Part II

Immunology

Universities Press
3-6-747/1/A & 3-6-754/1, Himayatnagar
Hyderabad 500 029 (A.P.), India
Phone: 040-2766 5446/5447
Email: info@universitiespress.com
marketing@universitiespress.com
© Universities Press (India) Private Limited Universities Press
 INFECTION

© Universities Press (India) Private Limited Universities Press

 INFECTION

• Saprophytes – Free living, subsist on dead

or decaying matter, incapable of multiplying
on living tissue, some (B.subtilis) infect
devitalised tissue
• Parasites – Establish themselves and
multiply in the host pathogens or
commensals

© Universities Press (India) Private Limited Universities Press

 INFECTION

• Pathogens – Capable of producing disease

in host
• Commensal – Harmony with host without
causing disease

© Universities Press (India) Private Limited Universities Press

 CLASSIFICATION

• Primary infection – initial infection

• Reinfection – subsequent infection with
same parasite
• Secondary infection – new parasite, pre-
existing infectious disease
• Focal infection – localised sites
• Cross-infection – new infection from
another host or another source

© Universities Press (India) Private Limited Universities Press

 CLASSIFICATION

• Nosocomial infection/hospital acquired/

healthcare associated infection – cross-
infection in hospitals
• Iatrogenic infection – physician induced due
to therapeutic/investigative cause

© Universities Press (India) Private Limited Universities Press

 CLASSIFICATION

• Inapparent infection/subclinical infection -

clinical effects not apparent
• Atypical infection – characteristic clinical
manifestations not apparent
• Latent infection – latent or hidden form

© Universities Press (India) Private Limited Universities Press

 SOURCES OF INFECTION

HUMANS
• Carrier – harbours the pathogen
• Healthy carrier – harbours the pathogen, but
never suffered from the disease
• Convalescent carrier – recovered from
disease and continues to harbour the
pathogen

© Universities Press (India) Private Limited Universities Press

 SOURCES OF INFECTION

HUMANS
• Temporary carrier – less than six months
• Chronic carrier – several years
• Contact carrier – acquires pathogen from
carrier
• Paradoxical carrier – acquires pathogen
from another carrier

© Universities Press (India) Private Limited Universities Press

 SOURCES OF INFECTION

ANIMALS
• Reservoir host – maintain the parasite in
nature
• Zoonoses – diseases transmitted from
animals to human beings

© Universities Press (India) Private Limited Universities Press

 SOURCES OF INFECTION

Possible sources of infection (*Tetanus bacilli occur in the feces of

these animals)
© Universities Press (India) Private Limited Universities Press
 SOURCES OF INFECTION

INSECTS
• Vectors – mechanical vectors
biological vectors
• SOIL AND WATER
• Spores of tetanus
• Geophilic dermatophytes
• Acquatic vectors – cyclops

© Universities Press (India) Private Limited Universities Press

 METHODS OF TRANSMISSION

CONTACT
• Contagious disease – direct contact
indirect contact – fomite
INHALATION
• Respiratory infections – droplet nuclei

© Universities Press (India) Private Limited Universities Press

 METHODS OF TRANSMISSION

INGESTION
• Waterborne
• Foodborne
• Fingerborne
INOCULATION
• Deep wounds - tetanus
• Dog bite – Rabies
• Unsterile needles – iatrogenic – HIV,
Hepatitis B
© Universities Press (India) Private Limited Universities Press
 METHODS OF TRANSMISSION

INSECTS
• Mechanical or biological vectors
CONGENITAL
• Vertical transmission
• Teratogenic infections
IATROGENIC AND LABORATORY INFECTIONS

© Universities Press (India) Private Limited Universities Press

 MICROBIAL PATHOGENICITY

• Pathogenicity – ability of a microbial species

to produce disease
• Virulence – ability of a strain of
microorganism to produce disease
• Exaltation – enhancement of virulence
• Attenuation – reduction of virulence

© Universities Press (India) Private Limited Universities Press

 MICROBIAL PATHOGENICITY

• Adhesion – attachment of bacteria to body

surfaces
• Specific reaction between surface receptors
on host cells and adhesive structures
(ligands) on the surface of bacteria
• Adhesins – organised structures – fimbrae,
pili or colonising factors

© Universities Press (India) Private Limited Universities Press

 MICROBIAL PATHOGENECITY

INVASIVENESS
• Spreading lesions – Streptococci
• Localised lesions – Staphylococci
TOXIGENICITY
• Exotoxins
• Endotoxins

© Universities Press (India) Private Limited Universities Press

 EXOTOXINS & ENDOTOXINS
Distinguishing features of exotoxins and endotoxins
Exotoxins
• Proteins
• Heat labile
• Actively secreted by cells; diffuse into surrounding
medium
• Readily separable from cultures by physical means
such as filtration
• Action often enzymic
• Specific pharmacological effect for each exotoxin
• Specific tissue affinities
• Active in very minute doses
• Highly antigenic
• Action specifically neutralised by antibody
© Universities Press (India) Private Limited Universities Press
 (Continued…

Endotoxins
• Lipopolysaccharides
• Heat stable
• Form part of cell wall; do not diff use into
surrounding medium
• Obtained only by cell lysis
• No enzymic action
• Effect non-specific; action common to all endotoxins
• No specific tissue affinity
• Active only in very large doses
• Weakly antigenic
• Neutralisation by antibody ineffective
© Universities Press (India) Private Limited Universities Press
 BIOLOGICAL ACTIVITY OF ENDOTOXIN

• Pyrogenicity
• Activation of complement
• Leucocytosis
• Macrophage inhibition
• Lethal action
• Intravascular coagulation
• Inhibition of glucose and stimulation of B
lymphocytes

© Universities Press (India) Private Limited Universities Press

 BIOLOGICAL ACTIVITY OF ENDOTOXIN

• Interferon release
• Depression of blood pressure
• Leucopenia
• Stimulation of B lymphocytes
• Induction of prostaglandin synthesis

© Universities Press (India) Private Limited Universities Press

 MICROBIAL PATHOGENICITY

PLASMIDS
• Enterotoxin produced by E.coli and S.aureus
• Multiple drug resistance (R) plasmids
BACTERIOPHAGES
• Toxin producing beta of tox +
corynephages

© Universities Press (India) Private Limited Universities Press

 MICROBIAL PATHOGENECITY

BACTERIAL PRODUCTS
• Coagulase
• Fibrinolysin
• Hyaluronidase
• Leucocidins
• Hemolysin

© Universities Press (India) Private Limited Universities Press

 MICROBIAL PATHOGENECITY

BACTERIAL APPENDAGES
• Capsule
• Surface antigens – Vi antigen – S.typhi
K antigen – E.coli
• Withstand phagocytosis and lytic activity of
complement

© Universities Press (India) Private Limited Universities Press

 MICROBIAL PATHOGENECITY

BIOFILMS
• Well organised microcolonies of bacteria
enclosed in self-produced extracellular
polymer matrices known as glycocalyx
• Types - Monomicrobial and polymicrobial
• Free floating bacteria come in contact with
medical devices and attach to them with pili

© Universities Press (India) Private Limited Universities Press

 TYPES OF INFECTIOUS DISEASES

• Localised/generalised
• Superficial/deep
• Bacteremia – circulation of bacteria in blood
• Septicemia – bacteria circulate and multiply
in the blood
• Pyemia – pyogenic bacteria produce
septicemia with multiple abscesses in
internal organs

© Universities Press (India) Private Limited Universities Press

 DEPENDING ON SPREAD

• Endemic disease - constantly present in a

particular area
• Epidemic disease – involves many people in
an area at the same time
• Pandemic disease – epidemic that spreads
through many areas of the world

© Universities Press (India) Private Limited Universities Press