Immune deficiency: changing spectrum of pathogens.

Area of Science:

• Immunology
• Infectious Diseases
• Clinical Microbiology

Background:

• UK national standards prioritize bacteriology surveillance in severe antibody-deficient patients.
• Limited guidance exists for virology screening and managing viral infections in these individuals.

Purpose of the Study:

• To assess the prevalence of positive virology and bacteriology results in respiratory and stool samples from immune-deficient patients.
• To identify common viral and bacterial pathogens.
• To characterize symptomatic and persistent viral infections.

Main Methods:

• Retrospective audit of patient medical notes over a 2-year period.
• Analysis of respiratory and stool samples for virology and bacteriology.
• Review of clinical data to identify infection types and patient outcomes.

Main Results:

• 39.7% of severe immune-deficient patients had positive virology results; 55.6% had positive bacteriology results.
• Rhinovirus, norovirus, Haemophilus influenzae, Pseudomonas spp., and Staphylococcus aureus were most common.
• 97% of positive viral detections were in symptomatic patients; low IgA levels correlated with positive virology.

Conclusions:

• Virology screening can aid antimicrobial treatment decisions in symptomatic antibody-deficient patients.
• A significant proportion of these patients may suffer from persistent viral infections, leading to considerable morbidity.