection in Neutropenic patients - Fungi (5)
Candida Aspergillus Cryptococcus neoformans Histoplasmosis capsulatum Pneumocystis jiroveci
Causes of infection in Neutropenic patients - Parasites (2)
Toxoplasma gondii
Strongyloides stercoralis
Causes of infection in Neutropenic patients - Viruses (6)
Herpesviruses (MOST COMMON) Hepatitis B Hepatitis C Polyomaviruses- BKV, JCV Adenoviruses HIV
AIDS infections
Lack of CMI —> Intracellular microbes
Cellular Immune Dysfunction- Bacteria and Fungi (9)
Listeria monocytogenes Salmonella Nocardia asteroids Legionella Mycobacterium tuberculosis, non-mycobacterium tuberculosis Cryptococcus neoformans Histoplasma capsulatum Coccidiodes immitis Pneumocystis jiroveci
Cellular Immune Dysfunction- Viruses and Protozoa (3)
HSV, CMV, VZV
Cryptosporidium
Toxoplasma gondii
Principles of empiric antibiotic therapy (3)
1- Intravenous administration
2- Cover both Gram -ve and Gram +ve
3- Give Bactericidal agents (e.g. Aminoglycoside —> Vancomycin)
How does Empiric therapy work? (3)
After culture collection DONT WAIT for Lab reports
1- Gram Negative —> Anti-pseudomonal activity
2- Gram Positive suspected —> Vancomycin
3- Fungi suspected —> Amphotericin B
Vaccines for what?
Pneumococcal, VZV
Chemoprophylaxis for what?
PJP
