Infection & Host Resistance

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• Infection- a condition in which
pathogenic microbes penetrate host
defenses, enter tissues & multiply

• Disease – any deviation from health,

disruption of a tissue or organ caused
by microbes or their products
• Pathology: Study of disease
• Etiology: Study of the cause of a disease
• Pathogenesis: Development of disease
• Infection: Colonization of the body by pathogens;
a condition in which pathogenic microbes
penetrate host defenses, enter tissues & multiply
• Disease: An abnormal state in which the body is
not functionally normally; any deviation from
health, disruption of a tissue or organ caused by
microbes or their products
 Normal Flora, Normal Microbiota,
Resident flora
• Microorganisms that establish more or less
permanent residence (colonize) but do not
produce disease under normal conditions
»Bacteria
»Fungi
»Protozoa
»Viruses
»Arthropods
Normal Flora, Normal Microbiota,
Resident flora
• most areas of the body in contact with the
outside environment harbor resident
microbes
• large intestine: highest numbers of bacteria
• internal organs, tissues & fluids: microbe-
free
• bacterial flora benefit host by preventing
overgrowth of harmful microbes
Bacterial flora benefit host by preventing
overgrowth of harmful microbes

• Candida albicans:
vaginitis
• Clostridium difficile:
pseudomembranous
Abdominal cramps
colitis
Bloody stools
Low grade fever
Urge to have a bowel
movement
Watery diarrhea
• Transient microbiota may be
present for days, weeks or
months

• Normal microbiota
permanently colonize the
host
 Host-Microbe Relationships
Symbiosis is the relationship between
normal microbiota & the host (living
together)
• Commensalism: one is benefited & the
other is unaffected
• Commensals
» Corynebacterium (eye)
» Saphrophytic mycobateria (ear & external genitalia)
Host-Microbe Relationships

• Mutualism: both are benefited

»Escherichia coli: synthesize
vit. K & some B vitamins
»Large intestines: provides
nutrients
• Parasitism: one is benefited at
the expense of another
 Host-Microbe Relationships
• True pathogens – capable of causing disease
in healthy persons with normal immune
defenses
– Influenza virus, plague bacillus, malarial
protozoan
• Opportunistic pathogens – cause disease when
the host’s defenses are compromised or when
they grow in part of the body that is not natural
to them
– Pseudomonas sp & Candida albicans
• Microbial antagonism is competition
between microbes.
Normal microbiota protect the host by:
» occupying niches that pathogens
might occupy
» producing acids
» producing bacteriocins
Probiotics are live microbes applied to or
ingested into the body, intended to exert a
beneficial effect
• Locations of
normal
microbiota
on and in
the human
body
Colonized regions of the respiratory
tract
Normal Flora Locations & Species

Basically every Note that much of those

surface (except deep locations not mentioned
lungs and, perhaps, are sterile in healthy
the stomach). individuals.
 Classifying Infectious Diseases: Understand the
terminology involved in the classification of disease
• Symptom: A change in body
function that is felt by a patient as a
result of disease
• Sign: A change in a body that can
be measured or observed as a
result
• Syndrome: A specific group of signs
and symptoms that accompany a
disease
• Communicable disease : A disease
that is spread from one host to
another.
• Noncommunicable disease A disease
that is not transmitted from one host
to another.
• Contagious disease A disease that is
easily spread from one host to
another
 Severity or Duration of a Disease

• Acute disease: Symptoms develop rapidly

• Chronic disease: Disease develops slowly
• Subacute disease: Symptoms between
acute and chronic
• Latent diseases: w/ Disease with a period
of no symptoms when the patient is
inactive
Extent of Host Involvement

• Local infection:
Pathogens limited to
a small area of the
body
 Extent of Host Involvement
• Systemic infection: An infection
throughout the body
 Extent of Host Involvement

• Focal infection:
Systemic infection that
began as a local
infection
 Extent of Host Involvement

• Bacteremia: Bacteria in the

blood
• Septicemia: Growth of
bacteria in the blood
Predisposing factors
• Make the body more susceptible to
disease
• Short urethra in females
• Inherited traits such as the sickle-cell
gene Climate and weather
• Fatigue
• Age
• Lifestyle
• •Chemotherapy
 Predisposing factors
• Toxemia: Toxins in the blood
• Viremia: Viruses in the blood
• Primary infection: Acute infection that
causes the initial illness
• Secondary infection: Opportunistic
infection after a primary (predisposing)
infection
• Subclinical disease: No noticeable signs
or symptoms (inapparent infection)
Overview of infection
Portals of entry
• skin
• gastrointestinal tract
• respiratory tract
• urogenital tract
 Infectious dose (ID)
• minimum number of microbes
required for infection to proceed
• microbes with small IDs have greater
virulence
» 1 rickettsial cell in Q fever
» 10 bacteria in TB, giardiasis
» 109 bacteria in cholera
• Lack of ID will not result in infection
Mechanism of adhesion:
•fimbrae
•flagella
•adhesive slimes
or capsules
•cilia
•suckers
•hooks
 Virulence factors
• Exoenzymes or extracellular enzymes digest
epithelial tissues & permit invasion of pathogens
• Leukocidins – destroy WBC [Streptrococci]
• Hemolysins – destroy RBC
Clostridium perfringens; Streptococci (streptolysin)

• Coagulases – coagulate fibrinogen [Staphylococcus]

• Hyaluronidase – hydrolyzes hyaluronic acid
Streptococci

• Collagenase – breaks down collagen [Clostridium]

• Necrotizing factor
• Hypothermic factor
• Lecithinase
• Siderephores
Virulence factors

• Toxigenicity – capacity
to produce toxins at the
site of multiplication
– endotoxins – lipid A of
LPS of gram-negative
bacteria
– exotoxins – proteins
secreted by gram-
positive and gram-
negative bacteria
EXOTOXIN: produced inside the bacteria as
part of their growth & metabolism; & released
into the surrounding medium
Cytotoxin kills host cell
Neurotoxin intereferes w/ nerve impulse
Enterotoxin affects the lining of GIT
Corynebacterium diphtheriae: diphtheria Toxin
Streptococcus pyogenes: Cytotoxins A, B, C are
erythrogenic [damage blood capillaries & produce skin
rash] == Scarlet fever
Clostridium botulinum: Botulinum toxin [neurotoxin]
Clostridium tetani: Tetanus Toxin
Vibrio cholerae: Vibrio enterotoxin
Staphylococcus aureus: Staphylococcal enterotoxin
ENDOTOXIN- Part of outer portion of cell wall of Gram
negative bacteria. They are liberated when the bacteria die&
the cell wall breaks apart.
Chills, fever, weakness, generalized aches, shock,
death.

• Can induce miscarriage

• Activates blood-clotting
proteins to form blood
clots (disseminated
intravascular clotting)
.
More on Toxins
Virulence factors
• Antiphagocytic
factors – help
bacteria to kill or
avoid
phagocytes,
include
leukocidins and
capsules
Avoidance of Phagocytosis
Avoidance of Phagocytosis
Exotoxins vs. Endotoxins
Portals of exit

• Respiratory, saliva
• Skin scales
• Fecal exit
• Urogenital tract
• Removal of blood
• Sequelae – long-term or permanent
damage to tissues or organs
The Stages of a Disease
Course of Infectious Disease
Course of Infectious Disease

Convalescence is
a time of
recuperation and
recovery from
illness.

Depending on various
Incubation period is factors an individual may
the interval still be infectious during
between exposure either incubation or
and illness onset. convalescence.
 Events
1. Contamination
2. Correct portal of entrance
3. Break Through External Defense
(barriers)
4. Break Through Internal Defenses
(phagocytosis,interferon, antibodies, etc.)
5. Colonization and growth in tissues
6. Tissue Damage (disease)
 Reservoirs of infection
• Primary habitat in the natural world from which a
pathogen originates
• Living reservoirs may or may not have
symptoms
– Asymptomatic carriers
– Passive carriers
– Vectors – live animal that transmits infectious disease
• Nonliving reservoirs – soil, water
Types of carriers
Reservoirs of infection are continual sources of
infection.
• Human — AIDS, gonorrhea
• Carriers may have inapparent infections or latent
diseases
• Animal — Rabies, Lyme disease
• Some zoonoses may be transmitted to
humans
• Study Question 4. What is a zoonosis?
• Nonliving — Botulism, tetanus
• Soil
Vectors
 Patterns of transmission
• Direct contact
• Indirect contact
– Vehicle – inanimate material, food, water,
biological products, fomites
– Airborne – droplet nuclei, aerosols
• Vehicle Transmission by an inanimate
reservoir (food, water, air)

• Vectors Arthropods, especially fleas,

ticks, and mosquitoes (live fomites)
» Mechanical: Arthropod carries pathogen on feet
» Biological: Pathogen reproduces in vector
Nosocomial infections
• Diseases that are acquired during a
hospital stay
» 5-15% of all hospital patients acquire nosocomial
infections

• Most commonly involve urinary tract,

respiratory tract, & surgical incisions
• Most common organisms involved gram-
negative intestinal flora, E. coli,
Pseudomonas, Staphylococcus