MICROBIOLOGY

WITH DISEASES BY BODY SYSTEM SECOND EDITION

Microbial Diseases of the Respiratory System

Lecture prepared by Mindy Miller-Kittrell, University of Tennessee, Knoxville
Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

Normal Microbiota
Normal Microbiota of the Respiratory System
Lower respiratory system
Typically microorganisms are not present
Upper respiratory system
Normal microbiota limit growth of pathogens
Normal microbiota may be opportunistic pathogens
Examples of normal microbiota
Haemophilus influenzae can colonize the nose
Staphylococcus aureus is present as normal microbiota in
some individuals without causing disease
Diphtheroids can colonize the nose and nasal cavity
Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

Bacterial Diseases of the Upper Respiratory System, Sinuses, and Ears

Streptococcal Respiratory Diseases

Signs and symptoms
Sore throat, difficulty swallowing; may progress to scarlet or
rheumatic fever
Pathogen and virulence factors
Caused by Group A streptococci (S. pyogenes)
Virulence factors include M proteins, hyaluronic acid
capsule, streptokinases, C5a peptidase, pyrogenic toxins,
streptlysins
Pathogenesis
Typically occur when normal microbiota are depleted, large
inoculum is introduced, or adaptive immunity is impaired

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

Bacterial Diseases of the Upper Respiratory System, Sinuses, and Ears

Streptococcal Respiratory Diseases

Epidemiology
Spread via respiratory droplets
Occurs most often in winter and spring
Diagnosis, treatment, and prevention
Often confused with viral pharyngitis
Penicillin is an effective treatment

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

Bacterial Diseases of the Upper Respiratory System, Sinuses, and Ears

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

Bacterial Diseases of the Upper Respiratory System, Sinuses, and Ears

Diptheria
Signs and symptoms
Sore throat, oozing fluid that hardens into a
pseudomembrane that can obstruct airways
Pathogen and virulence factors
Caused by Cornybacterium diphtheriae
Virulent C. diptheriae produce diphtheria toxin, which prevents
polypeptide synthesis and causes cell death

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

Bacterial Diseases of the Upper Respiratory System, Sinuses, and Ears

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

Bacterial Diseases of the Upper Respiratory System, Sinuses, and Ears

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

Bacterial Diseases of the Upper Respiratory System, Sinuses, and Ears

Diphtheria
Pathogenesis and epidemiology
Spread person to person via respiratory droplets or skin
contact
Immunocompromised or nonimmune individuals develop
symptomatic infections
Diagnosis, treatment, and prevention
Diagnosis based on presence of a pseudomembrane
Treated by administration of antitoxin and antibiotics
Immunization is an effective prevention

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

Bacterial Diseases of the Upper Respiratory System, Sinuses, and Ears

Sinusitis and Otitis Media

Signs and symptoms
Sinusitis: pain and pressure of the affected sinus
accompanied by malaise
Otitis media: severe pain in the ears
Pathogen and virulence factors
Caused by various bacteria such as Streptococcus
pneuomoniae, Staphylococcus aureus, Haemophilus
influenzae, and Moraxella catarrhalis

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

Bacterial Diseases of the Upper Respiratory System, Sinuses, and Ears

Sinusitis and Otitis Media

Pathogenesis and epidemiology
Bacteria in the pharynx spread to the sinuses via their
connection with the throat
Sinusitis is more common in adults; otitis media is more
common in children
Diagnosis, treatment, and prevention
Symptoms often diagnostic
No known way to prevent sinusitis

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

Bacterial Diseases of the Lower Respiratory System

Lower respiratory organs are usually axenic
When bacterial infection of the lower respiratory system
occurs life-threatening illness can result

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

Bacterial Diseases of the Lower Respiratory System

Bacterial Pneumonias
Inflammation of the lungs accompanied by fluidfilled alveoli and
bronchioles
Can be described by the affected region or the organism causing
the disease
E.g., lobar pneumonia involves entire lobes of the lungs
Bacterial pneumonias are the most serious and the most
frequent in adults

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

Bacterial Diseases of the Lower Respiratory System

Pneumoccocal Pneumonia
Signs and symptoms
Fever, chills, congestion, cough, chest pain, and short, rapid breathing
Pathogen and virulence factors
Caused by Streptococcus pneumoniae
Virulence factors include adhesins, capsule, pneumolysin
Pathogenesis and epidemiology
Infection occurs by inhalation of bacteria
Bacterial replication causes damage to the lungs
Diagnosis, treatment, and prevention
Penicillin is the drug of choice for treatment
Vaccination is method of prevention

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

Bacterial Diseases of the Lower Respiratory System

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

Bacterial Diseases of the Lower Respiratory System

Primary Atypical (Mycoplasmal) Pneumonia
Signs and symptoms
Atypical symptoms including fever, malaise, sore throat, excessive
sweating
Pathogen and virulence factors
Caused by Mycoplasma pneumoniae
Virulence factors include an adhesion protein
Epidemiology
Nasal secretions among individuals in close contact spread the bacteria
Diagnosis, treatment, and prevention
Treated with tetracycline and erythromycin
Prevention is difficult because individuals can be infective despite lack of
symptoms

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

Bacterial Diseases of the Lower Respiratory System

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

Bacterial Diseases of the Lower Respiratory System

Klebsiella Pneumonia
Signs and symptoms
Typical pneumonia symptoms combined with a thick, bloody sputum and
recurrent chills
Pathogen and virulence factors
Caused by Klebsiella pneumoniae
Virulence factors include a capsule
Pathogenesis and epidemiology
Immunocompromised individuals at greatest risk for infection
Diagnosis, treatment, and prevention
Treated with antimicrobials
Prevention involves good aseptic technique by health care workers

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

Bacterial Diseases of the Lower Respiratory System

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

Bacterial Diseases of the Lower Respiratory System

Other Bacterial Pneumonias
Cause Haemophilus influenzae, Staphylococcus aureus, Yersinia pestis,
and Chlamydia species
Portal of entry inhalation, also via blood with Y. pestis
Signs/Symptoms typical pneumonia symptoms with frothy, bloody
sputum in the case of Y. pestis
Incubation period variable depending on cause, although Y. pestis can
produce symptoms in hours
Susceptibility typically young children most susceptible
Treatment antibiotic treatment
Prevention good hygiene; vaccine available for H. influenzae

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

Bacterial Diseases of the Lower Respiratory System

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

Bacterial Diseases of the Lower Respiratory System

Legionnaires Disease
Signs and symptoms
Typical pneumonia symptoms and possible complications of
the gastrointestinal tract, CNS, liver, and kidneys
Pathogen and virulence factors
Caused by Legionella pneumophila
Pathogenesis
L. pneumophila kills human cells, causing tissue damage and
inflammation

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

Bacterial Diseases of the Lower Respiratory System

Legionnaires Disease
Epidemiology
The elderly, smokers, and immunocompromised individuals
are at increased risk for infection
Diagnosis, treatment, and prevention
Quinolones or macrolides are the drugs of choice for
treatment
Reduction of bacterial presence in water is successful control
measure

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

Bacterial Diseases of the Lower Respiratory System

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

Bacterial Diseases of the Lower Respiratory System

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

Bacterial Diseases of the Lower Respiratory System

Tuberculosis
Pathogenesis
M. tuberculosis can remain viable for long periods in aerosol
drops
Three types of tuberculosis
Primary tuberculosis initial case of tuberculosis disease
Secondary tuberculosis reestablished tuberculosis
Disseminated tuberculosis tuberculosis involving
multiple systems
Epidemiology
Immunocompromised individuals are most at risk
Tuberculosis is the leading killer of HIV+ individuals
Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

Bacterial Diseases of the Lower Respiratory System

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

Bacterial Diseases of the Lower Respiratory System

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

Bacterial Diseases of the Lower Respiratory System

Pertussis (Whooping Cough)
Signs and symptoms
Initially cold-like, then characteristic cough develops
Pathogen and virulence factors
Bordetella pertussis is the causative agent
Virulence factors include various toxins including pertussis
toxin, adenylate cyclase toxin, dermonecrotic toxin, and
tracheal cytotoxin
Pathogenesis
Four phases incubation, catarrhal, paroxysmal, and
convalescent
Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

Bacterial Diseases of the Lower Respiratory System

Pertussis (Whooping Cough)

Epidemiology
Highly contagious; the bacteria spread through the air in
airborne droplets
Diagnosis, treatment, and prevention
Symptoms are usually diagnostic
Treatment is primarily supportive
Prevention is with the DTaP vaccine

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

Bacterial Diseases of the Lower Respiratory System

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

Bacterial Diseases of the Lower Respiratory System

Inhalational Anthrax
Signs and symptoms
Resemble a cold or flu but progress to severe coughing,
shortness of breath, shock, and death
Pathogen and virulence factors
Bacillus anthracis is the causative agent
Virulence factors include a capsule and secretion of anthrax
toxin
Pathogenesis and epidemiology
Anthrax not spread from person to person
Acquired by contact or inhalation of endospores
Copyright 2009 Pearson Education Inc., publishing as Pearson Benjamin Cummings

Bacterial Diseases of the Lower Respiratory System

Inhalation Anthrax
Diagnosis, treatment, and prevention
Diagnosis based on identification of bacteria in sputum
Early and aggressive treatment with antimicrobials necessary
Anthrax vaccine available to military personnel, researchers,
and health care workers dealing with anthrax patients

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