1. Why is it that wounds tend to be poly-microbial, meaning you usually can find more than one species of bacteria in a wound?

Wounds tend to be poly-microbial due to the concept of biofilm, where bacteria naturally accumulate on a surface. The bacteria form a sedentary community of different varieties of bacteria and fungi, which can infect a would simultaneously. For instance, biofilms can form on surfaces of medical equipment such as catheters and directly on skin tissues. The formation of biofilms makes it possible to have different species of bacteria on a wound. An example of a biofilm is Pseudomonas aeruginosa and Staphylococcus epidermidis, which have equal potential to infect a wound.

2. Why is an eye infection with Acanthamoeba often associated with the use of contact lenses?

Acanthamoeba is naturally common as it is found in water bodies and soil. The eye infection with Acanthamoeba is highly associated with contact lens use because it must get into direct contact with the eye (Niederkorn, 2020). The infection cannot occur from indirect contacts such as drinking the water and is transmitted when contact lens solution containing the organism comes into contact with the eye. 

3. Why do viral skin infections often lead to secondary bacterial infections, whereas bacterial skin infection does not lead to secondary viral infections?

Viral infections lead to secondary bacterial infections due to increased levels of infiltration. Bacterial infiltration means that the bacteria on the surface gains access to the inner tissues to cause secondary infections. During viral infection, T-cells produce inflammatory cytokines that contribute to lethal immunopathology. An example is during a respiratory viral infection; a patient is likely to conduct secondary bacterial infection due to excess inflammatory cytokines.

4. Why are smokers at a higher risk for bacterial bronchitis? 

Smoking interferes with the structural and functional state of the body defense cells leading to compromised immunology. Tobacco smoke increases the risk for bacterial bronchitis as the anti-bacterial capacity of leukocytes is compromised. The smoke affects the neutrophils, monocytes, and T cells, making the body susceptible to bacterial infection.

5. For which population would need the intranasal flu vaccine not be recommended, and why?

Population comprising elderly above the age of 49 years and individuals with an underlying medical condition are not recommended to get intra-nasal flu. Pregnant people are not recommended for the vaccine due to a weakened immune system. The intranasal flu vaccine is a weakened virus and works by causing the immune system of a healthy person to produce antibodies. In the mentioned cases, the immune system is low and might not respond effectively to the live attenuated vaccine (Armitage et al., 2018).

6. What is an indication that a chronic cough may be due to fungal infection?

Chronic cough may be due to fungal infection when a patient experiences "sensation of mucus in the throat." The SMIT indicates possible fungal colonization along the human airways which triggers coughing. Some of the common fungi that cause chronic cough are the basidiomycetes and aspergillus. Fungal infection such as aspergillosis invades the lungs, which causes coughing and nasal blockage (Ogawa et al., 2014). The presence of fungi in the airways during chronic cough confirms a diagnosis that antifungal drugs can be treated.

7. Which have the higher risk of a bad outcome, hospital or community-acquired pneumonia, and why?

Hospital-acquired pneumonia has a higher risk of a bad outcome due to the sick-state of the body. In most cases, patients diagnosed with pneumonia while in the hospital tend to be very sick, making it difficult for the immune system to fight off germs. Secondly, the germs present at the hospital tend to have a higher resistance to treatment than those in a community setting (Lanks, Musani, & Hsia, 2019). The variety of germs in hospital are high which makes the pneumonia infections severe.