Infection

B.PT 2nd Year

Mr. Harit Kumar

Asstt. Professor
Deptt. of Microbiology
 Terminologies
Terminology Explanation
Saprophytes Free-living microbes that live on dead or
decaying organic matter.
- Usually found in soil and water and are
generally unable to invade the living host.
Parasites Microbes that live on a living host, derive
nutrition from the host and also cause
harm to the host.
Commensal Harmless microbes that harbour on a living
s host as normal flora of the host without
causing any injury to the host
 Terminologies

Terminology Explanation
Pathogens Microbes capable of causing disease.
Represents only a very small
proportion of the microbial world.
Opportunisti Causes disease only in
c pathogens immunocompromised people.
 Terminologies
Terminolo Explanation
gy
Infection Process in which a pathogenic organism
enters, establishes itself, multiplies and
invades the normal anatomical barrier of
the host; resulting in disease.
Infectiou When infection becomes apparent
s disease results in clinical manifestation.
 Terminologies
Terminolo Explanation
gy
Colonizat Pathogenic organism enters, multiplies but does not
invade, and neither causes disease or nor elicits
ion specific immune response. (not same as normal
flora).
• Commensals are limited to a particular anatomical
site, e.g. intestine, respiratory and genital tract.
When they enter through other routes, they may
behave as pathogen. (Escherichia coli normal flora
in intestine, but when enters through respiratory
tract can be colonization or infection).
Infestatio Distinct from infection in that it applies specifically to
parasites of macroscopic size, such as parasitic worms
n in intestine or arthropods (e.g. lice, itch mite etc.) on
the body surface.
 Classification of infections

Terminolog Explanation
y
Primary Initial infection with a pathogenic
infection microorganism in a host.
Reinfection Result of subsequent infection by the
same microbe.
Secondary New pathogen sets up an infection in a
infection host whose immunity is already
lowered by a pre-existing infection.
 Classification of infections

Terminolog Explanation
y
Focal Indicates a condition where, due to
infection infection at localised sites (such as in
(or focal the appendix or tonsils), generalised
sepsis) effects are produced.
Cross- When in a patient already suffering
infections from a disease a new infection sets up
from another host or another external
source.
 Classification of infections

Terminology Explanation
Nosocomial Cross-infections occurring in hospitals
infections are called nosocomial infections.
Iatrogenic Refers to the infections induced by the
(or professional activity of the physician
physician or other health care workers resulting
induced) from preventive, diagnostic,
treatment.
 Classification of infections

Terminolog Explanation
y
Depending on the source of infection
Endogenou Source of infection is within the body,
s infections either normal flora if breeches the
anatomical barrier, or endogenous
reactivation of a latent infection.
Exogenous Source is outside the host's own body.
infections
 Classification of infections

Terminology Explanation
Based on the clinical manifestation produced
Asymptomatic or Infection that is active but does
in-apparent or not produce noticeable
subclinical symptoms.
infection
Symptomatic or o Acute infection- here, the
apparent symptoms last for a short term
infections period.
o Chronic infection- symptoms
persist for a long period.
 Classification of infections

Terminology Explanation
Based on the clinical manifestation produced
Latent infection refers to an infection that is
inactive or dormant or in hidden
form; but capable of reactivating
later.
Atypical infection -, the usual manifestations of the
disease are not present. Instead,
atypical symptoms may be
present
 Epidemiological Pattern of Infection

Terminology Explanation
Endemic Infections that occur at a persistent,
usually low level in a certain
geographical area.
Epidemic Infections that occur at a much
higher rate than usual in a particular
geographic area.
Pandemic Infection that spreads rapidly over
large areas of the world.
 SOURCES AND RESERVOIR OF INFECTION

• Source and reservoir are not always synonymous.

• Source-
o The source of infection refers to the person, animal, or
object from which a microorganism is transmitted to
the host.
• A reservoir is the natural habitat in which the
organism lives, multiplies.
 Type of reservoirs
1. Human reservoirs.
2. Animal reservoirs.
3. Non living reservoirs.
 Human reservoirs

Communicable diseases
Cases or patients
Carrier
Incubatory carriers
Healthy carriers
Convalescent carrier
• Temporary carriers
• Chronic carriers
 Animal reservoirs

• Zoonoses - Disease and the infections which are

transmitted to man from vertebrates.
• Common examples include-
o From animals- rabies (from dog), yellow fever (from
monkeys), leptospirosis (from rodents), and influenza
(from pigs), etc.
o Birds may be source of infection for various diseases
like influenza, Chlamydophila psittaci infection
(psittacosis), histoplasmosis etc.
 Non living reservoirs

• Soil and inanimate matter can also act as

reservoir/source of infection.
• Example soil may harbour the agents of
tetanus, anthrax and some intestinal
helminths.
 MODE OF TRANSMISSION

• Microorganisms may be transmitted from the reservoir

or source to a susceptible host in different ways :
o Contact
o Inhalation
o Airborne
o Ingestion
o Inoculation
o Transmission of Blood borne infections
o Vector borne (mechanical or biological)
o Vertical transmission
 Contact transmission

o Direct contact from skin and mucosa of an infected

person- through unclean hand, kissing, or sexual contact.
e.g. Common cold, skin and eye infections and agents of sexually
transmitted diseases (STD) such as HIV, Neisseria gonorrhoeae,
Chlamydia trachomatis and Treponema pallidum etc.
o Indirect contact through the agency of fomites, which are
inanimate objects such as clothing, toys, etc which may be
contaminated by a pathogen and act as a vehicle for its
transmission.
 e.g. face towels shared by various persons may lead to spread
of trachoma.
 Inhalation transmission

• Agents causing respiratory infections are

acquired by inhalational route.
• These organisms are shed into the environment
by patients in secretions from the nose or throat
during sneezing, coughing or speaking in the
form of droplets.
 Air borne transmission

• Droplet nuclei (<10 µm size) can remain suspended in air for long
periods, and can act as source of infection.
• Droplet (dust) transmission- Larger droplets (>10 µm size) travel
for a short distance, settle down on clothing and other objects
and become a part of the dust.
o Respiratory viruses (e.g., influenza, parainfluenza virus, adenovirus,
respiratory syncytial virus) and Bordetella pertussis.
• Airborne (droplet nuclei) transmission-When the droplet is small
(1- 10 µm), it can travel a long distance; can infect any person it
finds on its way. Primary contact with the source is not necessary.
o Organisms transmitted through this route include agents causing
tuberculosis, measles and chickenpox virus.
 Ingestion

• Intestinal infections like cholera, dysentery, food

poisoning and most of the parasitic infections are
acquired by ingestion of food or drink
contaminated by pathogens.
• Food borne infec­tions occur mostly through
carriers engaged in handling or preparation of
food and contaminating the food stuffs.
• The water supply may get contaminated with the
feces of the patients or carriers.
 Inoculation
• Pathogens, in some instances, may be inoculated
directly into the skin or tissues of the host.
• Animal bite- for example, rabies virus is
inoculated directly by bite of a rabid animal.
• Inoculated directly into tissues-Spores of
Clostridium tetani present in the soil, get
deposited directly into the host tissues following
severe wounds leading to tetanus.
 Transmission of Blood borne infections

• Blood borne infections such as hepatitis B,

hepatitis C and HIV may be transmitted by-
o Needle prick and other sharp injuries (with
contaminated sharps)
o Blood transfusion
o Intravenous drug abuse (through contaminated
needles)
 Vector borne (mechanical or biological)

• Arthropod vectors such as mosquitoes, flies, fleas, ticks,

mite, and lice are the vectors that transmit many diseases.
Vector may be of two types.
• Mechanical vectors: These carry the microorganisms
(which do not multiply) and transmit them to the eatables.
• Biological vectors: The pathogen multiplies in the body of
the vector, often undergoing part of a development cycle
in it. Such vectors are named biological vectors (e.g.
female Anopheles mosquito in malaria; Culex mosquito in
filariasis).
 Vertical transmission

• Refers to transmission of infection from mother to the fetus.

• It may be categorized into-
o Transplacental transmission –Infection occurs via the placental
barrier; leads to abortion, miscarriage or stillbirth. If babies are
born, they suffer from congenital malformations. Examples include
TORCH infections-Toxoplasma, Others (Treponema pallidum and
Varicella virus), Rubella, Cytomegalovirus, Herpes simplex virus
• Transmission via the birth canal without causing congenital
malformation in the baby- Examples include-Group B
Streptococcus, Neisseria gonorrhoeae, Chlamydia
trachomatis, Viruses-Hepatitis B, Hepatitis C and HIV, Listeria
monocytogenes.
 Difference between endotoxin and
exotoxins.
Feature Endotoxins Exotoxins
Nature Lipopolysaccharides Proteins

Source Part of cell wall of Secreted both by Gram positive

Gram negative & negative bacteria; diffuse into
bacteria surrounding medium

Released by Cell lysis Actively secreted by the bacteria

Not by secretion
Heat stability Highly stable Heat labile destroyed at 60oC

Mode of action ↑IL-1 and TNF Mostly enzyme like action

Difference between endotoxin and exotoxins.

Feature Endotoxins Exotoxins

Effect Non-specific (fever, Specific action on
shock, etc) particular tissues
Tissue affinity No Specific affinity for
tissues
Fatal dose Only large doses are More potent, even
fatal smaller doses- fatal
Antigenicity Poorly antigenic Highly antigenic

Neutralisation Ineffective Neutralized by specific

by antibodies antibodies

Used for No effective vaccine is Toxoid forms are used

vaccine available using as vaccine; e.g. tetanus
endotoxin toxoid