Infections in compromised hosts: considerations on prevention.

Area of Science:

• Infectious Diseases
• Hospital Epidemiology
• Antimicrobial Prophylaxis

Background:

• Compromised patients are at high risk for nosocomial infections from resistant bacteria.
• Gram-negative bacillary and staphylococcal infections are common in severely ill or hospitalized patients.
• Existing prophylaxis methods have limitations and variable efficacy.

Purpose of the Study:

• To review and summarize current strategies for preventing common hospital-acquired infections in immunocompromised patients.
• To highlight effective and emerging prophylactic measures against specific pathogens.
• To identify areas lacking consensus in infection prevention.

Main Methods:

• Review of existing literature on antimicrobial prophylaxis and infection control in compromised hosts.
• Analysis of strategies for preventing gram-negative bacilli, Staphylococcus epidermidis, Streptococcus, Pneumocystis carinii, fungal, and viral infections.
• Evaluation of the efficacy and tolerability of different prophylactic regimens.

Main Results:

• Oropharyngeal or oral antibiotics, handwashing, and low-microbial diets reduce gram-negative bacilli colonization.
• Intravenous device care reduces Staphylococcus epidermidis infections.
• Cotrimoxazole is effective for Pneumocystis carinii pneumonia prophylaxis.
• Ketoconazole may prevent Candida infections; ganciclovir/acyclovir for cytomegalovirus; immune globulins/acyclovir for herpesvirus infections.

Conclusions:

• Multiple strategies exist to prevent specific nosocomial infections in compromised patients.
• Antibiotic prophylaxis, hygiene, and supportive care are crucial.
• Further research is needed for optimal prevention of certain infections like streptococcal and Aspergillus infections.