INFECTIOUS DISEASES: Edited by Alimuddin ZumlaRespiratory tract infections in the immunocompromisedGodbole, Gauria,b; Gant, Vanyaa Author Information aUCLH Hospitals NHS Foundation Trust bNorth Middlesex University Hospital NHS Trust, UK Correspondence to Dr Vanya Gant, Department of Microbiology, UCLH NHS Foundation Trust, 60 Whitfield Street, London W1T 4EU, UK. Tel: +44 203 447 9912; e-mail: [email protected] Current Opinion in Pulmonary Medicine: May 2013 - Volume 19 - Issue 3 - p 244-250 doi: 10.1097/MCP.0b013e32835f82a9 Buy Metrics Abstract Purpose of review Pulmonary infections are particularly common in the immunosuppressed host. This review discusses emerging threats, newer modalities of diagnostic tests and emerging treatment options, and also highlights the increasing problem of antimicrobial resistance. Recent findings Nosocomial pneumonia is increasingly due to multidrug-resistant Gram-negative organisms in immunosuppressed patients. Viral pneumonias remain a very significant threat, present atypically and carry a high mortality. Aspergillosis remains the most common fungal infection, and infections due to Mucorales are increasing. Multidrug-resistant tuberculosis is on the increase throughout the world. Mixed infections are common and early bronchoscopy with appropriate microbiological tests, including molecular diagnostics, optimise management and reduce mortality. Conclusion Pulmonary infection remains the most frequent infectious complication in the immunocompromised host. These complex infections are often mixed, have atypical presentations and can be due to multidrug-resistant organisms. Multidisciplinary involvement in specialist centres with appropriate diagnostics, treatment and infection control improves outcome. There is a desperate need for new antimicrobial agents active against Gram-negative pathogens. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
