ABSTRACT
Implementing appropriate strategies to prevent infection in any immunocompromised patient begins with an assessment of the type of immune defects from which they suffer. This then helps define the types of infections that pose the greatest risk to that patient. The major types of immune defects that clinicians encounter can be divided into six broad categories: (1) granulocytopenia, (2) deficiencies of cellular immunity, (3) deficiencies of humoral immunity, (4) obstruction of a normal lumen by tumor or fibrosis, (5) central nervous system dysfunction, and (6) damage to normal anatomical barriers, such as the skin or mucosal surfaces (Table 1). Although approaches to preventing infection vary with each type of immune defect and the severity of the defect in a given patient four general approaches can be applied to all patients: (1) attempt to improve the patient’s immune defects, (2) reduce acquisition of potential pathogens, (3) suppress organisms with which the patient is already colonized that are likely to cause infection later, and (4) reduce or avoid procedures that disrupt normal anatomical barriers (Table 2).
