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Simon M. Fox

, Angela M. Minassian

, Thomas Rawlinson

, and Brian J. Angus

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date: 09 July 2020

Immunocompromised patients have increased susceptibility to all the common hospital- and community-acquired bacterial infections affecting the general population. Therefore, the bacterial species most frequently isolated in routine inpatient blood cultures (staphylococci, streptococci, enterococci, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, etc.) are also the most commonly isolated in the immunocompromised. For example, community-acquired pneumonia in both the immunocompetent and immunocompromised, is predominantly (~85%) due to Streptococcus pneumoniae, Haemophilus influenza, or Moraxella catarrhalis. Most of the remaining 15% is caused by Mycoplasma pneumoniae, Chlamydophila pneumoniae, or Legionella spp. In most circumstances, therefore, standard first-line antibiotic protocols are appropriate in the immunocompromised. However, the immunocompromised are also more susceptible to bacterial infections that do not ordinarily cause severe disease in the immunocompetent host. Frequent hospitalization and recurrent use of antibiotics make the dangers posed by multi-resistant organisms particularly significant. This chapter focuses on bacterial pathogens of particular relevance in the immunocompromised.

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