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Microbiology Of Lower Respiratory Tract Infections Notes

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This is an extract of our Microbiology Of Lower Respiratory Tract Infections document, which we sell as part of our Respiratory System Notes collection written by the top tier of Bristol University students.

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Lecture 11 Microbiology of Lower Respiratory Tract Infections

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Definition of LRTI o Any infection of respiratory tract from vocal cords downwards o Includes bronchi, bronchioles, alveoli, parenchyma, pleura & pleural cavities Normal flora of LRT o Normal LRT is bacteriologically sterile o Inhaled particles including microorganisms are trapped by mucus & moved to URT by epithelial cilia Abnormal flora of LRT o Paralysis of cilia o Excessive volume &/or viscosity of mucus o Paralysis, ventilation, failure to protect LRT o Failure to cough up debris from larger airways o Loss of swallowing reflex o "Colonisers" of LRT often from URT (such as Haemophilus influenza and Streptococcus pneumoniae) o Antibiotic therapy WILL affect URT colonisation Types of LRTI o Acute cough (<3w) o Bronchiolitis o Bronchitis (acute exacerbation in COPD) o Bronchiectasis
? Abnormality of anatomy of respiratory tract
? Dysfunctional bag full of pus that becomes infected o Non-pneumonic LRTI o Pneumonia (community-acquired, hospital-acquired) o Lung abscess/Emphysema Infective exacerbation of chronic bronchitis (aka. COPD) o Antibiotic therapy indicated if two of
? Increased breathlessness, increased sputum volume, increased purulence o Patients with COPD may have colonisation of LRT with organisms normally found in URT such as H. influenza (50%), M. catarrhalis and to less extent S. pneumoniae o Give amoxicillin, tetracycline or macrolide Pneumonia o Types
? Community acquired pneumonia

* General o Symptoms of acute LRTI (cough and one other) o New focal chest signs on examination o One systemic feature (fever, shivers etc./raised temp) o No other explanation for illness, treated with CAP antibiotics

* Bacteria o Streptococcus pneumoniae
? Gpos laceolate diplococcus, 83 capsular serogroups

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