10ch34 Lecture

Brock Biology of Microorganisms
Twelfth Edition
Madigan / Martinko Dunlap / Clark
Chapter 34
Person-to-Person Microbial Diseases
Lectures by Buchan & LeCleir
Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings
Types of Person-to-Person Disease Transmission

Respiratory
Contact
Sexually Transmitted Infections (STIs)
High-Speed Photograph of an Unstifled Sneeze
Figure 34.1
I. Airborne Transmission of Diseases

34.1 Airborne Pathogens
34.2 Streptococcal Diseases

34.3 Cornyebacterium and Diphtheria 34.4 Bordetella and Pertusis 34.5 Mycobacterium, Tuberculosis, and Hansens Disease 34.6 Neiserria meningitidis, Meningitis, and Meningococcemia
34.7 Viruses and Respiratory Infections

34.8 Colds 34.9 Influenza
Aerosols are important vehicles for person-to-person transmission of many infectious diseases Most pathogens survive poorly in air, thus, are effectively transmitted among humans only over short distances

Respiratory Infections
Different pathogens characteristically colonize the respiratory tract at different levels The upper and lower respiratory tracts offer different environments and favor different microbes
The Respiratory Tract of Humans
Figure 34.2

Streptococcus pyrogenes (group A Streptococcus; GAS)
Commonly found in low numbers in the upper respiratory tract of healthy individuals Causative agent of strep throat Can also cause infections of the inner ear, mammary glands, and skin
Infections occur if host defenses are weakened or a new

highly virulent strain is introduced
Lancefield Typing Scheme for -hemolytic Streptococci
Streptococcal Pharyngitis
Epidemiology Recurrent disease due to reinfection or treatment failure, not resistance to penicillin
Erysipelas: A S. Pyogenes Infection of the Skin
Figure 34.5

Streptococcus pyrogenes (contd)
Certain GAS strains carry a lysogenic bacteriophage that encodes exotoxins responsible for symptoms of toxic shock syndrome and scarlet fever Untreated or insufficiently treated infections can lead to
other diseases (e.g., rheumatic fever)
Symptoms Characterized by Difficulty swallowing Fever
Red throat with pus patches

Enlarged tender lymph nodes
Localized to neck
Most patients recover uneventfully in approximately a week
Causative Agent
Streptococcus pyogenes
Gram-positive Coccus in chains
hemolytic
Complete hemolysis of red blood cells
Commonly referred to as Group A

Streptococcus
Due to group A carbohydrate in
Pathogenesis Causes a wide variety of illnesses Due to numerous virulence factors Bacteria produces enzymes and toxin that destroy cells Complications of infection can occur during acute illness Examples include scarlet fever Caused by strains infected by lysogenic bacteriophage which has the gene for erythrogenic toxin
-hemolytic Streptococci
Streptococci which produce -hemolysis on sheep blood agar Typing scheme based on cell wall antigens developed in 1930s by Dr. Rebecca Lancefield, a microbiologist at Rockefeller Institute for Medical Research Group A = Strep pyogenes Group B = Strep agalactiae
etc
Pathogenesis Certain complications can develop late post streptococcal sequelae Acute glomerulonephritis Accumulation of Ab in kidney Acute rheumatic fever Anti-GAS Ab cross rx w/ heart tissue
Treatment Prevention
No vaccine available
New possibilities on horizon
Confirmed strep throat treated with 10 days of antibiotics

Penicillin or erythromycin are drugs of choice
Eliminates organisms in 90% of
cases
Adequate ventilation Avoid crowds Sore throats in presence of fever should be cultured for
prompt treatment
Prompt treatment is essential to prevent complications
Scarlet Fever
Figure 34.6
Typical Lesions of Impetigo
Figure 34.4
Streptococcus pneumoniae is the causative agent of pneumonia Definitive diagnosis of streptococcus strains is by culture
Infections by both strains are treatable by antimicrobial

agents, but drug-resistant strains of S. pneumoniae are common
The Gram-Positive Pathogen Streptococcus Pneumoniae
Figure 34.3
34.3 Cornyebacterium and Diphtheria

Diphtheria
A severe respiratory disease that typically infects children
Caused by Cornyebacterium diphtheriae

A bacterium that forms irregular rods during growth
Preventable and treatable
Diphtheria: Cells of Corynebacterium diphtheriae
Figure 34.7a

Cornyebacterium diphtheriae
Spread by airborne droplets and enters the body via the respiratory route
Previous infection or immunization provides resistance

Pathogenic strains lysogenized by bacteriophage produce a powerful exotoxin that causes
Tissue death The appearance of the pseudomembrane in the patients throat
Pseudomembrane (Arrows) in Active Case of Diphtheria
Figure 34.7b

Diagnosis of Diphtheria
C. diphtheriae must be isolated from the throat
Prevention of Diphtheria
Accomplished with a highly effective vaccine
Treatment of Diphtheria
Treated with antibiotics Diphtheria antitoxin available for acute cases
Early administration necessary
34.4 Bordetella and Pertussis

Pertussis (whooping cough)
An acute, highly infectious respiratory disease Caused by infection with Bordetella pertussis Observed frequently in school-age children Characterized by a recurrent, violent cough There has been a consistent upward trend of infections since
the 1980s
Inadequately immunized children, adolescents, and adults are at high risk for acquiring and spreading pertussis
Whooping Cough
Pathogenesis Enters respiratory tract with inspired air and attaches to ciliated cells Organism colonizes structures of the upper and lower
respiratory tract
Mucus secretion increases, pertussis toxin kills ciliated cells Cough reflex is only mechanism for clearing secretions
Pertussis in the United States
Figure 34.8
34.4 Bordetella and Pertussis

Diagnosis
Made by fluorescent antibody staining of a nasopharyngeal swab specimen & culture of the organism PCR molecular dx
Prevention
Administration of vaccine soon after birth
Treatment
Treated with antibiotics But elimination is helped by the immune response
Whooping Cough
Treatment Prevention
Directed at vaccination of infants
Prevents disease in 70% of individuals Acellular Pertussis vaccine combined with diphtheria and tetanus toxoids (DTaP)
Injections given at 6 weeks,
Azithrothromycin is effective at reducing symptoms if given early Antibiotic usually eliminates bacteria from respiratory secretions
4,6,and 18 months
Immunity wanes by adolescence
Atypical Bacterial Pneumonias

Mycoplasma pneumoniae Mycoplasmas lack a cell wall Chlamydia pneumoniae Obligate intracellular pathogens
Legionella pneumophila
Require special media i.e. BCYE
Respiratory Chlamydial Infections C. psittaci causes respiratory disease in Psittacine birds,
psittacosis (pneumonia) in humans
C. pneumoniae - walking pneumonia in humans
34.5 Mycobacterium, Tuberculosis, and Hansens Disease

Tuberculosis
An important infectious disease of humans worldwide Incidence is increasing in part because of the emergence of
drug-resistant strains
M. tuberculosis is transmitted by airborne droplets Cell-mediated immunity plays a critical role in the prevention of active disease after infection Classified as a primary (initial) infection or postprimary infection (reinfection)
Tuberculosis is caused by Mycobacterium tuberculosis Hansens disease (leprosy) is caused by M. leprae All mycobacteria are acid-fast due to the waxy mycolic
acid content of their cell walls

Require special culture media containing lipids for cell wall Long incubation period, 4-6 weeks, due to long generation time
Tuberculosis
Pathogenesis Cell-mediated immune response Organisms are carried to lymph nodes Granulomas produced in infected areas

Primary Infection
Hypersensitizes the patient to the bacteria and alters the individuals response to subsequent exposures This hypersensitivity can be measured by a diagnostic skin test (tuberculin test)
Postprimary Infection
Chronic tuberculosis often results in a gradual spread of tubercular lesions in the lungs
Tuberculosis X-Ray
Normal Chest X-Ray
An Advanced Case of Pulmonary Tuberculosis
Figure 34.10
Mycobacterium avium in an Acid-Fast Stained Lymph Node
Figure 34.9
Tuberculosis
Epidemiology
Estimated 10 million Americans
infected
Rate highest among non-white,
elderly poor people
Small infecting dose

As little as ten inhaled organisms
Factors important in transmission

Tuberculosis
Epidemiology
Tuberculin test used to detect those infected
Small amount of tuberculosis antigen is injected under the skin Injection site becomes red (erythema) and firm (induration) if infected Positive test does not indicate active disease
Quantiferon test for activated T cells is new test replacing skin test
Tuberculosis
Prevention
Vaccination for tuberculosis widely used in many parts of the world
Vaccine known as Bacillus of Calmette and Gurin
BCG derived from Mycobacterium bovis Gives partial immunity against tuberculosis
Treatment
Antibiotic treatment is given in cases of active tuberculosis
Two or more medications are given together to reduce potential antimicrobial resistance Antimicrobials include
Rifampin and Isoniazid (INH) Both target actively growing organisms and metabolically inactive intracellular organisms
Vaccine not given in United States because of low disease prevalance
Therapy is pronged
Lasting at least 6 months

Spread of tuberculosis is prevented by
Hospitalization of patients in negative-pressure rooms Use of face masks for healthcare workers
Treatment
Antimicrobial therapy with isoniazid
Treatment usually requires a 9-month regimen Affects the synthesis of mycolic acid in mycobacteria
Structure of Isoniazid (Isonicotinic Acid Hydrazide)
Figure 34.11

Hansens Disease (Leprosy)
M. leprae is the causative agent The armadillo is the only experimental animal that has
been successfully used to grow M. leprae

Most serious form is characterized by folded, bulblike lesions on the body
Lepromatous Leprosy Lesions on the Skin
Figure 34.12

Pathogenicity of M. leprae
Due to a combination of delayed hypersensitivity and the invasiveness of the organism Transmission is by both direct contact and respiratory routes
Incubation times vary from several weeks to years

The incidence of leprosy worldwide is low
34.6 N. meningitidis, Meningitis, and Meningococcemia

Meningitis
An inflammation of the meninges
Membranes that line the central nervous system,
especially the spinal cord and brain
Can be caused by viral, bacterial, fungal, or protist infections
34.6 N. meningitidis, meningitis, and Meningococcemia

Neisseria meningitidis
Causes one type of infectious bacterial meningitis and a related infection, meningococcemia Approximately 13 pathogenic strains are recognized
based on antigenic differences in their capsular

polysaccharides
Fluorescent Antibody Stain of Neisseria meningitidis
Figure 34.13
34.6 N. meningitidis, meningitis, and Meningococcemia

Meningococcal Meningitis
Often occurs in epidemics, usually in closed populations Typically affects older school-age children and young adults Transmission is typically via airborne routes Treatment is usually achieved with penicillin G Incidence has decreased in recent years due to widespread vaccination in susceptible populations
Causes of bacterial meningitis

Neisseria miningitidis Haemophilus influenzae type b Streptococcus pneumoniae

Viruses are less easily controlled by chemotherapeutic methods than bacteria because the propagation of viruses depends on host cell function
The most prevalent human infections are caused by

viruses Most viral diseases are acute, self-limiting infections A few serious viral diseases have been effectively controlled by vaccination (e.g., smallpox and rabies)
Virus Characteristics Shape

Icosahedral
Helical
Nucleic acid
DNA or RNA, sgl or dbl stranded
Enveloped or Unenveloped

Measles (rubeola or 7-day measles)
Often affects susceptible children as an acute, highly infectious, often epidemic disease Caused by a negative-strand RNA virus called a
paramyxovirus
Virus enters the nose and throat by airborne transmission
Measles in Children: Begins on the Head and Neck
Figure 34.14a
Measles in Children: Spreads to the Chest, Trunk, & Limbs
Figure 34.14b

Measles (contd)
Used to be a common childhood illness Now only occurs in rather isolated outbreaks
Due to widespread immunization programs that began in
the mid-1960s
Over 600,000 deaths per year worldwide Proof of immunization required for enrollment in U.S. public schools
Viral Diseases and Vaccines: Measles
Figure 34.15a

Mumps
Caused by a paramyxovirus (like measles)
Highly infectious Spread by airborne droplets Characterized by inflammation of the salivary glands
Mumps
Figure 34.16
Viral Diseases and Vaccines: Mumps
Figure 34.15b

Rubella (German measles or 3-day measles)
Caused by a single-stranded, positive-sense RNA virus of the togavirus group Disease symptoms resemble measles but are generally milder and less contagious Routine childhood immunization is practiced in the U.S.
Viral Diseases and Vaccines: Rubella
Figure 34.15c
In the U.S. the incidence of measles, mumps, and rubella has decreased significantly since the implementation of the MMR vaccine

Chickenpox (varicella)
Common childhood disease characterized by a systemic papular rash
Caused by varicella-zoster virus (VZV), a DNA

herpesvirus VZV is highly contagious and transmitted by infectious droplets A vaccine is presently used in the U.S.
Chickenpox
Figure 34.17

Chickenpox (contd)
VZV virus establishes a lifelong latent infection in nerve cells latency is characteristic of all Herpes group viruses (HSV, VZV, CMV, EBV) The virus occasionally migrates to the skin surface,
causing a painful skin eruption (shingles)
34.8 Colds
Colds
The most common of infectious diseases Viral infections transmitted via airborne droplets
Infections are usually of short duration

Symptoms milder than other respiratory diseases
Colds and Influenza
Figure 34.18
Cold vs Flu
Symptoms
Fever
Cold
Rare
Flu
Characteristic, high(100-102 degrees F); lasts 3-4 d Headache Rare Prominent General Aches, Pains Slight Usual; often severe Fatigue, Weakness Quite mild Can last up to 2-3 weeks Extreme Exhaustion Never Early and prominent Stuffy Nose Common Sometimes Sneezing Usual Sometimes Sore Throat Common Sometimes Chest Discomfort, Mild to moderate; Common; Cough hacking cough can become severe Vomiting/diarrheae Rare Caused by high fever
34.8 Colds
The Common Cold
Symptoms include rhinitis, nasal obstruction, watery nasal discharges, and malaise Most commonly caused by Rhinoviruses
Positive-sense, single-stranded RNA viruses Nearly 115 different strains identified
Approximately 15% of colds are due to Coronaviruses Approximately 10% of colds are due to Adenoviruses
34.9 Influenza
Influenza is caused by an RNA virus of the orthomyxovirus group There are three different types of influenza viruses (A, B,
C)
Influenza A is the most important human pathogen
Electron Micrograph of Influenza Virus
HA=hemagglutinin NA=neuraminidase
Figure 34.21
34.9 Influenza
Influenza outbreaks occur annually due to the plasticity of the influenza genome
Antigenic shift
Major change in influenza virus antigen due to gene reassortment
Antigenic drift
Minor change in influenza virus antigens due to gene
mutation
34.9 Influenza
Influenza epidemics and pandemics occur periodically

1957 outbreak of Asian flu 1997 outbreak of avian influenza 2009 Novel H1N2
An Influenza Pandemic
Figure 34.22
Avian Influenza
Figure 34.23
34.9 Influenza
Prevention
Controlled by immunization
Careful worldwide surveillance
Treatment
Use of various drugs Most effective when administered early Aspirin should be avoided
II. Direct Contact Transmission of Diseases
34.10 Staphylococcus
34.11 Helicobacter pylori and Gastric Ulcers

34.12 Hepatitis Viruses
34.10 Staphylococcus
Staphylococci cause diseases including acne, boils, pimples, impetigo, pneumonia, osteomyelitis, carditis, meningitis, and arthritis
Many diseases result from pyogenic infection or from the

actions of staphylococcal superantigen exotoxins
The Structure of a Boil
Figure 34.24a
The Rupture of a Boil
Figure 34.24b
34.11 Helicobacter pylori and Gastric Ulcers

Helicobacter pylori
A gram-negative, highly motile, spiral-shaped bacterium
Associated with gastritis, ulcers, and gastric cancers Colonizes the non-acid-secreting mucosa of the stomach and upper intestinal tract Transmitted via person-to-person contact or ingestion of
contaminated food or water

Hepatitis
A liver inflammation caused by viruses or bacteria Sometimes results in acute illness followed by
destruction of functional liver anatomy and cells

(cirrhosis) A restricted group of viruses is often associated with liver disease Hepatitis viruses are diverse
Hepatitis Viruses

Hepatitis A virus (infectious hepatitis)
Causes mild, but rare cases of severe liver disease occur
Hepatitis B virus (serum hepatitis)

Causes acute, often severe disease that can lead to liver failure and death
Hepatitis D virus
A defective virus that cannot replicate and express a
complete virus unless the cell is also infected with Hepatitis B
Hepatitis C virus
Produces a mild disease initially, but most individuals develop
chronic hepatitis that can lead to chronic liver disease
Hepatitis E virus
Causes an acute, self-limiting hepatitis that varies in severity
Hepatitis G virus
Causes very mild disease or is completely asymptomatic

Incidence and Prevalence of Hepatitis
Decreased significantly in the U.S. in the last 20 years But viral hepatitis is still a major public health problem
Due to the high infectivity of the viruses and the lack of effective treatment options
Vaccines are available for Hepatitis A and B viruses
III. Sexually Transmitted Infections
34.13 Gonorrhea and Syphilis
34.14 Chlamydia, Herpes, Trichomoniasis, and Human

Papillomavirus
34.15 Acquired Immunodeficiency Syndrome: AIDS and

HIV
III. Sexually Transmitted Infections

Sexually Transmitted Infections (STIs)
Also called sexually transmitted diseases (STDs) or
venereal diseases Caused by a variety of bacteria, viruses, protists, and even fungi Pathogens are generally only found in body fluids from the genitourinary tract that are exchanged during sexual activity
Sexually Transmitted Diseases and Treatment Guidelines

Gonorrhea and syphilis are preventable, treatable
bacterial STIs The overall pattern of disease differs between the two
Gonorrhea is prevalent and often asymptomatic in women Syphilis has low prevalence and exhibits very obvious
symptoms
The Causative Agent of Gonorrhea, Neisseria gonorrhoeae
Figure 34.29
Gonorrhea
Causative Agent
Neisseria gonorrhoeae
Gram negative diplococcus Typically found on or in leukocytes in urethral pus Infect only humans Most strains do not survive well outside host Transmitted primarily via intimate sexual contact
Increasing number of strains resistant to antibiotics
Gonorrhea
Symptoms
Incubation period 2 to 5 days post exposure
Asymptomatic infection can occur on both sexes

In men symptoms characterized as urethritis with
Pain on urination Discharge from penis
In women symptoms are

Painful urination, Mild discharge
May be overlooked Women more likely to be asymptomatic carriers
Gonorrhea
Symptoms
Incubation period 2 to 5 days post exposure
Asymptomatic infection can occur on both sexes In men symptoms characterized as urethritis with
Pain on urination Discharge from penis
In women symptoms are

Painful urination
Mild discharge

Gonorrhea
Caused by Neisseria gonorrhoeae Symptoms in females
Characterized by a mild vaginitis that often goes unnoticed
Untreated gonorrhea can lead to pelvic inflammatory disease
Symptoms in males
Characterized by a painful infection of the urethral canal
Reported Cases of Gonorrhea and Syphilis in the U.S.
Figure 34.28
Gonorrhea
Prevention and Treatment Prevention directed at Abstinence Monogamous relationship
Constant use of condom

No vaccine available
Fluoroquinolones and cephalosporins effective against 95% of

strains
Gonorrhea
Pathogenesis In women disease follows different course Organism thrives in cervix and fallopian tubes 15% to 30% of untreated women develop pelvic inflammatory disease (PID) Scar tissue formation in fallopian tubes lead to increased risk of ectopic pregnancy and sterility Gonococcal conjunctivitis & pneumonia of the newborn Acquired from infected birth canal Prevented with silver nitrate or erythromycin withn1 hour of birth

Syphilis
Caused by Treponema pallidum Often transmitted at the same time as gonorrhea
T. pallidum can be transmitted from an infected woman

to the fetus during pregnancy (congenital syphilis) Three stages: primary, secondary, and tertiary Penicillin highly effective for primary and secondary stages
The Syphilis Spirochete, Treponema pallidum
Figure 34.30a
The Syphilis Spirochete, Treponema pallidum
Figure 34.30b
Syphilis
Prevention
No vaccine Safer sex practices decrease risk Prompt identification and treatment of infected individuals and contacts
Treatment
Primary and secondary stages effectively treated with antibiotics/penicillin Antibiotics somewhat effective in tertiary but must be treated longer
Syphilis
Pathogenesis
Primary syphilis
Characterized by hard chancre from inflammatory response Chancre disappears in 2 to 6 weeks with or without treatment
Secondary syphilis
Characterized by mucous patches on skin
and mucous membranes
Disease can be transmitted by kissing at
this stage
Syphilis
Pathogenesis Organism penetrates mucous membranes and abraded skin Very low infecting dose Less than 100 organisms Organism multiplies in localized area Spreads to lymph nodes and bloodstream Three stages of disease Primary stage Secondary stage Tertiary stage
Primary Syphilis Lesions: Chancre on Lip
Figure 34.31a
Primary Syphilis Lesions: Chancres on Penis
Figure 34.31b
34.14 Chlamydia, Herpes, Trichomoniasis, and HPV
Chlamydia trachomatis causes a number of sexually transmitted diseases
Chlamydial Genital System Infections

Causative Agent
Chlamydia trachomatis
Spherical Obligate intracellular bacterium
Intracellular form is reticulate body

Elementary body is the extra-cellular form responsible for infection

Symptoms Generally appear in 7 to 14 days In men Thin grayish-white discharge from penis Sometimes painful testes In women Increased vaginal discharge Often painful urination Abdominal bleeding Upper and lower abdominal pain Women often asymptomatic

Pathogenesis
Infectious form attaches to host epithelial cells
This form called elementary body Cells take up organism through endocytosis
Much tissue damage results from cellular immune response In men

Infection spreads from urethra to tubules
Results in acute swelling
Bacterial enlarges in vacuole

Becomes non-infectious
Form called reticular body
In women
Infection commonly involves cervix, uterus and fallopian tubes
Resulting in PID, ectopic pregnancy or sterility
Reticular body divides repeatedly

Produces numerous elementary bodies
These infect nearby cells

Prevention and Treatment Abstinence Monogamous relationship Use of condom
All sexually active women should get tested annually

Semi annually if multiple partners Azithromycin effective single dose treatment Tetracycline or erythromycin less expensive alternatives
Chlamydia Infections of Neonates

Vaginal delivery from infected mothers can produce infections of the newborn similar to Neisseria gonorrhoeae Pneumonia Conjunctivitis
Herpes Simplex Virus Type I (HSV-1)

Infects the epithelial cells around the mouth and lips Causes cold sores (fever blisters) May occasionally affect other body sites
Spread via direct contact or through saliva

Lesions heal without treatment in 2 to 3 weeks
Herpesvirus: Severe Case of HSV-1 Blisters on Face
Figure 34.33a

Herpes Simplex Virus Type 2 (HSV-2)
Infections are associated primarily with anogenital region
Causes painful blisters on penis of male and cervix,

vulva, or vagina of females Typically transmitted through sexual contact and most easily transmitted when active blisters are present Genital herpes are presently incurable, however, a
limited number of drugs are successful in controlling the

infectious blister stage
Herpesvirus: HSV-2 Infection
Figure 34.33b
Guanine and the Guanine Analog Acyclovir
Figure 34.34
Genital Herpes
Prevention and Treatment Avoidance of sexual intercourse during active symptoms Use of condom and spermicide reduce but do not eliminate transmission
There is no cure for genital herpes

Medications such as acyclovir and famciclovir can decrease severity
Genital Herpes
Pathogenesis
Blisters/vessicles created by infected epithelial cells
Vessicular fluid contains large numbers of bacteria
Blisters rupture to produce painful ulcerations Latency follows ulceration Recurrence is due to replication of complete virions from latent DNA
Viruses re-infect area supplied by nerve
Congenital herpes can pose serious risk for newborn

1 in 3 newborns contract herpes if mother has primary infection at time of birth Can be debilitating and potentially lethal
Genital Herpes
Causative Agent Symptoms
Begin 2 to 20 days post infection Genital itching and burning Pain
Primarily in women
Usually herpes-simplex virus type 2 DNA virus Disease recurrence due to latent virus
Blisters develop on genitals Blisters heal spontaneously

Most patients will have recurrence

Trichomoniasis
Nongonoccal urethritis may be caused by infections with the protist Trichomonas vaginalis
Generally transmitted via sexual contact, but can also

transmit via contaminated toilet seats, paper towels, etc. Typically asymptomatic in males For females, infections are characterized by vaginal discharge, vaginitis, and painful urination
Papillomavirus Genital Warts and Cervical Cancer

Prevention and Treatment Condom use, HPV vaccine Women should have Pap smear annually Can identify precancerous lesions
Abnormal growth can be removed preventing development of

cancer Warts can be removed via laser treatment or freezing with liquid nitrogen

Causative agent
Human papillomavirus (HPV) Non-enveloped, double stranded DNA virus
Nearly 100 types of HPV
30 are transmitted sexually 15 type strongly associated with cancer
Most cervical cancers associated with high risk HPV types [16 & 18]
Warts caused by low risk HPV types [6 & 11]
http://www.cdc.gov/STD/HPV/STDFact-HPV.htm

Symptoms
Individual may be asymptomatic
Especially women
Genital warts most easily recognized symptom

Often appear on the head or shaft of penis, at the vaginal opening or around anus
Warts can become inflamed or bleed Precancerous lesion on cervix often

Genital tract infections by eukaryotic microbes

Candida albicans yeast infection
Trichomonas vaginalis trich
Trichomoniasis
Prevention and Treatment Abstinence, monogamy and use of condoms decreases risk of transmission Treatment with metronidazole usually successful in treatment of
disease
Trichomoniasis
Causative agent
Trichomonas vaginalis Flagellated protozoan Diagnosed via jerky motility on microscopic examination
Pathogenesis
Not fully understood Red swollen nature of vagina attributed to trauma of moving
protozoan
Frothy discharge is most likely due to gas production by organism
Trichomoniasis
disease
Trichomoniasis
Causative agent
Trichomonas vaginalis Flagellated protozoan Diagnosed via jerky motility on microscopic examination
Pathogenesis
protozoan
Trichomonas vaginalis
Figure 34.35
Cells of Chlamydia trachomatis
Figure 34.32a
Trichomoniasis
disease
Trichomoniasis
Causative agent
Trichomonas vaginalis Flagellated potozoan Diagnosed via jerky motility on microscopic examination
Pathogenesis
protozoan
Vulvovaginal Candidiasis
Prevention and Treatment Prevention directed at minimizing use and duration of antibiotic therapy Intravaginal treatment with antifungal medication usually
effective
Nystatin and clotrimazole most effective Fluconazole given by mouth usually effective 1 out of 7 suffer side effects
Vulvovaginal Cadidiasis
Symptoms
Most common symptoms
include
Itching
Burning
Scant vaginal discharge
White in curd-like clumps
Causative Agent
Candida albicans
Part of normal colonizers in approximately 35% of women
Involved area usually red and

swollen
Human Papillomavirus (HPV)

Causes several different infections Many infections are asymptomatic with some progressing to genital warts
Others cause cervical neoplasia, and few progress to

cervical cancers There is an effective HPV vaccine
34.15 Acquired Immunodeficiency Syndrome: AIDS & HIV

AIDS
Recognized as a distinct disease in 1981 Human immunodeficiency virus (HIV) is the causative agent
HIV
As many as 1.4 million people worldwide may be infected HIV is divided into two types
HIV-1 is the more virulent type HIV-2 is less virulent and causes a milder AIDS-like disease
Opportunistic infections are common in AIDS patients The most common is pneumonia caused by the protist Pneumocystis carinii
Opportunistic Pathogens Associated with AIDS
Candida albicans, from heart tissue of patient with systemic Candida infection.
Figure 34.36a
Cryptococcus neoformans, from liver tissue of a patient with cryptococcosis.
Figure 34.36b
Pneumocystis carinii, from patient with pulmonary pneumocytosis.
Figure 34.36d
Cryptosporidium sp. from small intestine of a patient with cryptosporidiosis.
Figure 34.36e
Toxoplasma gondii, from brain tissue of a patient with toxopolasma.
Figure 34.36f
Mycobacterium spp. infection of the small bowel (acid-fast stain).
Figure 34.36g
A frequent disease in AIDS patients is Kaposis sarcoma, an atypical cancer caused by Human Herpesvirus 8
Kaposis Sarcoma on the Heel and Lateral Foot
Figure 34.37a
HIV Pathogenesis
HIV infects cells that contain the CD4 cell surface protein
Infection results in a progressive decline in CD4 cells HIV also interacts with coreceptors on target cells

HIV infection can be diagnosed with an HIV-ELISA, HIVimmunoblot, or rapid tests These tests fail to detect HIV-positive individuals who just recently acquired the virus and have not made a detectable antibody response Laboratory tests that detect HIV RNA directly from blood are
available and can estimate the number of viruses present

This is useful for early detection and monitoring the progression of infection
Treatment
Four classes of drugs have been identified that delay the
symptoms of AIDS and prolong the life of those infected with HIV
Highly active antiretroviral therapy (HAART) is used
Chemotherapeutic Agents for HIV/AIDS Treatment

10ch34 Lecture

Hochgeladen von

Dokumentinformationen

Copyright

Verfügbare Formate

Dieses Dokument teilen

Dokument teilen oder einbetten

Freigabeoptionen

Stufen Sie dieses Dokument als nützlich ein?

Sind diese Inhalte unangemessen?

Copyright:

Verfügbare Formate

10ch34 Lecture

Hochgeladen von

Copyright:

Verfügbare Formate

Brock Biology of Microorganisms

Madigan / Martinko Dunlap / Clark

Types of Person-to-Person Disease Transmission

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

High-Speed Photograph of an Unstifled Sneeze

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

I. Airborne Transmission of Diseases

34.2 Streptococcal Diseases

34.7 Viruses and Respiratory Infections

34.1 Airborne Pathogens

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

34.1 Airborne Pathogens

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

The Respiratory Tract of Humans

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

34.2 Streptococcal Diseases

Infections occur if host defenses are weakened or a new

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

Lancefield Typing Scheme for -hemolytic Streptococci

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

Erysipelas: A S. Pyogenes Infection of the Skin

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

34.2 Streptococcal Diseases

other diseases (e.g., rheumatic fever)

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

Red throat with pus patches

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

Commonly referred to as Group A

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

Confirmed strep throat treated with 10 days of antibiotics

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

Typical Lesions of Impetigo

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

34.2 Streptococcal Diseases

Infections by both strains are treatable by antimicrobial

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

The Gram-Positive Pathogen Streptococcus Pneumoniae

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

34.3 Cornyebacterium and Diphtheria

Caused by Cornyebacterium diphtheriae

Preventable and treatable

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

Diphtheria: Cells of Corynebacterium diphtheriae

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

34.3 Cornyebacterium and Diphtheria

Previous infection or immunization provides resistance

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

Pseudomembrane (Arrows) in Active Case of Diphtheria

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

34.3 Cornyebacterium and Diphtheria

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

34.4 Bordetella and Pertussis

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

Pertussis in the United States

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

34.4 Bordetella and Pertussis

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

Atypical Bacterial Pneumonias

Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

Respiratory Chlamydial Infections C. psittaci causes respiratory disease in Psittacine birds,