Transmission of Microbes Flashcards
Routes of Entry of Microbes
Microbes can enter the host through breaches in the skin, by inhalation or ingestion, or by sexual transmission
Skin
Epidermal barrier
Mechanical defects (punctures, burns, ulcers)- Staphylococcus aureus, Candida albicans, Pseudomonas aeruginosa
Needle sticks- HIV, hepatitis viruses
Arthropod and animal bites- Yellow fever, plague, Lyme disease, malaria, rabies, Zika virus
Direct penetration Schistosoma
Gastrointestinal tract Epithelial barrier
Attachment and local proliferation
of microbes- Vibrio chloerae, Giardia
Attachment and local invasion of
microbes- Shigella, Salmonella, Campylobacter
Uptake through M cells- Poliovirus, certain pathogenic bacteria
GIT Acidic
Acid-resistant cysts and eggs Many protozoa and helminths
GIT Bile and pancreatic organism
Resistant microbial external coats Hepatitis A, Rotavirus, Norovirus
GIT Normal protective flora
Broad-spectrum antibiotic use Clostridium difficile
Respiratory tract Mucociliary clearance
attachment and local proliferation
of microbes- Influenza viruses
Ciliary paralysis by toxins- Haemophilus influenzae, M. pneumoniae, Bordetella pertussis
Respiratory tract- Resident alveolar macrophages
Resistance to killing by phagocytes M. tuberculosis
Urogenital tract Urination
obstruction, microbial attachment and local proliferation- E. coli
UGT, normal vaginal flora
Antibiotic use- candida albicans
UGT, Intact epidermal/epithelial barrier
Microbial attachment and local proliferation- Neisseria Gonorrhoeae
Direct infection/Local invasion- Herpes, Zika, T. Pallidum
Local Trauma- HPV
How do pathogens enter GIT?
food, drink, or contaminated water- especially during floods- diarrheal diseases are rampant.
What are some of the most important barriers against GIT infections
Acidic and Gastric secretions
How much dose of V. cholerae is needed for infection to manifest?
10^11
How many times does stomach acid neutralize the pathogen?
10,000 fold for V. cholerae
Shigella and Giardiasis
resistant to gastric acid, fewer than 100 organisms
The other normal defenses in GIT are
Viscous mucus layers; Lytic pancreatic enzymes and bile detergents; Mucosal and anti-microbial peptides called defensis; Normal flora; IgA antibodies made by MALT
Pathogens that use M cells to enter GIT
Polio, E coli, V. Cholerae, Salmonella, Shigella flexneri
how are host defenses weakened in GIT
Low gastric acidity, antibiotics, obstruction, and cessation of peristalsis
TOxins in food
S. aureus, Bacillus Cereus
How is the vagina protected from pathogens from puberty until menopause?
low pH by lactobacilli catabolism, antibiotics kill lactobacillus, causing overgrowth of yeast and result Vaginal candidiasis
Spread and Dissemination of Microbes
Within the Body
Some microorganisms proliferate locally, at the site of
the initial infection, whereas others penetrate the epithelial
barrier and spread to distant sites by way of the lymphatics, the blood, or nerves
Lysis and invasion
Some extracellular bacteria, fungi,
and helminths secrete lytic enzymes that destroy tissue and allow direct invasion.
S. aureus secretes
hyaluronidase, which degrades the extracellular matrix between host cells. Invasive microbes initially follow tissue planes of least resistance and drain
to regional lymphatics. S. aureus may travel from a localized abscess to the draining lymph nodes. This can
sometimes lead to bacteremia and spread to deep organs (heart, bone)
Through blood and lymph
. Microorganisms may be spread
either in extracellular fluid or within host cells. Some viruses (e.g., poliovirus, HBV), most bacteria and fungi,
some protozoa (e.g., African trypanosomes), and all helminths are transported in the plasma. Leukocytes can carry herpes viruses, HIV, mycobacteria, Leishmania, and
Toxoplasma.
parasites that are found in blood
Plasmodium and Babesia are
found within red cells
Cell-to-cell transmission
Most viruses spread locally from
cell to cell by replication and release of infectious virions,
but others may propagate from cell to cell by causing
fusion of host cells, or by transport within nerves (as with rabies virus and varicella-zoster virus)
The consequences of the bloodborne spread of pathogens
vary widely depending on
virulence of the organism, the magnitude of the infection, the pattern of seeding,
and host factors such as immune status
Sporadic bloodstream invasion by low-virulence or nonvirulent microbes
during brushing of teeth) is common but is quickly
controlled by normal host defenses. By contrast, disseminated viremia, bacteremia, fungemia, or parasitemia by
virulent pathogens poses a serious danger and manifests
as fever, hypotension, and multiple other systemic signs
and symptoms of sepsis
Can major manifestations of infectious disease appear at sites distant from the point of microbe entry?
Yes, Eg. V. zoster; Measles
Schistosoma mansoni
parasites penetrate
the skin but eventually localize in blood vessels of the portal system and mesentery, damaging the liver and intestine. Schistosoma hematobium also penetrates the skin,
but localizes to the urinary bladder and causes cystitis. The
rabies virus travels from the site of a bite by a rabid animal
to the brain by retrograde transport in sensory neurons,
where it then causes encephalitis and death.
Transmission of Microbes
Transmission depends on the hardiness of the microbe. Some microbes can survive for extended periods in dust,
food, or water. Bacterial spores, protozoan cysts, and thick shelled helminth eggs can survive in a cool and dry environment. Less hardy microorganisms must be quickly
passed from person to person, often by direct contact.
Skin as a mode of transmission
Skin flora, such as S. aureus and dermatophytes
(fungi), are shed in the desquamated skin. Some sexually transmitted pathogens are transmitted from genital
skin lesions, such as HSV and Treponema pallidum
(causing syphilis).
Oral secretions as a mode of secretion
Viruses that replicate in the salivary
glands and are spread in saliva include mumps virus,
CMV, and rabies virus
• Respiratory secretions
Viruses and bacteria can be shed
in respiratory secretions during talking, coughing, and
sneezing. Most respiratory pathogens, including influenza viruses, spread in large respiratory droplets, which
travel no more than 3 feet. However, a few organisms,
including M. tuberculosis and varicella-zoster virus, are
spread from the respiratory tract in small respiratory
droplets or within dust particles that can travel long
distances in the air. These properties determine the type
of isolation precautions that are used to prevent the
spread of infection
• Stool
Organisms shed in stool include many pathogens
that replicate in the lumen or epithelium of the gut, such
as Shigella, G. lamblia, and rotavirus. Pathogens that replicate in the liver (hepatitis A virus) or gallbladder (S.
enterica serotype Typhi) enter the intestine in bile and
are shed in stool.
Blood.
Pathogens spread via blood may be transmitted
by invertebrate vectors, medical practices (blood transfusion, reuse of equipment), or sharing of needles by
intravenous drug abusers. Bloodborne parasites, including Plasmodium spp. and arboviruses, are transmitted by
biting insects
Urine
Urine is the usual mode of exodus from the
human host for only a few organisms, including S. haematobium, which grows in the veins of the bladder and
releases eggs that reach the urine
Genital tract.
Sexually transmitted infections (STIs)
spread from the urethra, vagina, cervix, rectum, or oral
pharynx. Organisms that cause STIs depend on direct
contact for person-to-person spread because these
pathogens cannot survive in the environment. Transmission of STIs often is by asymptomatic individuals
who do not realize that they are infected. Infection with
one STI increases the risk for additional STIs, mainly
because the risk factors are the same for all STIs
Vertical transmission
Transmission of infectious agents
from mother to fetus or newborn child is a common
mode of transmission for some pathogens, and may
occur through several different routes
Placental-fetal
transmission is most likely to occur when the mother is
infected with a pathogen during pregnancy. Some of the
resulting infections interfere with fetal development,
and the degree and type of damage depend on the age
of the fetus at the time of infection.
rubella
infection during the first trimester
lead to heart malformations, mental retardation, cataracts, or deafness