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Textbook of Respiratory and Critical Care Infections
Francesco Blasi, George Dimopoulos
CHAPTER 1:
Genetic Predisposition for Respiratory Infections
INTRODUCTION
TLR-NF-kB Signaling
BACTERIAL INFECTIONS
Community-acquired Pneumonia
Klebsiella pneumonia
Diffuse Panbronchiolitis/Chronic Sinobronchial Inflammation
Tuberculosis
Mycobacterium Avium Complex
Sarcoidosis, a Mycobacterial Infection!
Acute Exacerbations of Chronic Obstructive Pulmonary Diseases
Cystic Fibrosis
Mycobacterium leprae
FUNGAL INFECTIONS
Aspergillosis
Coccidioidomycosis
Paracoccidioidomycosis
Chromoblastomycosis
Histoplasmosis
PARASITIC INFECTIONS
Hydatid Disease
Filariasis
Leishmaniasis
CONCLUSION
CHAPTER 2:
Upper Respiratory Tract Infections
INTRODUCTION
NATURAL OCCURRENCE OF THE DISEASE
DIAGNOSIS
Microbiology
Imaging
Nasal Endoscopy and Laryngoscopy
RHINITIS AND RHINOSINUSITIS
Acute Viral Rhinitis (Common Cold)
Acute Bacterial Rhinosinusitis
Chronic Rhinitis
PHARYNGITIS
Acute Viral Pharyngitis
Acute Bacterial Pharyngitis
EPIGLOTTITIS
LARYNGITIS
Diphtheria
Croup Illnesses
TRACHEITIS
COMPLICATIONS
CONCLUSION
CHAPTER 3:
Community Acquired Pneumonia
INTRODUCTION
CLINICAL PRESENTATION
MICROBIOLOGICAL ETIOLOGY OF COMMUNITY-ACQUIRED PNEUMONIA
DIAGNOSIS
Molecular Testing
Nucleic Acid Amplification Tests-Polymerase Chain Reaction
Antigen Detection
Serology
Inflammatory Response
Invasive Diagnostic Techniques
SEVERITY ASSESSMENT
MANAGEMENT
ADDITIONAL THERAPIES
Corticoids
NONRESPONSE TO TREATMENT
PREVENTION
CONCLUSION
CHAPTER 4:
Atypical Pneumonias
INTRODUCTION
CHARACTERISTICS OF ATYPICAL PATHOGENS
ATYPICAL BACTERIA AS A CAUSE OF COMMUNITY-ACQUIRED PNEUMONIA
CLINICAL CHARACTERISTICS OF ATYPICAL PNEUMONIA INFECTIONS
SEVERITY SCORING SYSTEMS AND BIOMARKERS IN ATYPICAL PNEUMONIA
MICROBIOLOGICAL DIAGNOSIS
Culture
Serology
Legionella Urinary Antigen Test
Nucleic Acid Amplification Techniques
TREATMENT FOR ATYPICAL BACTERIAL RESPIRATORY INFECTIONS
Need for Atypical Coverage in Empirical Treatment of CAP Patients
CONCLUSION
CHAPTER 5:
Healthcare-associated Pneumonia
INTRODUCTION
DEFINITION
EPIDEMIOLOGY
Incidence
PATHOGENESIS
Oropharyngeal Flora in the Hospitalized Patient
Sources of Colonization
ETIOLOGY AND RISK FACTORS
Healthcare-associated Pneumonia versus Community-acquired Pneumonia
Morbidity and Mortality
Culture Positive versus Culture Negative Healthcare-Associated Pneumonia
Cost
DIAGNOSIS
Clinical Presentation
Diagnostic Testing
Microbiologic Testing
Sputum and or Lower Respiratory secretion Examination
Blood Cultures
Urinary Antigen Testing and Serology
Biomarkers-Procalcitonin
TREATMENT
Duration of Antibiotic Treatment in Healthcare-associated Pneumonia
Prevention
CONCLUSION AND FUTURE DIRECTIONS
CHAPTER 6:
Community-acquired Methicillin-resistant Staphylococcus aureus Pneumonia
INTRODUCTION
EPIDEMIOLOGY
MICROBIOLOGICAL AND MOLECULAR CHARACTERISTICS OF CA-MRSA STRAINS
The mec Gene Complex
The Accessory Gene Regulator
Panton-Valentine Leukocidine and the LukS-PV and LukF-PV Genes
MOLECULAR EPIDEMIOLOGY AND EMERGING RESISTANCE
CLINICAL MANIFESTATIONS
DIAGNOSIS
TREATMENT
Vancomycin
Linezolid
Trimethoprim/Sulfamethoxazole
Clindamycin
Newer Agents
APPROACH TO TREATMENT
ADJUNCTIVE TREATMENTS AND PREVENTION OF CA-MRSA PNEUMONIA
CONCLUSION
CHAPTER 7:
Acute Exacerbations of Chronic Bronchitis and Chronic Obstructive Pulmonary Disease
INTRODUCTION
DEFINITION AND FREQUENCY OF EXACERBATIONS
OUTCOMES OF EXACERBATIONS AND RISK FACTORS OF ADVERSE OUTCOMES
ETIOLOGY OF EXACERBATIONS
NON-ANTIMICROBIAL TREATMENT OF EXACERBATIONS
ANTIMICROBIAL TREATMENT OF EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
PREVENTION OF EXACERBATIONS
Antimicrobial Treatment of Exacerbations Importance of Eradication
Antimicrobials in Stable State Treatment of Chronic Bronchial Infection
Other Preventive Treatments
Other Interventions During Exacerbations
CONCLUSION
CHAPTER 8:
Viral Respiratory Infections
INTRODUCTION
RESPIRATORY SYNCYTIAL VIRUS
Basic Knowledge-Epidemiology-Pathophysiology
Clinical Picture in Infants and Young Children
Other Clinical Presentations in Children and Adults
Diagnosis
Differential Diagnosis
Treatment
PARAINFLUENZA VIRUS
Basic Knowledge-Epidemiology-Pathophysiology
Clinical Picture
Diagnosis
HUMAN RHINOVIRUS
Basic Knowledge-Epidemiology-Pathophysiology
Clinical Picture
Diagnosis
Treatment
INFLUENZA VIRUS
Basic Knowledge-Epidemiology-Pathophysiology
Clinical Picture
Influenza Related Complications
Influenza A H1N1-2009 Related Pandemic
Diagnosis
Treatment
Prevention
ADENOVIRUS INFECTIONS
Basic Knowledge-Epidemiology-Pathophysiology
Clinical Picture
Other Adenovirus Related Syndromes
Adenovirus and Immunocompromised Subjects
Diagnosis
Differential Diagnosis
Treatment
Prevention
CORONAVIRUS
Basic Knowledge-Epidemiology-Pathophysiology
Clinical Picture
Novel Coronaviruses
Coronaviruses and Other Clinical Associations
Diagnosis
Treatment
HUMAN METAPNEUMOVIRUS
Basic Knowledge-Epidemiology-Pathophysiology
Clinical Picture
Diagnosis
Treatment
ENTEROVIRUS INFECTION
Basic Knowledge-Epidemiology-Pathophysiology
Clinical Picture
Diagnosis
Treatment
HUMAN BOCAVIRUS
Basic Knowledge-Epidemiology-Pathophysiology
Clinical Picture
Diagnosis
Treatment
CHAPTER 9:
Respiratory Infections in Specific Populations: HIV Patients
INTRODUCTION
BACTERIAL INFECTIONS
VIRAL INFECTIONS
FUNGAL INFECTIONS
Cryptococcal Lung Disease
Coccidioidomycosis
Histoplasmosis
Zygomycosis
Aspergillosis
PARASITIC INFECTIONS
MYCOBACTERIAL INFECTIONS
Nontuberculous Mycobacteria
IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME
Immune Mechanisms in the Pathogenesis of Immune Reconstitution Inflammatory Syndrome
Immune Reconstitution Inflammatory Syndrome and Pulmonary Disease
Clinical and Laboratory Predictors of Future Development of Immune Reconstitution Inflammatory Syndrome
Diagnosis and Treatment of Immune Reconstitution Inflammatory Syndrome
CONCLUSION
CHAPTER 10:
Respiratory Infections in Specific Populations: Transplant Patients
INTRODUCTION
EPIDEMIOLOGY OF LOWER RESPIRATORY TRACT INFECTIONS IN TRANSPLANT PATIENTS
DIAGNOSIS OF PNEUMONIA IN TRANSPLANT PATIENT
Common Pathogens
Prophylaxis
Noninfectious Causes of Pulmonary Disease
Approach to Diagnosis and Therapy
CHAPTER 11:
Respiratory Infections in Specific Populations: Lung Cancer Patients
INTRODUCTION
EPIDEMIOLOGY
Prevalence
PATHOGENS
PREVENTION
Granulocyte Colony-stimulating Factors
Antibiotics
Vaccination
DIAGNOSTIC EVALUATION
TREATMENT
CONCLUSION
CHAPTER 12:
Respiratory Infections In Specific Populations: Drug Users
INTRODUCTION
DRUG USE AND INFECTIONS: GENERAL CONCEPTS
Malnutrition
Human Immunodeficiency Virus Infection
Immunomodulation
DRUG USE-ASSOCIATED RESPIRATORY INFECTIONS
Aspiration Pneumonia
Community-acquired Pneumonia
Septic Pulmonary Emboli
Fungal Pneumonia
Pulmonary Tuberculosis
DIFFERENTIAL DIAGNOSIS
A FINAL WORD
CHAPTER 13:
Tuberculosis
INTRODUCTION
ETIOLOGY
PATHOGENESIS
EPIDEMIOLOGY
CLINICAL FEATURES
DIAGNOSIS
TREATMENT
PREVENTION
CONCLUSION
CHAPTER 14:
Invasive Fungal Infections in Critically Ill Patients
INTRODUCTION
POSTMORTEM EPIDEMIOLOGICAL EVIDENCE AND TEMPORAL TRENDS
DIAGNOSIS OF INVASIVE FUNGAL INFECTION
CLINICAL EPIDEMIOLOGY OF INVASIVE FUNGAL INFECTIONS
INVASIVE CANDIDIASIS AND CANDIDEMIA
Clinical Spectrum and Definitions
Incidence and Temporal Trends
Emergence of Non-Albicans Candida Species
Pathophysiology of Candida Infection
Risk Factors for Candida Bloodstream Infection
Diagnostic Tools
Multisite Candida Colonization
Impact of Invasive Candidiasis
INVASIVE PULMONARY ASPERGILLUS INFECTIONS
Clinical Spectrum and Definitions
Incidence of Invasive Pulmonary Aspergillosis
Aspergillus Species
Pathophysiology of Pulmonary Aspergillus Infection
Risk Factors for Invasive Pulmonary Aspergillosis
Diagnostic Tools
HEALTH-ECONOMIC IMPACT OF FUNGAL INFECTION
CONCLUSION
CHAPTER 15:
Adjunctive Therapies for Respiratory Infections
INTRODUCTION
HOST-PATHOGEN INTERACTIONS AND SEVERE LOWER RESPIRATORY TRACT INFECTIONS
Host Immune Response
Activation of the Coagulation Cascade
CLASSIFICATION OF ADJUNCTIVE THERAPIES
Macrolides
Immunoglobulins
Statins
Corticosteroids
Anticoagulants
CONCLUSION
CHAPTER 16:
Parapneumonic Pleural Effusions
INTRODUCTION
DEFINITIONS
PATHOPHYSIOLOGY AND CLASSIFICATION
CLINICAL PRESENTATION
BACTERIOLOGY OF PLEURAL INFECTION
IMAGING TECHNIQUES
Chest X-ray
Chest Ultrasonography
Computed Tomography
Positron Emission Tomography Scan
PLEURAL FLUID ANALYSIS
DIFFERENTIAL DIAGNOSIS
TREATMENT
Antibiotic Treatment
Repeat Thoracentesis
Intrapleural Fibrinolytics
Thoracoscopy
CHAPTER 17:
Intensive Care Unit-associated Infections: Pathogenesis, Diagnosis, Management, and Prevention
INTRODUCTION
CATHETER-ASSOCIATED URINARY TRACT INFECTIONS
Introduction
Pathogenesis
Diagnosis
Management
Prevention
VENTILATOR-ASSOCIATED PNEUMONIA
Introduction
Pathogenesis
Diagnosis
Management
Prevention
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTION
Introduction
Pathogenesis
Diagnosis
Management
Prevention
CLOSTRIDIUM DIFFICILE INFECTION
Introduction
Pathogenesis
Diagnosis
Management
Prevention
CONCLUSION
CHAPTER 18:
Ventilator-associated Pneumonia
INTRODUCTION
DEFINITION
EPIDEMIOLOGY
Incidence
Mortality
PATHOGENESIS
Role of Tracheal Tube in the Pathogenesis of Ventilator-associated Pneumonia
Sources of Colonization
Impairment of Respiratory Defense During Critical Illness and Tracheal Intubation
ETIOLOGY AND RISK FACTORS FOR MICROORGANISMS
DIAGNOSIS
TREATMENT
Choice of the Empiric Antimicrobials Likely to Be Active Against Causative Microorganisms
Antimicrobial Therapy in Special Situations
Modifications of Therapy and Duration of Treatment
PREVENTION
General Prophylactic Measures
Noninvasive Ventilation
Tracheal Tube Cuff
Tracheal Tubes Coated with Antimicrobial Agents
Aspiration of Subglottic Secretions
Tracheostomy
Ventilator Circuit Management
Body Position
Stress Ulcer Prophylaxis and Enteral Feeding
Modulation of Oropharyngeal and Gastrointestinal Colonization
CONCLUSION
CHAPTER 19:
Diagnosis and Management of Hospital-acquired Pneumonia Due to Methicillin-resistant Staphylococcus aureus
INTRODUCTION
DIAGNOSIS OF PNEUMONIA
Microbiologic Identification
INCIDENCE AND EPIDEMIOLOGY
RESISTANCE AND VIRULENCE
TREATMENT
Vancomycin
Linezolid
Teicoplanin
Telavancin
Quinupristin/Dalfopristin
Tigecycline
Ceftaroline and Ceftobiprole
Rifampin
Daptomycin
CONCLUSION
CHAPTER 20:
Management of Multidrug-resistant Pathogens
INTRODUCTION
COLISTIN
TIGECYCLINE
FOSFOMYCIN
β-LACTAMS
The Inhibitors
Temocillin
Cephalosporins
Carbapenems
Other Therapeutic Options
CONCLUSION
CHAPTER 21:
Using PK/PD Properties of Antibiotics in the Treatment of Respiratory Infections
INTRODUCTION
Principles of Pharmacokinetics and Pharmacodynamics
Antifungal Pharmacodynamics
Polyene Pharmacodynamics
Triazole Pharmacodynamics
Echinocandin Pharmacodynamics
PHARMACOKINETICS/PHARMACODYNAMICS CONSIDERATION ON VENTILATOR-ASSOCIATED PNEUMONIA
CONCLUSION
CHAPTER 22:
Scores for the Assessment of Pneumonia Severity and Outcome
COMMUNITY-ACQUIRED PNEUMONIA
General Population
Pneumonia Severity Index
CURB and Its Modifications
Other Scores
Critical Appraisal
Validation of Predictive Tools for the Assessment of Community-acquired Pneumonia Severity
Impact Analysis of Predictive Tools in the Community
Practical Issues in the Use of Predictive Tools
Advantages and Limitations of Predictive Tools
Severe Community-acquired Pneumonia
SMART-COP
España Rule
Risk of Early Admission to Intensive Care Unit Index
Validation Studies of Predictive Rules for Severe Community-acquired Pneumonia
Critical Appraisal
Practical Issues
HOSPITAL-ACQUIRED PNEUMONIA
VAP-PIRO Score
IBMP-10 Score
CHAPTER 23:
Biomarkers in the Diagnosis and Treatment of Respiratory Infections
INTRODUCTION
PROCALCITONIN
Key Points
PROADRENOMEDULLIN
Key Points
NEOPTERIN
Key Points
PRESEPSIN
Key Points
sTREM-1
Key Points
CONCLUSION
CHAPTER 24:
Vaccine-preventable Respiratory Infections
INTRODUCTION
INFLUENZA
Influenza Viruses
Epidemiology
The Vaccines
Efficacy
Safety
PNEUMOCOCCAL VACCINES
Pneumococci
Epidemiology
Polysaccharide Vaccines
Conjugated Vaccines
Efficacy
Current Recommendations
Safety
CONCLUSION
CHAPTER 25:
Pulmonary Endothelium in Sepsis and Infections
INTRODUCTION
BASIC FUNCTIONS
LUNG ENDOTHELIUM IN DISEASE
Endothelial Responses to Pathogens
Molecular Pathways in Sepsis
ENDOTHELIUM AND INFECTIONS
Specific Interactions of Microorganisms with the Endothelium
CONCLUSION
CHAPTER 26:
Bioterrorism and Respiratory Infections
INTRODUCTION
VIRAL AGENTS
Hemorrhagic Fever Viruses
Smallpox (Variola)
Category C Biological Threats
Nipah Virus
SARS Coronavirus
BACTERIAL AGENTS
Bacillus anthracis
Francisella tularensis
Yersinia pestis
Coxiella burnetii
Burkholderia mallei
Burkholderia pseudomallei
Chlamydophila psittaci
CHAPTER 27:
The Role of the Nurse in the Treatment of Respiratory Infections
INTRODUCTION
PREVENTING INFECTION
PERFORMING A NURSING ASSESSMENT OF THE RESPIRATORY TRACT
FOLLOWING DOCTOR's ORDERS
POSITIONING THE PATIENT
ADMINISTERING OXYGEN THERAPY
Prongs and Catheters
Masks
Nursing Considerations19–22,34–37
CARING FOR THE PATIENT ON INVASIVE MECHANICAL VENTILATION
Nursing Considerations17–22,34–37
CARING FOR ENDOTRACHEAL TUBES
Nursing Considerations18–22,34–37
CARING FOR THE PATIENT ON NONINVASIVE VENTILATION
Nursing Considerations18–22,34–37
AEROSOL THERAPY
Nursing Considerations19–22,34–37
CARING FOR PATIENTS WITH TRACHEOTOMY
Nursing Considerations
SPUTUM ANALYSIS
Collection by Expectoration
Collection by Tracheal Suctioning
Collection by Bronchoscopy
BLOOD ANALYSES
Arterial Blood Gas Analysis
White Blood Cell Count and Differential White Blood Cell Count
INFORMING PATIENT AND FAMILY
SUPPORTING AND EDUCATING PATIENT AND FAMILY
CONCLUSION
CHAPTER 28:
Lung Infections in Cystic Fibrosis
INTRODUCTION
LUNG INFECTION IN CYSTIC FIBROSIS
BASIC DEFECT AND SUSCEPTIBILITY OF THE CYSTIC FIBROSIS AIRWAY TO PSEUDOMONAS INFECTIONS
PSEUDOMONAS INFECTION AND LOWER AIRWAY COLONIZATION IN CYSTIC FIBROSIS: CLINICAL ASPECTS
THE CFTR GENE, MODIFIER-GENE POLYMORPHISMS, LUNG INFECTION, AND PROGRESSION OF LUNG DAMAGE IN CYSTIC FIBROSIS
AIRWAY INFECTION AND INFLAMMATORY RESPONSE IN CYSTIC FIBROSIS
PREVENTION AND EARLY TREATMENT OF PSEUDOMONAS LUNG INFECTION IN CYSTIC FIBROSIS PATIENTS
Burkholderia cepacia Complex
Staphylococcus aureus
Aspergillus fumigatus and Allergic Aspergillosis
Other Pathogens
ACUTE EXACERBATIONS
ROLE OF VIRAL INFECTIONS
MONITORING THE PROGRESSION OF LUNG DISEASE
CHRONIC MANAGEMENT OF LUNG INFECTION IN CYSTIC FIBROSIS PATIENTS
Chest Physiotherapy
Changing Mucus Composition
Inhaled Antibiotics
Anti-inflammatory Treatment
Managing the Severe Patient and Lung Transplant Programs
CONCLUSION
INDEX
TOC
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