Host-Microbe Interactions

Normal Microflora

● Normal resident flora (biota)

○ refers to a large array of microorganisms that favorably inhabit
the human body in abundance

● Acquiring resident flora:

○ Microbes accumulate over time immediately following birth by
simple interaction with the environment
 Normal Microflora

● The normal microflora even plays a role in the body’s

defense by producing antibodies and inhibiting entry
and growth of other pathogens

● Some pathogens can be found among the normal

flora but generally don’t cause problems because
competition limits their growth
○ Some can become opportunistic pathogens, e.g. E. coli and
Pneumocystis jirovecii
 Normal Microflora

● Microbes are found almost everywhere on and in the

body but are more prominent in locations exposed to
the environment (skin and digestive tract)

● Transient microflora
○ may be present for several days, weeks, or months and then
disappear
 Initial Colonization

● Uterus is normally sterile but at birth, microbes from

the vagina can enter the womb and colonize the skin
of the baby
● During birth the baby is exposed to more microbes
● Respiratory system colonization from first breath
● Intestine colonization at first feeding
● Stabilization of the eventual adult flora occurs
following weaning, the introduction of solid food, and
the eruption of teeth
Relationship between normal biota and host

● Microbial antagonism
○ Example: E. coli produces bacteriocins that can inhibit
Salmonella and Shigella
○ Another example is the inhibition of C. albicans growth due to
the presence of normal microbiota
● Mutualism – both parties benefit
● Commensalism – one benefits, the other is
unaffected
● Parasitism – one benefits, the other is harmed
 Cooperation Between Microbes

● cooperation among microbes can also be a factor in

causing disease
○ For example, pathogens that cause periodontal disease and
gingivitis have been found to have receptors, not for the teeth,
but for the oral streptococci that colonize the teeth.
 Classifying Infectious Diseases

● Symptoms – changes in body function, e.g. pain and

malaise
● Signs – objective changes that the physician can
observe and measure; e.g. fever, lesions
● Syndrome – a specific group of symptoms
accompanying certain signs
 Classifying Infectious Diseases

Classification:
● Communicable – infectious agent transferred from
infected person to another, who also becomes
infected; e.g. chickenpox, flu
● Contagious – very communicable diseases
● Non-communicable – cannot transfer from one
person to another
 Disease Occurrence

● Incidence - number of people in a population who

develop a disease during a particular time period
● Prevalence - number of people in a population who
develop a disease at a specified time

● Frequency:
○ Sporadic - occasionally occurring
○ Endemic – constantly present in population, e.g. Common
cold
○ Epidemic – many people acquire disease in a very short time
○ Pandemic – global scale
 Severity and Duration

● Acute – develops rapidly but lasts only a short while,

e.g. influenza

● Chronic – develops more slowly

● Subacute – between acute and chronic

● Latent – causative agent is inactive for some time but

then becomes active
 Extent of Host Involvement

● Local infection – confined to a small area of the body,

e.g. boils

● Systemic (generalized) – spread by blood or lymph

● Focal – confined to a specific part, e.g. teeth, tonsils

● Sepsis - spread of microbes, especially bacteria or

their toxins, from a focus of infection
 Exposure and Infection

● Carrier - harbors a particular pathogen without

manifesting any signs and symptoms

● Exposure - process of inoculating an infective agent

● Infection - establishment of the infective agent in

the host
 Stages

● Incubation - interval between the initial infection

and the first appearance of any signs or symptoms

● Prodromal - characterized by early, mild symptoms

of disease, such as general aches and malaise

● Period of illness – disease is most severe; overt

signs and symptoms
 Stages

● Period of decline - signs and symptoms subside;

patient is vulnerable to secondary infections

● Period of convalescence - the person regains

strength and the body returns to its prediseased state.
Recovery has occurred
 Reservoirs of infection

Source of infection
● Human carriers
● Animal reservoirs – zoonoses are diseases that
occur in wild animals and can be transmitted to
humans, e.g. rabies and leptospirosis
● Nonliving: soil and water

● Vectors such as mosquitoes

○ Mechanical and biological
 Transmission

● Direct contact
● Indirect contact by fomites (nonliving object involved
in spread of infection) such as handkerchiefs
● Droplets, e.g. from sneezing
● Vehicle transmission, e.g. from water, food or air
 Epidemiology

● The science that studies when and where diseases

occur and how they are transmitted in populations
Microbial Mechanisms of
Pathogenicity
Production of disease is a series of steps
● Transmission to a susceptible host
● Adherence to appropriate target tissue
● Invasion
● Colonization
● Damage to host while evading defenses
● Exit from host
● Survival before being transmitted to another host
 Infection

1. Pathogenicity
●Refers to a microorganism’s potential to cause an
infection or disease
○ True pathogens are microbes with the ability to cause
disease in individuals with normal immune systems
○ Opportunistic pathogens cause disease when the defenses
are compromised
 Infection

2. Virulence factors
●Properties that enable a microbe to invade and
infect a host
●Virulence
○ The ability of a microbe to cause infection that takes the
presence or absence of virulence factors into account
 Human-Microbe Interaction

3. Portal of Entry
●The characteristic route that a microbe takes to
enter body tissues
○ Exogenous agents enter the body from the outside
environment; ex. common cold
○ Endogenous agents already exist in the body; ex.
Candidiasis
●Many pathogens only cause disease when they enter
through a specific portal
 Human-Microbe Interaction

●Skin as a portal
1) Most pathogens enter through damaged areas
in the skin
2) Some can burrow through the skin or enter
through insect bites
3) The conjunctiva is also susceptible to
infection
 Human-Microbe Interaction

●GI tract as a portal

1) A large number of microbes enter through the
mucus membranes
2) The rectum isn’t a normal portal of entry for
microbes but may become a portal with individuals
who practice anal sex
●Respiratory tract as a portal
1) Smaller microbes are more likely to enter
through this portal
 Human-Microbe Interaction

●Urogenital tract as a portal

1) The agents of sexually transmitted diseases and
urinary tract infections (UTI’s) enter here
2) Some enter directly through the skin (broken or
unbroken); others enter via the urethral mucosa or
vaginal lining
 Human-Microbe Interaction

4. Invasion
●Adhesion
○ Process by which microbes
gain a more stable position in
the body
○ Bacteria often attach via
fimbrae, flagella, pili, slime
layers, or capsules
 Human-Microbe Interaction

● Viruses often attach to a specific receptor on the cell

surface; may involve specific viral proteins (spikes)
● Protozoa use their structures of locomotion to burrow
into the host cell
● Worms mechanically fasten using suckers, hooks or
barbs
 Evading Host Defenses

● Enzymes
● Antigenic variation – altering surface antigens;
some bacteria have alternative genes
○ Neisseria gonorrhoae and Trypanosoma brucei, among others
● Host cytoskeleton penetration – e.g. production
of invasins that rearrange actin filaments of the host
cell
 Human-Microbe Interaction

●Tissue damage
1) Often caused by a microbe’s virulence factors
a) Enzymes
i) Directly inflict tissue damage
ii) Breakdown a host’s defenses and allow
the microbe to move deeper into the tissue
 Human-Microbe Interaction

Examples:
(a) Mucinase – digest the
protective coating on mucus
membranes
(b) Keratinase – digests keratin,
a primary component of skin,
hair, and nails
(c) Collagenase – digests the
collagen fibers of connective
tissue
(d) Hyaluronidase – digests the Hyaluronidase
component holding animal cells destroys loose CT
together
 Human-Microbe Interaction

b) Bacterial toxins
●Toxin is any chemical that is poisonous to another
organism
(a) Exotoxin – released by living bacterial cells
into infected tissue
(b) Endotoxin – released when the bacteria are
damaged or destroyed
 Human-Microbe Interaction

5. Infection Types
●Localized infection
●Mixed infection
●Systemic infection
●Focal infection
 Human-Microbe Interaction

D) Related Terms
a) bacteremia – circulation of bacteria in the
bloodstream
b) septicemia – acute illness caused by bacteria or
toxin in the blood (a.k.a blood poisoning)
c) toxemia – the agent remains localized but its
toxins are spread throughout the body
d) viremia – circulation of a virus in the blood
 Human-Microbe Interaction

6. Portal of Exit
●Specific route taken by pathogens to leave the host
●Often exit through the same portal of entry
●Respiratory & Salivary Portals
1) Mucus, sputum, saliva, nasal drainage and other moist
secretions act as media for exit
2) Breathing, coughing, sneezing, laughing and talking
push these pathogens into the environment
 Human-Microbe Interaction

●Skin Scales
1) Most individuals shed billions of dead skin
cells each day and it is the largest component of
household dust
2) Potential exit for the agents of fungal skin
infections, syphilis, herpes simplex and
smallpox
 Human-Microbe Interaction

●Fecal exit
1) Common exit for intestinal pathogens and
helminth worms (specifically eggs or larva)
2) Fecal contamination of drinking water and its
use as a fertilizer often raise public health issues
 Human-Microbe Interaction

●Urogenital tract
1) Vaginal discharge/semen
a) STDs
b) Vagina is also location of neonatal infectious agents
2) Urine
a) High acidity make is less common mode of exit but
agents of typhoid fever and tuberculosis may exit in urine
 Human-Microbe Interaction

●Blood
1) There is no natural exit for blood except menses
2) Blood-feeding insects often carry pathogens from
human blood
3) Shared needles and small abrasions causes by
intercourse can also result in the transmission of
pathogens especially HIV and hepatitis