Spread of Infection

Dr. Linroy D. Christian

Microbial Interactions with Humans

Billions of bacterial cells are present in or on the human body Normal Flora
Beneficial organisms Intimately associated with various body sites

Parasites
Live in or on the host and may be harmful to the host Many parasites are pathogens

Normal Flora
Are commensals and generally do not harm the host. Some play a role in the nutrition of the host Different species occupy different sites in or on the body. This is dependent upon the characteristics of the site such as pH, oxygen content, temperature and nutrition Some species may be transient at some sites whereas others are resident flora

Benefits of Normal Flora

Prevent invasion of harmful species Challenge the immune system Some species produce vitamins B and K in the intestines Steroid metabolism

Normal Flora of the Oral Cavity

During the first year of life the flora is predominantly aerotolerant bacteria such as streptococci and lactobacilli When teeth appear there is a shift to more anaerobic bacteria and bacteria adapted to growth on surfaces and in the crevices of teeth Dental plaque forms on teeth and is constituted by bacterial cells in a matrix with extracellular polymers and salivary products The bacterial species associated with plaque include streptococci, fusobacteria, spirochetes, diphtheroids and some gram negative cocci

Normal Flora of the Gastrointestinal Tract

Normal Flora of the Genitourinary Tract

E. coli, Proteus mirabilis and other gram negative rods attach to the epithelial cells that line the urethra The vagina of adult females is generally weakly acidic and contain significant numbers of Lactobacillus acidophilus which ferments the glycogen to produce acid Before puberty the vagina is alkaline and lacks L. acidophilus and does not produce glycogen. The flora is predominantly streptococci, staphylococci, diphtheroids and E. coli Other normal flora of the adult female vagina may include yeasts, streptococci and E. coli

Pathogens
Pathogenic microorganisms are able to invade tissue and cause infection which may lead to disease Pathogenicity The ability of a microbe to cause disease Virulence The degree of pathogenicity of the microbe Some pathogens may be opportunistic pathogens

Susceptibility to Infection
A pathogen must gain access to the body before damage can be done Access is generally prevented by physical barriers such as the skin, mucous membranes and the intestinal epithelium If injury occurs, pathogens can gain access across these barriers The other line of defense is the host immune system

Susceptibility to Infection
The general well-being of the host as well as use of chemotherapeutic agents influence the susceptibility of the host In some instances normal flora organisms may act as opportunistic pathogens Normal flora from one site may migrate to another site and cause an endogenous infection Example, E. coli infections of the urinary tract

Stages in the Development of Infection

Penetration of the Tissue
Microbes must be able to adhere to specific cells Microbes must be able to withstand host defense

Some microbes may produce toxins that cause damage to the cell Other microbes grow and penetrate into the tissue and cause damage

Stages in the Development of Infection

Multiplication in the host
The initial dose of the pathogen is not always enough to cause disease symptoms. The pathogen must grow in order to produce disease Growth is dependent upon availability of nutrients, oxygen, temperature and interaction with the normal flora

Stages in the Development of Infection

Spread to other tissue
Some pathogens remain at the site of infection and produce localised symptoms Other pathogens migrate and cause widespread infection Spread of infection is based on host conditions as well as the virulence factors of the pathogen

Stages in the Development of Infection

Tissue damage
This may occur due to the action of enzymes and other proteins:
Collagenase Coagulase Hemolysin

May occur due to the action of toxins

Endotoxins Exotoxins

Sources and Reservoirs of Microorganisms

The site where the organism live is referred to as its reservoir Reservoirs are not always the source of infection Organisms persist in the environment in reservoirs It is important to identify the source of infection during outbreaks

Example of Reservoirs
Soil Clostridium tetani Water Legionella pneumophila Cattle E. coli Poultry Salmonella Human respiratory tract Rhinovirus Human gut Rotavirus

Route of Microbial Transmission

Microbes generally gain access through the respiratory tract by inhalation and to the gut via ingestion In order to spread to another host the microbe must be excreted. They can be excreted in the form of droplets from the upper respiratory tract and also from the gastrointestinal tract Transmission may be direct or indirect

Direct Transmission
Direct contact between body surfaces Direct contact with bodily secretions
Respiratory Genitourinary Gastrointestinal

Indirect Transmission
Airborne particles Hands Equipment Food and water Insects and animals

Excuse me

Epidemiology
The study of incidence and prevalence of disease in a population
Incidence refers to the number of infected individuals Prevalence refers to the proportion of the population that is infected

Some diseases may be always present in a population in low numbers, referred to as an endemic disease

Epidemiology
Infections may spread leading to an outbreak in a particular location, this is referred to as a epidemic A pandemic occurs when the infection is worldwide