Patients host-associated risk factors

The risk factors for sulfadiazine nephrotoxicity in patients with AIDS include (a) more prolonged courses of therapy as compared to those for community-acquired infections in normal hosts (b) difficulty in maintaining high oral fluid intake in patients with toxoplasma encephalitis because of chronic illness, anorexia, and altered mental status (c) concurrent fluid loses due to diarrhea (d) levels of plasma creatinine within the range of "normal" despite impaired renal function due to AIDS-associated... 

Cigarette smoking is the primary modifiable risk factor for the development of COPD however, the disease can be attributed to a combination of risk factors that results in lung injury and tissue destruction. The risk factors associated with the development of COPD can be divided into host factors and environmental factors (Table 27-1), and commonly, the interaction between these risks leads to expression of the disease. Host factors, such as genetic predisposition, may not be modifiable but are important for identifying patients at high risk of developing the disease. Environmental factors, such as tobacco smoke and occupational dust and chemicals, are modifiable factors that, if avoided, may reduce the risk of disease development. 

Several factors could explain the possible association between bronchoscopy and VAP, including the use of large volumes of BAL that impede the clearance of bacteria from the lower respiratory tract and the introduction of nosocomial pathogens into the lower airway by dislodging bacterial aggregates from the endotracheal tube surface. As discussed previously, when bacteria encased in biofilm embolize to different areas of the lung, they may be particularly difficult for host defenses to clear effectively (145,146). These pathogenic mechanisms are theoretical, and prospective cUnical studies are required to evaluate the actual risk of bronchoscopy in ventilated patients. 

---