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1、浅谈免疫受损宿主的肺部感染青霉素的发现是医学史上 里程碑意义的事件The war against infectious diseases has been win-U.S.Surgeon General 1969 TODAY每年因感染性疾病死亡的人数超过2000万TB等一些已被控制的疾病“死灰复燃”Definition of immunocompromise“A state in which the response of the host to a foreign antigen is not normal”Immunocompromise can be congenital or acqu
2、iredBasic immunology Nonspecific Anatomical barriers:纤毛运动,酶,粘膜屏障等 Immunology responses:抗原递呈作用,TLRs,j巨噬细胞和白细胞的吞噬作用,分泌性IgA等 Specifica real challengeWide array of pathogensHigh mortality不同类型ICH感染存在显著差异 WBC500mm3:绿脓杆菌、大肠杆菌、克雷白杆菌等G-杆菌,真菌亦较常见。屏障破坏致防御机制损害:葡萄球菌、绿脓杆菌和毗邻部位的定殖菌。Risks from treatment of hematolo
3、gic malignancies Neutropenia from chemotherapy Bacterial infections(especially Pseudomonas)and Aspergillus Hodgkins disease/splenectomy Streptococcus pneumoniae,H.influenzae,Treatment of graft versus host disease Fungal,mycobacterial and viral HIV infection Pneumococcal pneumonia and tuberculosis at any CD4 count The risk of opportunistic infections causing pneumonia rises substantially when the CD4 lymphocyte count is below 200