EH is a 68-year-old male who comes into the clinic complaining of a fever with a temperature of 103 °F. He has had a cough for the last three days that is producing some thick green brown mucous. The MD feels he most likely has bacterial pneumonia. He also has a history of having rheumatoid arthritis and being immune-compromised as he is on an immunosuppressant methotrexate. He has noted that over the last year he has lost weight unintentionally and feels he is underweight. a. Understanding epidemiologic concepts of the chain of transmission of organisms from host to victim, describe how EH could have been infected. b. Describe the epithelial barriers that were overcome by EH’s bacteria. c. Identify risk factors that put EH at risk for getting a bacterial pneumonia. Give rationale. d. After looking at each of the risk factors, list three things that you would suggest to EH to help prevent infections in the future.

A- It could have been spread by direct contact with the bacteria since it may have been on any living surface or vector like any animal, and the patient then entered his hand into the mouth, inhaling the bacteria, or by human-human transmission by saliva droplets / aerosol medium from a human contaminated with said bacterium, or also inhaling the spore of the bacterium in an unsanitary area or place.

Also a means of transmission that is not ruled out is in the hospital setting since we cannot rule out whether or not he went to a hospital in recent times.

b-The mucosal barrier of the epithelium of respiration and the protective mocus of the respiratory tract.

This bacterium was able to cross the mucous lining of the airways, the beautiful nasal passages, the cilia of the maxillary sinuses and the mocus that covers the respiratory surfaces.

After crossing these physical barriers that are from the innate immune response this bacterium due to the pathology that it generated invaded the alveoli.

c-Risk factors: that the patient is a smoker, that he is malnourished or malnourished, that he is immunosuppressed or depressed, that he has chronic respiratory diseases such as COPD in his physiological history, that he does not have the adequate coverage or vaccination plan to immunize his organism before the bacteria, that has a long time of exposure to the bacteria for labor or other reasons.

d-Adequate nutrition, gain weight, use preventive antibiotic methods if you are immunosuppressed, live or stay in ventilated / ventilated environments, use a mask, maintain hygiene of your hands and your home in addition to your workplace, comply with all coverage or vaccination plan, perform physical activity that improves your lung capacity as swimming.

Explanation:

Methotrexate is a drug that is used in oncology and is acidic, as well as another factor that must be taken into account is that when the patient consumes other acidic drugs, the purification mechanism of methotrexate by the renal route becomes saturated and it remains more in the blood, that is, it will present a longer half-life and bioavailability, generating that the adverse effects are worse, in this situation we can say that the immunosuppression will be greater or more noticeable and the immune system will be more weakened if acidic drugs are consumed than not. that clearing of methototexate is successful.

This is a factor to consider after a pharmacological point of view.