Principles of Medical Microbiology

Principles of Infectious Disease: The Host-Parasite Relationship Colonization, Normal Microbiota & Symbiotic Relationships Pathogenicity and Virulence Mechanisms of Pathogenicity Epidemiology Mechanisms of Immunity Beneficial Harmful Manipulated Antimicrobial Chemotherapy

Principles of Infectious Disease

The Host-Parasite Relationship Colonization and Normal Microbiota Permanent residents, transients and opportunists Symbiotic Relationships Mutualism, Commensalism, Parasitism Pathogenicity and Virulence Evolution of parasitism Attenuation of virulence The Infectious Process: 1) Exposure: Oral, respiratory, parenteral, etc 2) Attachment: Pili, capsules, proteins, etc 3) Colonization: Metabolism, replication, avoid clearance 4) Tissue Damage: Toxins, invasiveness, immune response
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Principles of Infectious Disease

The Host-Parasite Relationship Colonization and Normal Microbiota Permanent residents, transients and opportunists Symbiotic Relationships Mutualism, Commensalism, Parasitism
Pathogenicity and Virulence Evolution of parasitism Attenuation of virulence The Infectious Process: 1) Exposure: Oral, respiratory, parenteral, etc 2) Attachment: Pili, capsules, proteins, etc 3) Colonization: Metabolism, replication, avoid clearance 4) Tissue Damage: Toxins, invasiveness, immune response
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Colonization

Normal Microbiota

Principles of Infectious Disease

The Host-Parasite Relationship Colonization and Normal Microbiota Permanent residents, transients and opportunists Symbiotic Relationships Mutualism, Commensalism, Parasitism

Pathogenicity and Virulence -Evolution of parasitism -Attenuation of virulence The Infectious Process: 1) Exposure: Oral, respiratory, parenteral, etc 2) Attachment: Pili, capsules, proteins, etc 3) Colonization: Metabolism, replication, avoidance of immune clearance 4) Tissue Damage: Toxins, invasiveness, adverse immune response
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Routes of Exposure

Attachment

Colonization

Avoiding the Immune Response

Avoiding the Immune Response

Tissue Damage: Invasiveness

Tissue Damage: Invasion

Tissue Damage: The Action of Exotoxins

Superantigens

The Action of Endotoxin: LPS

Epidemiology

Reservoirs of Agents
Humans, Animals, Inanimate, Nosocomial

Transmission of Agents
Contact, Vectors, Vehicles

Disease Categories
Infectious vs contagious; Chronological sequence; Geographical distribution; Incidence rates; Extent of involvement; Agents; Clinical nature
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Where the Microorganisms Reside

Nosocomial Infections

Transmission: How the Microorganisms Spread

Portals of Entry: How the agents enter the body

Incidence

Emerging Diseases

The Immune System

Functions of the Immune System Types of Immune Responses Organization of the Immune System Innate Defense Mechanisms Acquired Defense Mechanisms Applied Immunology

A macrophage

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The Immune System

Functions of the Immune System

Defense Recognition of Homeostasis Recognition of Surveillance Recognition of

Types of Immune Responses

Humoral Transferred by Cellular Transferred by Innate First and second line defenses Acquired Antigen driven third line defenses
Recognition, Specificity, Memory

Organization of the Immune System Innate Defense Mechanisms Acquired Defense Mechanisms Applied Immunology
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Epithelial Barriers

Chemical Barriers

The Immune System

Functions of the Immune System

Types of Immune Responses

Organization of the Immune System

Cells: Phagocytes: Neutrophils, macrophages, APCs Antigen responsive cells: B and T cells Tissues: Primary: Bone marrow, thymus Secondary: Lymph nodes, spleen, diffuse lymphoid tissue Molecules: Enzymes, interferons, complement, interleukins, antibody

Innate Defense Mechanisms Acquired Defense Mechanisms Applied Immunology

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Hematopoiesis

Tissues

The Immune System

Functions of the Immune System Types of Immune Responses Organization of the Immune System

Innate Defense Mechanisms

Phagocytosis Inflammation Interferon Complement

Acquired Defense Mechanisms Applied Immunology

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Distribution of Phagocytic Cells

Phagocytosis

Inflammation

Interferon

The Immune System

Functions of the Immune System Types of Immune Responses Organization of the Immune System Innate Defense Mechanisms

Acquired Defense Mechanisms

-Humoral vs cellular specific immunity -The nature of antigens -The nature of antibodies -The functions of antibodies -Clonal selection -Humoral (antibody) immune responses -Cellular immune responses -Natural killer cells

Applied Immunology

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Antigens

Antibodies

Functions of Antibodies

Passive Transfer of Antibody

Clonal Selection

Antibody Production

Immunity:
-APCs
-Ag Processing -Il-1 Production -Ag Presentation -Th Activation -Il-2 Production -Th Development -Th1 and CMI -Th2 and Antibody -Tc Developement -Tc Killing

The Immune System

Functions of the Immune System Types of Immune Responses Organization of the Immune System Innate Defense Mechanisms Acquired Defense Mechanisms

Applied Immunology
-Methods of acquiring immunity

-Vaccination -Immunological-based testing: ELISA assays -Clinical immunology

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Figure 17.1

Pregnancy Testing

ELISA Testing

The Immune System

Clinical Immunology:
Hypersensitivity Transplantation Immunology Autoimmunity Immunotherapy Immunosuppression Immunodeficiency Cancer of the Immune System

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Type I Hypersensitivity: Immediate

Allergy Testing

Immunotherapy

Type II Hypersensitivity: Cytotoxic

Type III Hypersensitivity: Immune Complex

Type IV Hypersensitivity: Delayed

Antimicrobial Chemotherapy

History
Ancient, Ehrlich, Domagck

Terminology
Antibiotics, Synthetic antibiotics, Semi-synthetic antibiotics

Properties of Antibiotics
Selective toxicity, Therapeutic index, Spectrum of activity

Adverse Reactions
Toxicity, Allergy, Disrupt normal microbiota, Resistance

The Ideal Antibiotic Mechanism of Action

Bacteria, Viruses, Fungi, Protozoa, Helminths
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