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Microbe-Human Interactions. A Continuum of Interactions Exists. Routine Contact with Microorganisms Infection – a condition in which pathogenic microbes penetrate host defenses, enter tissues and multiply Disease – Deviation from Normal Health.
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A Continuum of Interactions Exists • Routine Contact with Microorganisms • Infection – a condition in which pathogenic microbes penetrate host defenses, enter tissues and multiply • Disease – Deviation from Normal Health
The Normal State is that Humans are Host to a Variety of Microorganisms
Humans are Colonized from the Moment of Birth Babies Readily Acquire Flora During Delivery and from the External Environment
Regions that Host Flora • Skin • Oral cavity • Lower GI tract • Upper Respiratory • Genitourinary Tract
Skin Flora Staphylococcus, Micrococcus Propionibacterium
Flora of the Mouth and Pharynx Streptococcus, Neisseria, Staphylococcus, Lactobacillus, Bacteroides
Flora of the GI Tract Bacterioides, Lactobacillus, Enterococcus, Coliforms
Flora of the Genitourinary Tract Lactobacillus, Streptococcus, E. coli, Staphylococcus
Maintenance of the Normal Resident Flora • Normal flora is essential to the health of humans • Flora create an environment that may prevent infections and can enhance host defenses • Antibiotics, dietary changes, and disease may alter flora • Probiotics – introducing known microbes back into the body
Types of Pathogens True vs. Opportunistic Pathogens
True Pathogens • Capable of causing disease in a healthy person • Generally associated with a recognizable disease • Can be weak to fatal in their effects
Opportunistic Pathogens • Cause disease in weakened host • Sometimes cause disease when they colonize a different region of the body • See Table 13.4 for pre-disposing conditions
Pathogenicity vs. Virulence • Pathogenicity = ability to cause disease • Virulence = relative capacity of a pathogen to invade and harm host cells
Gaining Access – Portal of Entry The Skin or Membrane Barrier through which Pathogens Gain Entry to the Body
Some Agents that Enter the Skin • Staphylococcus aureus • Streptococcus pyogenes • Clostridium sp. • Insect-borne diseases • Hypodermic needle contaminants
GI Tract Entrants • Salmonella sp. • Vibrio sp. • E. coli • Shigella sp. • Entamoeba sp. • Giardia sp.
Respiratory Entrants • This is the most frequent route of entry • Streptococcus (Strep throat) • Influenza viruses • C. diptheriae • B. pertussis • Many others
Urogenital Entry Agents • Syphilis • Gonorrhea • Human Papilloma Virus • HIV • Chlamydia • Hepatitis B
Placental & Neonatal Agents STORCH = Syphilis, toxoplasmosis, others (hepatitis), rubella, cytomegalovirus, herpes simplex
Infectious Dose Minimum number of organisms required for an infection to be successful; lack of ID will not result in infection
To be Successful, a Pathogen Must • Adhere to the host • Penetrate host barriers • Establish a colony in host tissue
Some Methods of Adhesion • Fimbriae • Flagella • Adhesive Capsules • Binding to Receptors (Viruses)
Virulence factors Traits used by pathogens to invade and establish themselves in the host; also determine the degree of tissue damage that occurs
Some Virulence Factors • Extracellular Enzymes • Exotoxins • Endotoxins • Anti-phagocytic Factors
Exotoxins – Secreted by Living Cells Examples: Botulin Toxin, Hemolysins (Strep and Staph)
Endotoxins are Released by Dead Cells Example: Lipopolysaccharides from Gram- cells
Antiphagocytic Factors Ex.: Leukocidins, Slime Layers
The Process of Infection and Disease • Distinct stages of clinical infections: • incubation period - time from initial contact with the infectious agent to the appearance of first symptoms; agent is multiplying but damage is insufficient to cause symptoms; several hours to several years • prodromal stage – vague feelings of discomfort; nonspecific complaints • period of invasion – multiplies at high levels, becomes well established; more specific signs and symptoms • convalescent period – as person begins to respond to the infection, symptoms decline
Patterns of Infection • Localized - Contained • Systemic – Agent Circulates Freely • Focal – Localized infection breaks loose or attacks a distant target with toxin • Mixed – more than one agent invades
Temporal Patterns of Infection • Acute = short-lived but severe • Chronic = long-lived, persistent
Signs of Disease vs Symptoms • Signs = objective evidence of disease • Symptoms = subjective evidence sensed by patient (discomfort)
Some Signs of Infection • Inflammation • Skin lesions • Elevated WBC count • Bacteria or virus in blood
Portals of Exit for Pathogens • Respiratory/ Salivary • Skin • GI tract • Urogenital • Blood
Persistence of Infection • Latent infections & recurrent disease • Sequelae – long term damage to organs/tissues
Epidemiology The Study of Disease in Populations
Classifications of Diseases • Endemic – exhibits a relatively stable frequency in a particular location over time • Sporadic – occasional cases at irregular intervals • Epidemic – increase beyond what might be expected in a given population • Pandemic – spread of epidemics across continents
Pathogen Reservoirs vs Sources • Reservoir = habitat where the organism occurs • Source = Actual contact which provides the infection
Disease Carriers Shelter and Spread a Pathogen Inconspicuously
Carrier States • Asymptomatic – No signs of infection • Incubation – Spreads infection while it is incubating (still no symptoms) • Convalescent – Sheds microbes while recuperating • Chronic – Latent infections can be sheltered after apparent recovery • Passive – Mechanically picks up and transfers microbes
Disease Vectors Animals that transport an infection from one host to another
Biological Vectors • Actively participate in pathogen’s life cycle • Can inject infected saliva (mosquito) • May defecate around bite wound (flea) • Regurgitate blood into a wound (tsetse fly)
Mechanical Vectors Move the Pathogen from one Host to Another Without being Infected
Zoonosis An infection naturally found in animals, but transmissible to humans (See Table 13.10)
Communicable & Contagious Diseases • Communicable diseases can be transferred from one host to another and infection established • Contagious diseases are highly transmissible and move readily from host to host • Non-communicable diseases are not transmitted from one host to another