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Micro - Opportunistic Infections (i) (intro (exploit circumstances to gain…

- - - - e.g. neutropenia
        
        if severe + prolonged: increased risk of BSIs + RTIs
        
        < 500 cells/mm^3 or < 0.5 x 10^9/L
        
        or decreases by that amount in 48 hrs
        
        neutropenic sepsis
        
        55-60% caused by gram +ve cocci
        
        40-45% caused by gram -ve bacilli
        
        some caused by fungi (aspergillum + candida)
        
        infection sites: blood (in 10-25% of cases), oral cavity, skin, perirectal, genital, lung, IV catheters, foreign bodies
- - - - e.g. skin burns
        
        areas can become colonised + infected with end or exogenous bacteria (e.g. S aureus, P aeruginosa)
    - - e.g. malfunctioning cilia due to primary ciliary dyskinesia (aka immotile ciliary syndrome + Kartagener syndome)
    - - pathogen can adapt (e.g. form a biofilm)
      - often antibiotic resistant (drugs poorly penetrate biofilm)
      - e.g. tracheostomy, central venous catheter
  - - - malnutrition
      - low Ig levels
      - impaired cellular + CK response
      - poor mononuclear migration
      - increased risk of E Coli, GBS, listeria, candida, HSV
    - - risk of chemo-induced mucositis
      - also IV lines break barrier
      - also GI lining broken down (bacteria can translocate)
    - - DM (malfunctioning neutrophils)
      - malnutrition
    - - NB to prevent organ/graft rejection
      - e.g. cyclosporin, mycophenolate mofetil , tacrolimus
      - cause lymphopenia + less CK release
      - increase risk of UTIs, BSIs, CMV, PCP