(P) Lec 3.1: Bacterial Pathogenesis and Epidemiology, Antimicrobials and Mechanism of Bacterial Resistance, and Indigenous Microbial Flora Flashcards
Chapter 2 of Mahon's
T or F: There are more microorganisms than humans.
True the fire
T or F: Microorganism-human encounters are inevitable.
True the fire ulit
The mechanism of exposure depends on _____
Person’s activity/behavior
Harmless microorganisms that inhabit the human body in large numbers
Pathogen
Competes with potential pathogens for resources and attachment sites
Pathogen
This aids in the digestion and nutrient absorption
Vitamin K
What are the sterile body parts?
Blood
Lungs
Brain
Serous Fluids (pericardial, peritoneal, and pleural)
What does sterile mean?
No microorganisms should be present.
What happens if there are microorganisms present in supposedly sterile body parts?
Sepsis
They are commonly found on or in body sites of healthy persons and are homegrown/native.
Indigenous Microbial Flora
They colonize an area for months or years and are life-long members of the community.
Resident Microbial Flora
They are present at a site temporarily (passing by daw sabi ni Sir Mabaggu) and are eliminated by host’s inherent immune defenses or by competition with resident biota.
Transient Microbial Flora
What are the factors that determine the composition of the usual microbial flora?
- Nutritional and Environmental Factors
- Resistance to bile, lysozyme, or fatty acids
- pH
- Low Oxidation-Reduction Potential
Factors that determine the composition of the usual microbial flora
- More organisms inhabit moist areas than dry areas. (eg. diphtheroids & non-pathogenic corynebacterium)
Nutritional and Environmental Factors
Factors that determine the composition of the usual microbial flora
- Lipids and fatty acids are bactericidal to most bacteria.
- Propionibacterium spp. (ex. P. acne – causative agent of pimples)
They are able to breakdown the skin lipids to fatty acids.
Resistance to bile, lysozyme, or fatty acids
Factors that determine the composition of the usual microbial flora
- Female genital tract microbiota depends on the pH of that environment (4.0-5.0)
- Many bacteria do not survive at this extreme pH range (pero sabi ni Sir Mabaggu kaya daw ng Lactobacillus so maniwala na lang kayo hehe)
pH
Factors that determine the composition of the usual microbial flora
What is the usual pH of the female genital tract microbiota?
4.0 to 5.0
Factors that determine the composition of the usual microbial flora
- This environment supports only organisms capable of fermentation. (eg. gingival crevices - bacteroides and fusobacterium, obligate anaerobes)
Low Oxidation-Reduction Potential
Composition of Microbial Biota
Has numerous mechanisms to prevent infection and protect underlying tissue.
Skin
Composition of Microbial Biota
This includes:
* physical separation
* presence of fatty acids
* excretion of lysozyme (sweat glands)
* desquamation (skin)
Skin
Composition of Microbial Biota (Skin)
Armpit, groin, axillae, and between toes
Aerobic Diphtheroids – Corynebacterium spp
Composition of Microbial Biota (Skin)
Hair Follicles, sweat and sebaceous gland
Staphylococcus epidermidis and Propionibacterium spp.
Composition of Microbial Biota
The oral cavity — contains a large number of bacteria, with Streptococcus being the predominant genus
Upper Respiratory Tract
Composition of Microbial Biota (URT)
Mouth
Gram (-) anaerobes
Composition of Microbial Biota (URT)
Nose
Diplococci and diphtheroids
Composition of Microbial Biota (URT)
Oropharynx
Mixture of streptococci (mitis, mutans, milleri, sanguinis, salivarius, pneumoniae)
Composition of Microbial Biota
- Comprises the esophagus, stomach, small intestine, and colon
- Less microbial population in esophagus (mostly transient)
Gastrointestinal Tract
Composition of Microbial Biota (GI Tract)
Stomach
Streptococcus
Enterococcus
Prevotella
Opportunistic Helicobacter pylori
Composition of Microbial Biota (GI Tract)
Colon
(contains 70% of all the microbes in the body; these microbes (on the right) outnumber g(-) bacteria in the large intestine)
Obligate anaerobes (Bacteroides, Clostridium, Prevotella, Porphyromonas)
Composition of Microbial Biota
Kidney, bladder, cervix, and fallopian tube are?
Normally Sterile
Composition of Microbial Biota (Genitourinary Tract)
Vaginal biota (before puberty)
Yeasts
Gram (-) bacilli
Gram (+) cocci
Composition of Microbial Biota (Genitourinary Tract)
Vaginal biota (childbearing years)
Lactobacilli
Anaerobic gram (-) bacilli
Gram (+) cocci
Composition of Microbial Biota
Vagina epithelial cells maintain a ____ pH, which encourages the colonization of listed bacteria.
Low
Some organisms that make up the microbial biota live off the _____
Host’s nutrients
in most cases, they provide some benefit to the host, creating a ____ relationship.
Symbiotic
Activation of Immune System
- Secretion of metabolic products
- Prevention of pathogen adhesion
Recognized to cause disease in healthy immunocompetent individuals a high percentage of the time
Yersinia pestis and Bacillus anthracis
True Pathogens
Causes disease when their habitat is altered or when the host’s immune system is compromised
Opportunists
Can be found in traumatized areas (accidental/surgical) and may reach sterile or other parts where these organisms are not part of the microbial biota
Opportunists
Name the organisms (sorry, I’m not a sadist)
Foreign bodies (catheters, shunts, prosthetic heart valves)
- Staphylococcus epidermidis
- Propionibacterium acnes
- Viridans streptococci
- Serratia marcescens
- Pseudomonas aeruginosa
- Aspergillus spp
- Candida albicans
Name the organisms (sorry, I’m not a sadist)
Alcoholism
- Streptococcus pneumoniae
- Klebsiella pneumoniae
Name the organisms (sorry, I’m not a sadist)
Burns
- Pseudomonas aeruginosa
- Acinetobacter baumannii-calcoaceticus complex (drug-resistant)
- Staphylococcus aureus
Name the organisms (sorry, I’m not a sadist)
Hematoproliferative disorders
- Cryptococcus neoformans
- Varicella-zoster virus
Name the organisms (sorry, I’m not a sadist)
Cystic Fibrosis
- Pseudomonas aeruginosa
- Burkholderia cepacia
Name the organisms (sorry, I’m not a sadist)
Immunosuppresion (drugs, congenital disease)
- Candida albicans
- Pneumocystis jirovecii
- Herpes simplex virus
- Aspergillus spp.
- Diphtheroids (Corynebacterium spp.)
- Cytomegalovirus
- Staphylococcus spp.
- Pseudomonas spp.
What do you call an infection that occurs as the result of treatment?
Iatrogenic Infection
Relative ability of a microorganism to cause disease or the degree of pathogenicity
Virulence
Ability to resist phagocytes (macrophages, neutrophils, badings)
Virulence
Ability to survive intracellularly and proliferate
Virulence
Give the Virulence Factor
E.Coli
O antigen (smooth strains) — somatic
K antigen (acid polysacc) — capsular
Give the Virulence Factor
Neisseria gonorrhoeae
(G(-) diplococci)
Fimbriae
attaches to mucous membrane of GI tract
Give the Virulence Factor
Pseudomonas aeruginosa
Polysaccharide slime (surface slime)
Give the Virulence Factor
Salmonella typhi
Vi antigen (enteric fever – foodborne)
Give the Virulence Factor
Bacillus anthracis
Toxic complex
Capsular poly-D-glutamic acid
Check niyo yung transes for the table for microorganism, types of interference and mechanism.
Give yourself a break, ang hirap ng cards na ‘to </3
Disease from infection is noticeable only if tissue damage occurs
Ability to produce extracellular toxins and enzymes
May be from toxins, either exotoxins or endotoxins, or from inflammatory substances that cause host-diven, immunologically mediated damage.
Ability to produce extracellular toxins and enzymes
- Poisonous substances produced by organisms that interact with host cells
- Disrupts normal metabolism and causing harm
Toxins
Check niyo ulit yung table for the differences of exotoxins and endotoxins and the table for examples of exotoxins of pathogenic bacteria
Good luck, babes!
T or F: For diseases caused by endotoxins, adherence to host cells are not important.
F
Exotoxins, not endotoxins
What are the host resistance factors?
- Physical Barrier
- Cleansing Mechanisms
- Antimicrobial Substances
- Indigenous Microbial Flora
- Phagocytosis
Host Reistance Factors
Intact Skin and Microbial Flora and Sebaceous Glands
Physical Barrier
Host Reistance Factors
Stratified and cornified epithelium presents a physical barrier to penetration by most microorganisms
Intact Skin
Host Reistance Factors
Long-chain fatty acids secreted = low pH
Microbial Flora & Sebaceous glands
Host Reistance Factors
- Desquamation of the skin surface.
- Tears bathing the cornea and sclera = lubrication + wash foreign matter and infectious agents (also contain IgA and lysozyme)
Cleansing Mechanism
Host Reistance Factors (Antimicrobial Substances)
A substance that plays a major role in resistance to infection
Lysozyme
Host Resistance Factors (Antimicrobial Substances)
Hydrolyzes the peptidoglycan layer of bacterial cell walls
Lysozyme
Host Resistance Factors (Antimicrobial Substances)
- Found in mucous secretions of the respiratory, genital, and digestive tracts
- Serves as opsonins
- Enhances phagocytosis
- Fix complement and neutralize infecting organisms
Antibodies (especially secretory IgA)
Host Resistance Factors (Antimicrobial Substances)
Inhibits the proliferation of viruses
Interferons
Host Resistance Factors (Indigeneous Microbial Flora)
Lessens the chance that the pathogen will colonize the host
Competition
Host Resistance Factors (Indigeneous Microbial Flora)
Substances that inhibit the growth of closely related bacteria
Bacteriocins
Host Resistance Factors
Primary mechanism in the host defense against extracellular bacteria and numerous viruses and fungi
Phagocytosis
Host Resistance Factors
The PMNs, macrophages, and monocytes are the body’s first line of defense
Phagocytosis
Tissue Distribution of Monocytes/Macrophages
Blood
Monocyte
Tissue Distribution of Monocytes/Macrophages
Liver
Kupffer Cell
Tissue Distribution of Monocytes/Macrophages
Lung
Alveolar Macrophage
Tissue Distribution of Monocytes/Macrophages
Connective Tissue
Histiocyte
Tissue Distribution of Monocytes/Macrophages
CNS
Microglial Cell
Tissue Distribution of Monocytes/Macrophages
Kidney
Mesangial Cells
Tissue Distribution of Monocytes/Macrophages
Spleen, Lymph Nodes
Macrophage
Host Resistance Factors
Four activities must occur for phagocytosis to take place and be effective in host defense
Chemotaxis
Host Resistance Factors (Chemotaxis)
What are the four activities that must occur for phagocytosis?
- Migration of phagocyte to the area of infection
- Attachment of the particle to the phagocyte
- Ingestion
- Killing
Host Resistance Factors
Body’s non-specific response to injury or foreign body
Inflammation
Host Resistance Factors (Inflammation)
Accumulation of phagocytic cells
Hallmark
Host Resistance Factors
Consists of numerous cells and protein molecules that are responsible for recognizing and removing foreign substances
Immune Response
Host Resistance Factors (Immune Responses)
What are the two divisions of immune responses?
- Innate or Natural: little to no specificity
- Adaptive or Specific: highly specialized
Types of Immunity
- Non-specific, no memory
- Ex.
skin, stomach acid, PMN, and NK cells
Natural/Innate
Types of immunity
- Specific memory, with memory
- Ex. T cells (cytokines) and B cells (antibodies)
Adaptive/Specific
- T cell that secretes lymphokines
- Defense against Viral/Fungal (Intracellular)
Cellular Immunity
- B cells (plasma cells)
- Defense against bacterial infections (Extracellular)
Humoral Immunity
Antibodies/Immunoglobulins
- Activates complement (component of innate immunity)
- Greatest concentration in serum
- Crosses the placenta (confers protection in both prenatal and postnatal period)
- Secondary (in terms of response)
IgG
Antibodies/Immunoglobulins
- Prominent in early immune response
- Fixes complement
- Largest antibody; pentamer
IgM
Antibodies/Immunoglobulins
- Predominance in body secretions
- Primary defense against local infections at mucosal surface
- (Lysozyme, β-lysin)
- A dimer
IgA
Antibodies/Immunoglobulins
- Allergy
- Triggers the release of histamines from mast cells (tissue based basophil)
IgE
Antibodies/Immunoglobulins
- Present on B-cell surface (receptor for antigen)
- Unknown functions
IgD
Routes of Transmission
The first step in initiating an infection is for the infectious agent to?
Gain access to the host
Routes of Transmission
The agent must be able to?
Evade host defenses and colonize the tissue at the point of entry
Routes of Transmission
T or F: Most agents have a preferred route.
True the fire
Identify the route of transmission
- Influenza
- M. Tuberculosis
Respiratory droplets
Route of Transmission
- Capnocytophaga
- Rabies (sabi nung book)
Animal bite
Routes of Transmission
- Salmonella
- Shigella
Stool > water/food > mouth (Fecal-oral route)
Routes of Transmission
- Leptospira interrogans
- R. ricketsii
Zoonotic
Routes of Transmission
- Hepatitis B
- HIV
- Malaria
Needle prick
Blood transfusion
Routes of Transmission
- S. aureus (sabi ni Sir Mabaggu)
- Human papillomavirus (warts)
- Syphilis
Skin to Skin
Routes of Transmission
- N. gonorrhoeae
- Chlamydia trachomatis
Genital secretions
Routes of Transmission
- P. aeruginosa
- P. mirabilis
Urine > hand > catheter
Identify the organism responsible for the disease: Anthrax
Bacillus anthracis
Identify the organism responsible for the disease: Brucellosis
Brucella spp
Identify the organism responsible for the disease: Erysipeloid
Erysipeloithrix rhusiopathiae (acquired thru animal carcasses)
Identify the organism responsible for the disease: Leptospirosis
Leptospira interrogans
Identify the organism responsible for the disease: Tularemia
Franciscella tularensis (acquired thru animal carcasses)
Identify the organism responsible for the disease: Lyme dse
Borrelia burgdorferi
Identify the organism responsible for the disease: Plague
Yersinia Pestis (acquired thru anthropod vectors)
Identify the organism responsible for the disease: Rat bite fever
Streptobacillus monoliforms