Non-Specific Mechanisms of Resistance to Infection and their Influence on the Changing Pattern of Causative Agents
The commonest sites of serious infection in hospitals today are in the bronchopulmonary tree and in the urinary system. The mortality and morbidity rates from these infections continue to be high. Antimicrobial agents have had only limited usefulness in many of the clinical situations surrounding these groups of infections. In general, if one organism seems to be causing disease and is effectively eradicated and a second one replaces the first so that the underlying infectious process continues to progress, the problem can be solved in one of three ways. The first is to use a succession of drugs, which is what we generally have done. This has been of only modest benefit, as for example in the chronic bronchitic. Secondly, we may try to alter the available microbial flora to minimize the possibility of replacement. Thus we may try to free the gut of bacteria, or try to impose less pathogenic instead of more pathogenic organisms. Or we may take the longer term strategy of attempting to understand and perhaps thereby to influence host defenses, which must be a major variable influencing the ultimate outcome.
KeywordsPeritoneal Macrophage Bacterial Clearance Bladder Mucosa Pulmonary Macrophage Bacterial Aerosol
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