Microbiology

Week 7
presented by Amanda Arceo

Epidemiology

Keyword Concepts

infection and disease

epidemiology
nosocomial infections

Keywords

parasite
infection
disease
microbial antagonist
infectious disease
contagious disease
pathogenicity
virulence
epidemiology
incidence
prevalence
nosocomial infections

Host-Microbe Relations
symbiosis: interaction between two different organisms in
close proximity
mutualism: both species benefit from the interaction
(++)

parasitism: one species benefits while the other is harmed

by the interaction
(+-)

commensalism: one species benefits while the other is not

impacted by the interaction
(+0)

antagonism: both species are harmed by the interaction

(--)

contamination
microorganisms are present on an object, may be
parasites or non-parasitic microbes
IF a parasite is able to enter the body, it has the
possibility to create an infection
infection = the multiplication of parasitic organisms
inside the host
may or may not lead to disease/change in health

pathogenicity
not all pathogens have the same capacity for
causing disease
the capacity to produce disease is known as
pathogenicity
the intensity of the disease produced is called
virulence

your body
Your body has about 10
trillion human cells
and around 100 trillion
microbial cells!

Normal Microbiota
includes the well-established, permanent
colonization of microorganism on the body
Two types of normal microbiota:
resident
always present

temporary
comes and goes without notice

Where is it found?
conjunctiva

rectum

nose

urethra

mouth

vagina

pharynx

*not ALL parts of the body

contain normal microbiota

skin
large intestine

Opportunists
opportunists will cause disease if conditions are
correct:
immune system failure
introduction to new areas
changes in the normal microflora

microbial antagonism
normal microbiota compete with invaders
decrease the chance of infection

Difference in Disease
infectious
caused by pathogens

non-infectious
not caused by pathogens

Difference in Disease
communicable
spread from one
host to another

contagious
a communicable
disease that
spreads easily

non-infectious
do not spread host
to host but use
anther method,
such as
opportunistic
pathogens, toxin
ingestion,
environmental
exposure, etc.

the disease process

in order to cause disease, a microorganism must
first gain entry to the host and beat the immune
system in order to establish colonization
virulence factors are structural or physiological
characteristics that aid a microorganism in causing
an infection
adherence (attachment) to a host cell is the first step
most bacteria utilize adhesins, proteins that exist on
external structures that help them recognize and
attach to host cells

the disease process

once attached, the degree of invasiveness, ability to
invade the tissues, is related to the virulence factor
of the specific pathogen
few enzymes produced can greatly aid in this process
coagulase
accelerates blood clotting, walling off the bacteria from the
immune system

streotpkinase
dissolves blood clots, allowing the organism to spread

other issues
some diseases arent caused by the bacteria, rather
by the toxins produced by the bacteria
Endotoxins
lipopolysaccharide complexes created by gram negative
bacteria
large dose needed to cause disease

Exotoxins
often enzymes produced by gram-positive bacteria
small dose can produce very serious disease
ex: Clostridium botulinum can kill a human who puts
contaminated food into their mouth briefly before spitting it
out.

clinically important
exotoxins
hemolysins
lyse blood cells and partially or completely break down
hemoglobin
these have different appearances on blood agar plates and can
be used to differentiate between different species of
microorganisms.

leukoccidins
damage white blood cells; particularly the phagocytic white
blood cells

neurotoxins
acts on nervous system

enterotoxins
acts on your gut

Important terms
acute disease
develops rapidly and runs its course quickly

chronic disease
develops slowly, usually less severe, persists for a
long-time

subacute disease
between acute and chronic

latent disease
there is a period of inactivity between outbreaks

important terms
local infection

confined to a specific area of the body

focal infection

confined to a specific area but the pathogens, or their toxins, can spread to other areas

systemic infection

affects most of the body with the pathogens widely distributed

primary infection

initial infection by a pathogen

secondary infection

occurs when another pathogen causes disease after a primary infection, usually due to a
weakened immune system.
This is considered a superinfection if the disease results from the loss of microbial antagonism.

subclinical infection

do not have a syndrome associated with the disease, so the individual never knows they were
sick, but the immune response still occurs giving immunity

Four stages of infection

Incubation period
no signs or symptoms

Prodromal phase
vague symptoms

Invasive/Declining Phase
invasive: most severe signs and symptoms
decline: declining signs and symptoms

Convalescence period

turn to p. 415, figure 14.9

Epidemiology
the study of frequency and spread of diseases in a population

etiology is the study of what causes infectious diseases

the incidence of a disease is the number of new cases that occur during a
specific period of time
the prevalence of a disease is the total number of cases of a disease over
a set period of time
incidence is used to study the spread of a disease where prevalence
measures how seriously the disease impacts the population
morbidity rate is the number of individuals affected by a disease during a
set period
mortality rate is the number of deaths due to the disease during a set
period

epidemiology
diseases in a population are evaluated based on the
geographic area affected and the degree of harm, then
classified into one of several categories
endemic is always present in the population at low numbers
epidemic is when a disease has a sudden increase in
incidence in a certain population
pandemic is when an epidemic goes worldwide
sporadic diseases occur randomly and unpredictably
common-source outbreak is an epidemic that arises from
contact with a contaminated substance
(p. 426-428)

epidemiology
collecting frequency data is the basis of epidemiologic study

descriptive epidemiology looks at the physical aspect of an existing

disease and its spread by recording number of cases, segments of
population affected, and location/time period of the cases.
This is what the CDC does to find the source of a salmonella outbreak.

Analytical study focuses on cause-effect relationships investigating where

individuals had been and what they had done versus a control group.
Florence Nightengale used analytical study to examine the rates of
typhoid in general population versus soldiers in the east.
Experimental studies are designed to test a hypothesis about treating.
This is the most common way drug studies are run utilizing a placebo in a
double-blind set up so that nobody in the room with the drug knows if it its
really the drug or a placebo that theyre taking.

infection sites and

transmission
the sites a pathogen can enter the body are called
portals of entry
skin
mucous
membranes of the digestive, respiratory and urogenital
systems
any opening to the outside of the body

infection sites and

transmission
Pathogens may be introduced via:
tissue damage such as bites, burns injections and
wounds
some viruses can cross the placental barrier
portal of entry varies by pathogen species, some can
only utilize one while others are capable of utilizing
multiple

Then what?
Getting inside is only part of the battle
after a pathogen survives the immune system to become
a disease, it must be passed on to another host to
ensure survival.

Portals of exit often involve bodily fluids or feces:

coughing, sneezing, saliva, urine, semen, blood, breast
milk
the method by which the pathogen is passed host to host
is known as the mode of disease transmission
p. 435

nosocomial infection
is acquired from a hospital or other medical facility
10% of all patients in the US will acquire a
nosocomial infection
one of the leading causes of death in the U.S.

nosocomial infection
can be exogenous, caused by organisms that enter
the patient from the environment or endogenous
which are caused by opportunists among the
patients normal microbiota.
Patients in hospitals have a much greater
susceptibility to pathogens due to the fact that they
are a compromised host (p. 451)

Sites of nosocomial
infection
Most frequentleast frequent

urinary tract
surgical wounds
respiratory tract
skin
blood
GI tract
CNS

Prevention?
Universal Precautions (created by CDC)
all hospitals must monitor nosocomial infection and
have prevention and treatment plans in place