MICROBIOLOGY

WITH DISEASES BY BODY SYSTEM SECOND EDITION

Microbial Diseases of the Respiratory System

Lecture prepared by Mindy Miller-Kittrell, University of Tennessee, Knoxville
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Normal Microbiota

• Normal Microbiota of the Respiratory System

– Lower respiratory system
– Typically microorganisms are not present
– Upper respiratory system
– Normal microbiota limit growth of pathogens
– Normal microbiota may be opportunistic pathogens
– Examples of normal microbiota
– Haemophilus influenzae can colonize the nose
– Staphylococcus aureus is present as normal
microbiota in some individuals without causing
disease
– Diphtheroids can colonize the nose and nasal
cavity
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Bacterial Diseases of the Upper Respiratory System, Sinuses,
and Ears
• Streptococcal Respiratory Diseases
– Signs and symptoms
– Sore throat, difficulty swallowing; may progress to
scarlet or rheumatic fever
– Pathogen and virulence factors
– Caused by Group A streptococci (S. pyogenes)
– Virulence factors include M proteins, hyaluronic
acid
capsule, streptokinases, C5a peptidase, pyrogenic
toxins, streptlysins
– Pathogenesis
– Typically occur when normal microbiota are
depleted, large inoculum is introduced, or adaptive
immunity is impaired
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Bacterial Diseases of the Upper Respiratory System, Sinuses,
and Ears

• Streptococcal Respiratory Diseases

– Epidemiology
– Spread via respiratory droplets
– Occurs most often in winter and spring
– Diagnosis, treatment, and prevention
– Often confused with viral pharyngitis
– Penicillin is an effective treatment

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Bacterial Diseases of the Upper Respiratory System, Sinuses,
and Ears

Copyright © 2009 Pearson Education Inc., publishing as Pearson Benjamin

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Bacterial Diseases of the Upper Respiratory System, Sinuses,
and Ears

• Diptheria
– Signs and symptoms
– Sore throat, oozing fluid that hardens into a
pseudomembrane that can obstruct airways
– Pathogen and virulence factors
– Caused by Cornybacterium diphtheriae
– Virulent C. diptheriae produce diphtheria toxin,
which prevents polypeptide synthesis and causes
cell death

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Bacterial Diseases of the Upper Respiratory System, Sinuses,
and Ears

Copyright © 2009 Pearson Education Inc., publishing as Pearson Benjamin

Cummings
Bacterial Diseases of the Upper Respiratory System, Sinuses,
and Ears

Copyright © 2009 Pearson Education Inc., publishing as Pearson Benjamin

Cummings
Bacterial Diseases of the Upper Respiratory System, Sinuses,
and Ears

• Diphtheria
– Pathogenesis and epidemiology
– Spread person to person via respiratory droplets or
skin contact
– Immunocompromised or nonimmune individuals
develop symptomatic infections
– Diagnosis, treatment, and prevention
– Diagnosis based on presence of a
pseudomembrane
– Treated by administration of antitoxin and
antibiotics
– Immunization is an effective prevention
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Bacterial Diseases of the Upper Respiratory System, Sinuses,
and Ears

• Sinusitis and Otitis Media

– Signs and symptoms
– Sinusitis: pain and pressure of the affected sinus
accompanied by malaise
– Otitis media: severe pain in the ears
– Pathogen and virulence factors
– Caused by various bacteria such as
Streptococcus pneuomoniae, Staphylococcus
aureus, Haemophilus influenzae, and Moraxella
catarrhalis

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Bacterial Diseases of the Upper Respiratory System, Sinuses,
and Ears

• Sinusitis and Otitis Media

– Pathogenesis and epidemiology
– Bacteria in the pharynx spread to the sinuses via
their connection with the throat
– Sinusitis is more common in adults; otitis media is
more common in children
– Diagnosis, treatment, and prevention
– Symptoms often diagnostic
– No known way to prevent sinusitis

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Bacterial Diseases of the Lower Respiratory System

• Lower respiratory organs are usually axenic

• When bacterial infection of the lower respiratory
system occurs life-threatening illness can result

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Bacterial Diseases of the Lower Respiratory System

• Bacterial Pneumonias
– Inflammation of the lungs accompanied by fluid–
filled alveoli and bronchioles
– Can be described by the affected region or the
organism causing the disease
– E.g., lobar pneumonia involves entire lobes of the
lungs
– Bacterial pneumonias are the most serious and the
most frequent in adults

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Bacterial Diseases of the Lower Respiratory System

• Pneumoccocal Pneumonia
– Signs and symptoms
– Fever, chills, congestion, cough, chest pain, and short,
rapid breathing
– Pathogen and virulence factors
– Caused by Streptococcus pneumoniae
– Virulence factors include adhesins, capsule, pneumolysin
– Pathogenesis and epidemiology
– Infection occurs by inhalation of bacteria
– Bacterial replication causes damage to the lungs
– Diagnosis, treatment, and prevention
– Penicillin is the drug of choice for treatment
– Vaccination is method of prevention

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Bacterial Diseases of the Lower Respiratory System

Copyright © 2009 Pearson Education Inc., publishing as Pearson Benjamin

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Bacterial Diseases of the Lower Respiratory System

• Primary Atypical (Mycoplasmal) Pneumonia

– Signs and symptoms
– Atypical symptoms including fever, malaise, sore throat,
excessive sweating
– Pathogen and virulence factors
– Caused by Mycoplasma pneumoniae
– Virulence factors include an adhesion protein
– Epidemiology
– Nasal secretions among individuals in close contact spread
the bacteria
– Diagnosis, treatment, and prevention
– Treated with tetracycline and erythromycin
– Prevention is difficult because individuals can be infective
despite lack of symptoms

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Bacterial Diseases of the Lower Respiratory System

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Bacterial Diseases of the Lower Respiratory System

• Klebsiella Pneumonia
– Signs and symptoms
– Typical pneumonia symptoms combined with a thick,
bloody sputum and recurrent chills
– Pathogen and virulence factors
– Caused by Klebsiella pneumoniae
– Virulence factors include a capsule
– Pathogenesis and epidemiology
– Immunocompromised individuals at greatest risk for
infection
– Diagnosis, treatment, and prevention
– Treated with antimicrobials
– Prevention involves good aseptic technique by health care
workers

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Bacterial Diseases of the Lower Respiratory System

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Bacterial Diseases of the Lower Respiratory System

• Other Bacterial Pneumonias

– Cause – Haemophilus influenzae, Staphylococcus aureus,
Yersinia pestis, and Chlamydia species
– Portal of entry – inhalation, also via blood with Y. pestis
– Signs/Symptoms – typical pneumonia symptoms with frothy,
bloody sputum in the case of Y. pestis
– Incubation period – variable depending on cause, although Y.
pestis can produce symptoms in hours
– Susceptibility – typically young children most susceptible
– Treatment – antibiotic treatment
– Prevention – good hygiene; vaccine available for H. influenzae

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Bacterial Diseases of the Lower Respiratory System

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Bacterial Diseases of the Lower Respiratory System

• Legionnaires’ Disease
– Signs and symptoms
– Typical pneumonia symptoms and possible
complications of the gastrointestinal tract, CNS,
liver, and kidneys
– Pathogen and virulence factors
– Caused by Legionella pneumophila
– Pathogenesis
– L. pneumophila kills human cells, causing tissue
damage and inflammation

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Bacterial Diseases of the Lower Respiratory System

• Legionnaires’ Disease
– Epidemiology
– The elderly, smokers, and immunocompromised
individuals are at increased risk for infection
– Diagnosis, treatment, and prevention
– Quinolones or macrolides are the drugs of choice
for treatment
– Reduction of bacterial presence in water is
successful control measure

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Bacterial Diseases of the Lower Respiratory System

Copyright © 2009 Pearson Education Inc., publishing as Pearson Benjamin

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Bacterial Diseases of the Lower Respiratory System

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Bacterial Diseases of the Lower Respiratory System

• Tuberculosis
– Pathogenesis
– M. tuberculosis can remain viable for long periods
in aerosol drops
– Three types of tuberculosis
– Primary tuberculosis – initial case of
tuberculosis disease
– Secondary tuberculosis – reestablished
tuberculosis
– Disseminated tuberculosis – tuberculosis
involving multiple systems
– Epidemiology
– Immunocompromised individuals are most at risk
– Tuberculosis is the leading killer of HIV+
individuals
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Bacterial Diseases of the Lower Respiratory System

Copyright © 2009 Pearson Education Inc., publishing as Pearson Benjamin

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Bacterial Diseases of the Lower Respiratory System

Copyright © 2009 Pearson Education Inc., publishing as Pearson Benjamin

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Bacterial Diseases of the Lower Respiratory System

• Pertussis (Whooping Cough)

– Signs and symptoms
– Initially cold-like, then characteristic cough develops
– Pathogen and virulence factors
– Bordetella pertussis is the causative agent
– Virulence factors include various toxins including
pertussis toxin, adenylate cyclase toxin,
dermonecrotic toxin, and tracheal cytotoxin
– Pathogenesis
– Four phases – incubation, catarrhal, paroxysmal,
and convalescent

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Bacterial Diseases of the Lower Respiratory System

• Pertussis (Whooping Cough)

– Epidemiology
– Highly contagious; the bacteria spread through the
air in airborne droplets
– Diagnosis, treatment, and prevention
– Symptoms are usually diagnostic
– Treatment is primarily supportive
– Prevention is with the DTaP vaccine

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Bacterial Diseases of the Lower Respiratory System

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Bacterial Diseases of the Lower Respiratory System

• Inhalational Anthrax
– Signs and symptoms
– Resemble a cold or flu but progress to severe
coughing, shortness of breath, shock, and death
– Pathogen and virulence factors
– Bacillus anthracis is the causative agent
– Virulence factors include a capsule and secretion
of anthrax toxin
– Pathogenesis and epidemiology
– Anthrax not spread from person to person
– Acquired by contact or inhalation of endospores

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Bacterial Diseases of the Lower Respiratory System

• Inhalation Anthrax
– Diagnosis, treatment, and prevention
– Diagnosis based on identification of bacteria in
sputum
– Early and aggressive treatment with
antimicrobials necessary
– Anthrax vaccine available to military personnel,
researchers, and health care workers dealing with
anthrax patients

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