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Dr.T.V.Rao MD
infection
dictionary means
Dr.T.V.Rao MD
Definitions
Definitions
Pathogenicity and Virulence
Pathogenicity
Principles of Infection
Understanding the basic
principles of infection is
essential for any health
care worker in any field
of health care.
1.Disease transmission
2.Prevention of disease
transmission
Nature of Microorganisms
Microorganisms (microbes)
are small, living organisms
that are not visible to the
naked eye.
Infection is the
invasion of a host
organism's bodily
tissues by
disease-causing
organisms, their
multiplication,
and the reaction
of host tissues to
these organisms
and the toxins
they produce.
Infections are
caused by
microorganisms
such as viruses,
prions, bacteria,
and Viroids, and
larger
organisms
Dr.T.V.Rao
MD
Infection means
What is an Infection?
A harmful invasion and spread of foreign
species, or pathogen, in a host.
VIRUS
Small pox, measles, influenza, Ebola
PRIONS
Cows disease
BACTERIA
Tuberculosis, pneumonia, salmonella,
anthrax
FUNGUS
Athletes foot, ring worm
PROTISTS
Malaria, toxoplasmosis, Algae
COURSE OF INFECTIOUS
DISEASEs
Exposure/Invasion
of Host
Incubation -- period
of time between
exposure and onset
of symptoms -e.g., interval
between HIV
infection and
development of
AIDS can be as
long as 10-15Dr.T.V.Rao MD
Nature of Microorganisms
Saprophy
tes
Parasites
Pathogen
s
a
Viruses
Fungi
Protoz
oa
Helmin
ths
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Prions
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Types of Bacteria
Streptococci (chains)
Staphylococci (clusters)
Diplococci (pairs)
Micrococci (tiny)
Flagellated forms (tails)
Bacilli (rod-shaped)
Vibrios
Spirilla (spiral)
Spirochetes (comma)
Types of Microorganisms
Fungi
Types of Microorganisms
Protozoa
One-celled animal like organisms
often found in decayed materials
and contaminated water.
Many contain flagella which
allow them to move freely.
Cause diseases such as malaria,
trichomonas, and amebic
dysentery.
Types of
Microorganisms
Viruses
Classification of Infections
Primary Infection
Reinfection
Secondary Infection,
Focal infection,
Cross infection,
Nosocomial infections
Iatrogenic infection
Source of Infections
Endogenous
infection
Exogenous
infections
Clinical Presentations
In apparent infection
subclinical Infection
In apparent infection,
Atypical infections
Latent infections
Source of Infection
Source of Infections
Animals
Insects vectors
Mechanical
vector
Biological vector
Soil and water
Food
MODES OF COMMUNICABLE
DISEASE TRANSMISSION
Direct
Transmissi
on
Indirect
Transmissi
on
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Modes of Transmission
Direct contact
Indirect
contact
Droplet
transmission
Hands
Vector-borne
Nosocomial
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Transmission of Pathogens
Direct contact
Indirect contacts
Air
Objects
Vectors
Modes of Transmission
Direct
transmission
Indirect transmission
Direct contact
Airborne
Droplet spread
Vehicle borne
Vector borne
DIRECT TRANSMISSION
Immediate transfer of the disease agent by
direct contact between the infected and the
susceptible individuals
Occurs through such acts as touching, biting,
kissing, sexual intercourse, or by direct
projection (droplet spread) by coughing or
sneezing within a distance of one meter
Examples of diseases for which transmission
is usually direct are AIDS, syphilis,
gonorrhea, and the common cold
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INDIRECT TRANSMISSION
May be one of three types: air-borne, vehicleborne, or vector-borne
Air-borne transmission -- transmission of
microbial aerosols to a suitable port of entry,
usually the respiratory tract
Microbial aerosols are suspensions of dust
or droplet nuclei made up wholly or in part
by microorganisms -- may be suspended
and infective for long periods of time
Examples of air-borne diseases include
tuberculosis,Dr.T.V.Rao
influenza,
Histoplasmosis,
and
MD
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INDIRECT TRANSMISSION
(contd.)
27
INDIRECT TRANSMISSION
(contd.)
Also considered vehicles are water,
milk, food (e.g., common vehicles),
or biological products such as blood,
serum, plasma, organs and tissues
Almost any disease can be
transmitted by vehicles, including
those for which the primary mode of
transmission is direct, such as
dysentery and hepatitis
Causing an Infection
Endogenous disease originates
Redness
Swelling
Tenderness
Warmth
Drainage
Red streaks leading away
wound
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from
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Development of Infection:
Clinical Signs and Symptoms
Local signs
Inflammation
Purulent exudate if bacterial infection;
serous exudate if viral
Tissue necrosis
Lymphadenopathy
Respiratory effects
Systemic signs
Fever, fatigue, headache, nausea
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2. Colonization
Usually at the site of entry
3. Incubation Period
Asymptomatic period
Between the initial contact with the
microbe and the appearance of the
first symptoms
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Generalized Stages of
Infection
4. Prodromal Symptoms
Initial Symptoms
5. Invasive period
Increasing Severity of Symptoms
Fever
Inflammation and Swelling
Tissue Damage
Infection May Spread to Other Sites
Acme (Fastigium)
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Factors predisposing
pathogenicity
Pathogenicity
means ability of
the microbe to
produce disease
or tissue injury
Virulence
May undergo
variation
Virulence and
Pathogenicity
Pathogenicity: capacity of
microbes to cause disease
Virulence: degree of pathogenicity
of specific microbe
Based on:
Invasive qualities
Toxic qualities
Presence of pili or fimbriae for adhesion
Ability to avoid host defenses (mutate)
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Infectious Dose
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Virulence Factors
and Toxins
Enzymatic Virulence Factors
Examples:
Coagulase (Staphylococcus aureus)
Streptokinase (Streptococcus
pyogenes)
Hyaluronidase (Many pathogens)
Collagenase (Many pathogens)
Leukocidin (Many pathogens)
Hemolysin (Many pathogens)
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Protein A
(Staphylococc
us aureus)
Protein M
(Streptococcus
pyogenes)
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Virulence Factors
Virulence factors help bacteria to (1)
invade the host, (2) cause disease,
and (3) evade host defences. The
following are types of virulence
factors:
Adherence Factors: Many pathogenic
bacteria colonize mucosal sites by
using pili (fimbriae) to adhere to cells.
Virulence Factors
Invasion Factors: Surface
components that allow the bacterium
to invade host cells can be encoded
on plasmids, but more often are on
the chromosome.
Capsules: Many bacteria are
surrounded by capsules that protect
them from opsonisation and
phagocytosis
Virulence Factors
and Toxins
Exotoxins
A type of bacterial toxin with the
following properties:
May be produced by either gram-positive or
gram-negative bacteria
Is secreted by the bacteria
The action of the exotoxin does not
necessarily require the presence of the
bacteria in the host
Most exotoxins are peptide or protein
Most exotoxins are heat sensitive (exception:
enterotoxin of Staphylococcus aureus)
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Virulence Factors
and Toxins
Exotoxins (cont.)
Classes of exotoxins: Neurotoxic,
cytotoxic, or enterotoxic exotoxins
Neurotoxins: Interfere with proper
synaptic transmissions in neurons
Cytotoxins: Inhibit specific cellular
activities, such as protein synthesis
Enterotoxins: Interfere with water
reabsorption in the large intestine; irritate
the lining of the gastrointestinal tract
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Endotoxins
Endotoxins: The
lipopolysaccharide
endotoxins on Gram-negative
bacteria cause fever,
changes in blood pressure,
inflammation, lethal shock,
and many other toxic events.
Mechanism of Endotoxin
activity
Exotoxins
Exotoxins: Exotoxins include
several types of protein toxins
and enzymes produced and/or
secreted from pathogenic
bacteria. Major categories
include cytotoxins,
neurotoxins, and enterotoxins.
Exotoxins
Exotoxins, unlike the lipopolysaccharide
endotoxin, are protein toxins released from viable
bacteria. They form a class of poisons that is
among the most potent, per unit weight, of all
toxic substances. Most of the higher molecularsized exotoxin proteins are heat labile; however,
numerous low molecular-sized exotoxins are
heat-stable peptides. Unlike endotoxin, which is a
structural component of all Gram-negative cells,
exotoxins are produced by some members of
both Gram-positive and Gram-negative genera.
Exotoxins
The functions of these exotoxins for the
bacteria are usually unknown, and the
genes for most can be deleted with no
noticeable effect on bacterial growth. In
contrast to the extensive systemic and
immune-system effects of endotoxin on
the host, the site of action of most
exotoxins is more localized and is
confined to particular cell types or cell
receptors.
Exotoxins
Tetanus toxin, for example, affects
only intern uncial neurons. In
general, exotoxins are excellent
antigens that elicit specific
antibodies called antitoxins. Not all
antibodies to exotoxins are
protective, but some react with
important binding sites or enzymatic
sites on the exotoxin, resulting in
complete inhibition of the toxic
Exotoxins
Endotoxin is comprised of toxic
lipopolysaccharide components of the
outer membrane of Gram-negative
bacteria (see Ch. 2). Endotoxin exerts
profound biologic effects on the host and
may be lethal. Because it is omnipresent
in the environment, endotoxin must be
removed from all medical supplies
destined for injection or use during
surgical procedures.
Exotoxins
The term endotoxin was coined in 1893 by
Pfeiffer to distinguish the class of toxic
substances released after lysis of bacteria
from the toxic substances (exotoxins) secreted
by bacteria. Few, if any, other microbial
products have been as extensively studied as
bacterial endotoxins. Perhaps it is appropriate
that a molecule with such important biologic
effects on the host, and one produced by so
many bacterial pathogens, should be the
subject of intense investigation.
Other Factors
Plasmids
Bacteriopha
ges
Compatibilit
y
Coagulase
Fibrinolysin
Hyaluronida
se
Bacterial Appendages
Biofilms
Free floating bacteria come in
contact with medical devices
and attach to them with pili
Infecting Dose
Minimum
infective dose
Minimal lethal
dose
Bacteraemia
Septicaemia
Pyemia
Other types
Endemic disease
Epidemic disease
Pandemic disease
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Antimicrobial agents In
Infection
Anti-infective drugs such as antibiotics,
antiviral, antifungal and ant tubercular drugs
suppress infection. It can be administered by
mouth, topically or intravenously depending
on the infection extent and severity.
Sometimes, if drug resistance is known,
multiple drugs are used to stop drug
resistance and increase drug effectiveness.
Antibiotics only work for bacterial infection
and have no effect on viral ones.
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