Host Microbe Interaction

Mark Kerwin F. Sayas, RMT

Adjunct Faculty, Nursing Department
Learning Objectives
• Differentiate the types of infections as to etiology
and distribution.
• Describe the classification of diseases according
to their occurrence
• Explain the phases of infections
• Enumerate virulence factors
Pathogenesis
• Development of an infection and disease
• Virulence agents
• Host
• Disease
Infection
• Involves the growth and multiplication of
microorganisms that cause damage to their host.
• Bodily invasion of pathogenic microorganisms
– Reproduce, multiplication
• Cause disease through local cellular injury, toxin
secretion or antigen-antibody reaction
Types of Infection according to Cause
• Autogenous Infection
– Caused by microorganism form the microbiota of the
host.
• Iatrogenic Infection
– Infection that occurs as the results of some medical
treatment or procedure
• Opportunistic Infection
– Infection that affects immunocompromised hosts
– Overuse of antibiotics, immunosuppressive drugs and
chemotherapeutic agents
Types of Infection according to Cause
• Nosocomial Infection
– Hospital acquired infection
– Four Common Types
• Urinary Tract Infection
• Lung Infection (Pneumonia)
• Surgical Site Infection
• Blood Stream Infection
Types of Infection according to Cause
• Predisposing Factors of Nosocomial Infection
1. Wide variety of microbe in the hospital environment
2. Weakened or immunocompromised patients
3. Chain of Infections (Direct or Indirect)
1. Health Workers to Patients
2. Patient to Patient
3. Use of fomites (catheters, needles, dressings, bed, etc.)
4. Airborne Transmission
5. Vector Borne Transmission
Chain of Infection
Types of Infection according to host
distribution
• Local Infection
• Focal Infection
• Systemic Infection (Generalized Infection)
Local Infection
• Signs and symptoms are confined in one area
• Wounds, Boils, Abscess
Focal Infection
• Local infection  spread to the other parts
• Tooth infection, Tonsillitis, Wound Infection caused
by Clostrodium tetani
Systemic Infection
• Microbes spread throughout the body via blood or
lymph
– Bacteremia
– Septicemia
– Pyemia
– Toxemia
Bacteremia
• Presence of bacteria in blood
• Bacteria invade the bloodstream without active
multiplication
• Highest concentration of bacteria in the blood
occurs before the fever spikes.
Septicemia
• Active multiplication of the invading bacteria in the
blood.
Pyemia
• Condition wherein pus-producing organism
repeatedly invade the blood stream and become
localized at different parts of the body.
Toxemia
• Presence of toxin in blood
• Bacteria are localized in one area but produce
toxin that spreads and gets absorbed by the body
cells.
Extent of Infection
• Primary Infection
• Secondary Infection
• Latent Infection
• Mixed Infection
• Acute Infection
• Chronic Infection
Extent of Infection
• Primary Infection
– Initial infection that causes the illness
– Common Cold

• Secondary Infection
– Caused by opportunistic pathogen after the primary
infection
– Pneumonia, Bronchitis
Extent of Infection
• Latent Infection or Silent Phase
– Causes no noticeable illness
– Severe and acute infections manifest
– Asymptomatic Polio Fever

• Mixed Infections
– Two or more microorganisms
– Wound Infection
Extent of Infection
• Acute Infection
– Infection that develops and progresses slowly
– Whooping cough

• Chronic Infection
– Infection in which develops slowly with milder but
longer-lasting symptoms
– Tuberculosis
Routes of Infection
• Direct Transmission
Congenital Streptococcus agalactiae,
Neisseria gonorrheae, Treponema
pallidum subsp. pallidum
Sexual Contact Neisseria gonorrheae, Treponema
pallidum, Chlamydia trachomatis
Infectious Respiratory Streptococcus pyogenes,
Secretions and Droplets Neisseria meningitidis
Hand-to-hand Transmission Rhinovirus
Routes of Infection
• Indirect Transmission
– Fomites
– Water : Salmonella, Shigella & Vibrio
– Arthropod Borne: Borrelia, Francisella & Yersinia
Disease
• Specific illness or disorder
• Characterized by recognizable set of signs and
symptoms which are attributable to heredity,
infection, diet or environment
• Results when the infection produce notable
change in the human physiology
Classification of Infectious Diseases
• Communicable or Contagious Disease
– Spreads from one host to another, either directly or
indirectly
– Tuberculosis, Herpes, Flu and Chickenpox

• Non-communicable Disease
– Not spread from one host to another
– Caused by external microbes or opportunistic
pathogen
– Tetanus and botulism
Classification of Disease According to
occurrence
Classification Description
Sporadic Occurs occasionally
Disease
Endemic Constantly present in a particular location
Disease or population
Epidemic Disease affects a large number of people in
Disease a given population in short span of time
Pandemic Disease that affects population across
Disease large regions around the world
Effects of Infectious Disease
• Signs
– Objective changes that can be measured
– Fever, Redness, Swelling and Paralysis
• Symptoms
– Subjective indications of the disease in person
– Pain and Malaise
• Syndrome
– Groups of signs and symptoms
– AIDS
Classification of Disease According to
occurrence
Period Description
Incubation Time between the exposure to a
pathogenic organism; onset of symptoms
Prodromal Appearance of signs and symptoms
Clinical Peak of characteristics of signs and
symptoms of infection or disease
Decline Signs and symptoms begin to subside
Convalescenc Period in which the surviving host is
e recuperating towards full recovery
Predisposing Factors of Disease
• Gender
• Genetic Factors
• Climate and Weather
• Nutrition
• Fatigue/Stress
• Environment
• Lifestyle
• Age
• Occupation
General Classes of Pathogens
• True Pathogens
– Able to invade tissues of healthy individuals
– Normally found outside the host

• Opportunistic Pathogens
– Normally do not cause in their natural habitat
– Capable to cause disease if the host is
immunocompromised
Example of Opportunistic Pathogens
• Neisseria meningitidis
– Usually harmless in the respiratory tract but may cause
meningitis

• Escherichia coli
– UTI
Host Microbe Relationship
• Symbiosis
• Mutualism
• Commensalism
• Parasitism
Virulence
• Ability of microorganism to cause disease
• Degree of pathogenicity
• Factors Influencing Microbial Virulence
– Toxic Factors
– Enzymatic Factors
– Cellular Structure
Toxic Factors
• Toxins are substances produced by pathogenic
microorganisms causing tissue and cellular
damage
– Diptheria toxin
– Tetanospasmin
– Botulism Toxin
– Enterotoxin
– Streptococcal Erythrogenic Toxin (Scarlet Fever)
Enzymatic Factors
• Produced by bacteria that aid in the spread of
infection and disease
• Hyaluronidase
• Coagulase
• Leukocidin
• Collagenase
• Streptokinase
• Hemolysin
• Lecithinase
Cellular Structure
• Capsule resist phagocytosis
• Bacillus anthracis, Klebsiella pneumoniae,
Streptococcus pneumoniae
Host Resistance Factors
• Physical Barriers
– Skin serves as the physical and chemical barrier
– Outer layer of the skin provide impenetrable physical
barrier
– Urethral opening, Flushing Actions of urination
Host Resistance Factors
• Cleansing Mechanism
– Nasal hairs keep out airborne particles
– Cough-sneeze reflex
– Trachea – cilia
Indigenous/Normal Flora
• Commonly found in the body sites of healthy
person
• Microbiota
• Two types
– Resident Microbiota
• Temporarily inhabit, multiply in and colonize for months to
year
– Transient Microbiota
• Inhabit but don’t multiply, colonize an area until they are
eliminated
Body Sites and Microbiota
Body Site Microbiota
Skin Staphylococcus, Propionobacteria and
Corynebacterium
Mouth and Viridans Streptococcus
Oral Cavity
URT Viridans Streptococcus, Corynebacterium,
Staphylococcus epidermidis
Nasopharynx Staphylococcus aureus, Staphylococcus epidermidis,
Neisseria meningitidis (asymptomatic)
Colon Escherichia coli, Bacteriodes and Lactobacillus
Urethra Diptheroids, S. epidermitis, Alpha and Non-Hemolytic
Streptococcus
Notes to Remember
• H. influenzae, S. pneumoniae & N. meningitidis
are found in nasopharynx of healthy individuals.
• Small intestine contains few bacteria which
originates from colon
• Kidneys, bladder and fallopian tube are normally
sterile or free of microorganisms
Host Resistance Factors
• Phagocytosis
– Process by which phagocytes engulf and dispose
microorganisms
• Inflammation
– Serves as reinforcement mechanism against microbial
survival and proliferation of tissues and organs
• Immune Response
– Provides human host with the ability to create specific
protective response against microorganisms
Routes of Transmission
• Airborne Transmission
– Respiratory spread of infection disease is common
– Lower Respiratory Tract Infections less common
– Upper Respiratory Tract Infections more common
– Sneezing, Coughing and Talking
– Tuberculosis, Brucellosis, Tularemia, Legionellosis,
Plague
Routes of Transmission
• Transmission by Food or Water
– Fecal-oral-route
– Salmonella, Campylobacter, Yersinia enterolitica,
Escherichia coli O157:H7, Legionella and Aeromonas
• Close Contact
– Passage of organism through
– Salivary: Herpes simplex
– Skin: Warts and Syphilis
– Genital Tract: Gonorrhea, Syphilis and Hepatitis
Routes of Transmission
• Cuts and Bites
– Infections through the normal oral microbiota
• Arthropods
– Multiply within the arthropod
– Malaria
• Zoonoses
– Animal disease
– Plague, Brucellosis, Tularemia and Listeriosis