Vaccinations

Abstract

The greatest effect of immunosenescence and its interaction with chronic illness is increased infectious morbidity and mortality (see also Chapter 5) (1-5). The impact of many infections increases with age, including influenza, pneumonia, Clostridium difficile, nosocomial infections, and such recrudescent latent infections as herpes zoster. Use and abuse of antibiotics select resistant microorganisms that may spread from the primary source patient. This is especially true for methicillin-resistant Staphylococcus aureus and Streptococcus pneumoniae and also extended-spectrum beta-lactamase organisms and vancomycin-resistant enterococci. S. pneumoniae is increasingly resistant to antibiotics, is a leading cause of morbidity and mortality, and stands out among resistant organisms in that the most important pathogenic strains are vaccine preventable. Immunosenescence increases frequency and duration of infections and leads to atypical clinical presentations that can obscure the diagnosis.