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Download respiratory tract infections (rti)
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RESPIRATORY TRACT INFECTIONS (RTI) Dr B V Navaneeth, Dept of Microbiology Dr B V Navaneeth, Dept of Microbiology OVERVIEW URTIs common most often seen in GP LRTIs < common but > likely cause serious illness & death Diagnosis & therapy presents challenge to both clinician & lab staff Preventive strategies available for several RIs Dr B V Navaneeth, Dept of Microbiology GOALS General Principles of Pathogenesis of RTI Host Defenses in the URT, LRT Agents of Infection in URT, LRT Prevention and Treatment Dr B V Navaneeth, Dept of Microbiology Dr B V Navaneeth, Dept of Microbiology General Principles Encounter Entry Spread Multiplication Evasion of Host Defenses Damage Transmission Dr B V Navaneeth, Dept of Microbiology Pathogenesis – inhalation, aspiration, haemotogenous Nasal hairs & its mucus coverings - filters Epiglottis & cough reflexes Trachea & Bronchi – mucus lining & mucociliary escalator Antimicrobial factors in secretions – lysozyme, lactoferrin & secretary IgA, alveolar macrophages Dr B V Navaneeth, Dept of Microbiology Respiratory Pathogens Influenza virus Adhere to mucosal epithelial cells by specific surface antigens Under go genetic reassortment – expression of novel adhesins S pneumoniae & H influenzae Capsule – resist phagocytosis IgA protease – disabling mucosal IgA Mycobacterium – resist phagocytosis Dr B V Navaneeth, Dept of Microbiology Agents of Upper Respiratory Tract Infections Common cold (rhinitis) Many viruses; rhino, corona, adeno, influenza Pharyngitis and laryngotracheitis Streptococcus pyogenes Corynebacteria diphtheriae Many viruses Epiglottitis Haemophilus influenzae Bronchitis Bordetella pertussis Many viruses Dr B V Navaneeth, Dept of Microbiology Systemic Diseases that Begin in the URT Measles Mumps Influenza Meningitis Sinusitis Middle Ear Infection Pneumonia Dr B V Navaneeth, Dept of Microbiology Agents of Lower Respiratory Tract Infections Legionairre’s Disease; Legionella pneumophila Tuberculosis: Mycobacterium tuberculosis Pneumonia Bacteria Streptococcus pneumoniae Mycoplasma pneumoniae Staphylococcus aureus Almost ANY other Viruses Influenza Measles Many others Fungi & Parasites Dr B V Navaneeth, Dept of Microbiology Lab Diagnosis of LRTI Responsible pathogen not determined in as many as 50% of cases Sputum Expectorated Gastric aspirate (children) Induced Postural drainage / thoracic percussion/ aerosal induced Endotracheal / tracheostomy suction Bronchoscopy Bronchial washing / aspirate Bronchio-alveolar lavage (BAL) Protected bronchial brush samples Open lung biopsy Dr B V Navaneeth, Dept of Microbiology Over view Obtaining a protected catheter bronchial brush during a bronchoscopy examination Dr B V Navaneeth, Dept of Microbiology Lab Diagnosis of LRTI Direct exam Sputum / saliva Microscopy Gram stain / AFB Gomori methenamine-PCP DFA - Legionella Direct antigen test for viruses Culture BA / CA / MAC / LJ Identification tests AST Report & Interpretations Dr B V Navaneeth, Dept of Microbiology
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