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INFECTION
bascis
in·fec·tion
dictionary means
• a. Invasion by and multiplication of

pathogenic microorganisms in a bodily
part or tissue,...
Definitions
• Disease and Infectious Disease
–Disease

• Any deviation from a condition of
good health and well-being
–Inf...
Definitions
• Pathogenicity and Virulence
– Pathogenicity

• The ability of a microbe to cause disease
• This term is ofte...
Principles of Infection
• Understanding the basic principles
of infection is essential for any
health care worker in any f...
Nature of Microorganisms
• Microorganisms (microbes) are small,
living organisms that are not visible to the
naked eye.

•...
Infection means
• Infection is the invasion
of a host organism's
bodily tissues by diseasecausing organisms, their
multipl...
What is an Infection?
A harmful invasion and spread of foreign species, or
pathogen, in a host.
– VIRUS
• Small pox, measl...
COURSE OF INFECTIOUS DISEASEs
• Exposure/Invasion of
Host
• Incubation -- period of
time between exposure
and onset of sym...
Nature of Microorganisms
• Saprophytes
• Parasites
• Pathogens
Causative Agents effecting humans
u Bacteria
u Viruses
u Fungi

u Protozoa
u Helminths
u Prions

Dr.T.V.Rao MD

12
Types of Bacteria
•
•
•
•
•
•
•
•
•

Streptococci (chains)
Staphylococci (clusters)
Diplococci (pairs)
Micrococci (tiny)
F...
Types of Microorganisms
• Fungi
– A plantlike organism that lives on
dead organic matter.
– Yeasts and molds can be pathog...
Types of Microorganisms
• Protozoa
– One-celled animal like organisms often
found in decayed materials and
contaminated wa...
Types of Microorganisms
• Viruses
– Smallest of all microorganisms – visible only using an
electron microscope.
– Cannot r...
Classification of Infections
• Primary Infection
Reinfection
• Secondary Infection,
• Focal infection,
• Cross infection,
...
Source of Infections

• Endogenous
infection

•Exogenous
infections
Clinical Presentations
• In apparent infection
subclinical Infection
• In apparent infection,
• Atypical infections
• Late...
Source of Infection
•
•
•
•
•
•

Humans from patient or carrier
A healthy carrier
Convalescent carrier
Temporary carrier
C...
Source of Infections
•
•
•
•
•
•

Animals
Insects vectors
Mechanical vector
Biological vector
Soil and water
Food
MODES OF COMMUNICABLE DISEASE
TRANSMISSION

• Direct
Transmission
• Indirect
Transmission

Dr.T.V.Rao MD

22
Modes of Transmission
• Direct contact
• Indirect contact
• Droplet
transmission
• Hands
• Vector-borne
• Nosocomial
Dr.T....
Transmission of Patho
•Direct contact
•Indirect contacts
•Air
•Objects

•Vectors
Modes of Transmission
Direct
transmission

Indirect transmission

Direct contact

Airborne

Droplet spread

Vehicle borne
...
DIRECT TRANSMISSION
• Immediate transfer of the disease agent by direct
contact between the infected and the susceptible
i...
INDIRECT TRANSMISSION
• May be one of three types: air-borne, vehicle-borne, or
vector-borne
• Air-borne transmission -- t...
INDIRECT TRANSMISSION (cont’d.)
• Vehicle-borne transmission -- contaminated
materials or objects (fomites) serve as vehic...
INDIRECT TRANSMISSION (cont’d.)
• Also considered vehicles are water, milk, food
(e.g., common vehicles), or biological pr...
Causing an Infection
• Endogenous – disease originates within the body.
Ex: metabolic disorders, congenital abnormalities,...
Signs & Symptoms of Infection
•
•
•
•
•
•

Redness
Swelling
Tenderness
Warmth
Drainage
Red streaks leading away
wound
Dr.T...
Development of Infection:
Clinical Signs and Symptoms
• Local signs
– Inflammation
– Purulent exudate if bacterial infecti...
Generalized Stages of Infection
1. Entry of Pathogen
– Portal of Entry

2. Colonization
– Usually at the site of entry

3....
Generalized Stages of Infection
4. Prodromal Symptoms
– Initial Symptoms

5. Invasive period
– Increasing Severity of Symp...
Factors predisposing pathogenicity
• Pathogenicity means
ability of the
microbe to produce
disease or tissue
injury
• Viru...
Virulence and Pathogenicity
• Pathogenicity: capacity of microbes to cause
disease
• Virulence: degree of pathogenicity of...
Virulence Factors and Toxins
State of the Host
Immune System
• Number of
Pathogenic Cells
encountered by
the Host
•

– Inf...
Virulence Factors and Toxins
• Enzymatic Virulence Factors
– Examples:
• Coagulase (Staphylococcus aureus)
• Streptokinase...
Virulence Factors and Toxins
• Adhesion Factors
– Examples:

• Protein A
(Staphylococcus
aureus)
• Protein M
(Streptococcu...
Virulence Factors
• Virulence factors help bacteria to (1)
invade the host, (2) cause disease, and
(3) evade host defences...
Virulence Factors
• Invasion Factors: Surface components that
allow the bacterium to invade host cells can
be encoded on p...
Virulence Factors and Toxins
• Exotoxins
– A type of bacterial toxin with the following
properties:
• May be produced by e...
Virulence Factors and Toxins
• Exotoxins (cont.)
– Classes of exotoxins: Neurotoxic, cytotoxic, or
enterotoxic exotoxins
•...
Virulence Factors and Toxins
• Endotoxins
– A type of bacterial toxin having the following
properties:
• Produced only by ...
Virulence Factors and Toxins
• Endotoxins (cont.)
• Endotoxin is composed
of Lipid A: Part of the
lipopolysaccharide
layer...
Endotoxins
• Endotoxins: The
lipopolysaccharide
endotoxins on Gramnegative bacteria
cause fever, changes
in blood pressure...
Mechanism of Endotoxin activity
Exotoxins
• Exotoxins: Exotoxins
include several types of
protein toxins and
enzymes produced
and/or secreted from
pathoge...
Exotoxins
• Exotoxins, unlike the lipopolysaccharide
endotoxin, are protein toxins released from viable
bacteria. They for...
Exotoxins
• The functions of these exotoxins for the
bacteria are usually unknown, and the genes
for most can be deleted w...
Exotoxin and Endotoxins
Exotoxins
• Tetanus toxin, for example, affects only intern
uncial neurons. In general, exotoxins are
excellent antigens t...
Exotoxins
• Endotoxin is comprised of toxic
lipopolysaccharide components of the outer
membrane of Gram-negative bacteria ...
Exotoxins
• The term endotoxin was coined in 1893 by
Pfeiffer to distinguish the class of toxic substances
released after ...
Other Factors
• Plasmids
• Bacteriophages
• Compatibility
Other Bacterial factors
• Coagulase
• Fibrinolysin
• Hyaluronidase
• Other enzymes
Bacterial Appendages
• Biofilms
• Free floating
bacteria come in
contact with
medical devices
and attach to
them with pili
Infecting Dose

•Minimum infective
dose
•Minimal lethal dose
Types of Infectious diseases

• Bacteraemia
• Septicaemia
• Pyemia
Other types
• Endemic
disease
• Epidemic
disease
• Pandemic
disease
• Sporadic
diseases
Hospital acquired infections
• Infection which was
neither present nor
incubating at the time
of admission
• Includes infe...
Basic steps in Prevention of Infection
• There are possible
treatment and
prevention to stop
the infection cycle.
This is ...
Antimicrobial agents In
Infection
• Anti-infective drugs such as antibiotics,
antiviral, antifungal and ant tubercular dru...
Infection lecture basics
Infection lecture basics
Infection lecture basics
Infection lecture basics
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Infection lecture basics

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Infection lecture basics

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Infection lecture basics

  1. 1. INFECTION bascis
  2. 2. in·fec·tion dictionary means • a. Invasion by and multiplication of pathogenic microorganisms in a bodily part or tissue, which may produce subsequent tissue injury and progress to overt disease through a variety of cellular or toxic mechanisms. • b. The pathological state resulting from having been infected. Dr.T.V.Rao MD 2
  3. 3. Definitions • Disease and Infectious Disease –Disease • Any deviation from a condition of good health and well-being –Infectious Disease A disease condition caused by the presence or growth of infectious microorganisms or parasites Dr.T.V.Rao MD 3
  4. 4. Definitions • Pathogenicity and Virulence – Pathogenicity • The ability of a microbe to cause disease • This term is often used to describe or compare species – Virulence • The degree of pathogenicity in a microorganism • This term is often used to describe or compare strains within a species Dr.T.V.Rao MD 4
  5. 5. Principles of Infection • Understanding the basic principles of infection is essential for any health care worker in any field of health care. 1. Disease transmission 2. Prevention of disease transmission
  6. 6. Nature of Microorganisms • Microorganisms (microbes) are small, living organisms that are not visible to the naked eye. • Pathogens (germs) are microorganisms that cause disease. • Non-pathogens are microorganisms that do not cause disease; can be beneficial.
  7. 7. Infection means • Infection is the invasion of a host organism's bodily tissues by diseasecausing organisms, their multiplication, and the reaction of host tissues to these organisms and the toxins they produce. Infections are caused by microorganisms such as viruses, prions, bacteria, and Viroids, and larger organisms like parasites and fungi.MD Dr.T.V.Rao 7
  8. 8. What is an Infection? A harmful invasion and spread of foreign species, or pathogen, in a host. – VIRUS • Small pox, measles, influenza, Ebola – PRIONS • Cow’s disease – BACTERIA • Tuberculosis, pneumonia, salmonella, anthrax – FUNGUS • Athlete’s foot, ring worm – PROTISTS • Malaria, toxoplasmosis, Algae
  9. 9. COURSE OF INFECTIOUS DISEASEs • Exposure/Invasion of Host • Incubation -- period of time between exposure and onset of symptoms -- e.g., interval between HIV infection and development of AIDS can be as long as 10-15 years • Host reaction Dr.T.V.Rao MD 9
  10. 10. Nature of Microorganisms • Saprophytes • Parasites • Pathogens
  11. 11. Causative Agents effecting humans u Bacteria u Viruses u Fungi u Protozoa u Helminths u Prions Dr.T.V.Rao MD 12
  12. 12. Types of Bacteria • • • • • • • • • Streptococci (chains) Staphylococci (clusters) Diplococci (pairs) Micrococci (tiny) Flagellated forms (tails) Bacilli (rod-shaped) Vibrios Spirilla (spiral) Spirochetes (comma)
  13. 13. Types of Microorganisms • Fungi – A plantlike organism that lives on dead organic matter. – Yeasts and molds can be pathogenic. – Cause conditions such as ringworm, athlete’s foot, yeast infections, and thrush. – Antibiotics do not kill fungi. Antifungal medications are available, but expensive and may cause liver damage.
  14. 14. Types of Microorganisms • Protozoa – One-celled animal like organisms often found in decayed materials and contaminated water. – Many contain flagella which allow them to move freely. – Cause diseases such as malaria, trichomonas, and amebic dysentery.
  15. 15. Types of Microorganisms • Viruses – Smallest of all microorganisms – visible only using an electron microscope. – Cannot reproduce unless they are inside another living cell. – Spread by contact with blood and other body fluids. – Difficult to destroy. Not affected by antibiotics. – Associated with diseases such as the common cold, chicken pox, herpes, hepatitis B, measles, warts, polio, influenza, and AIDS.
  16. 16. Classification of Infections • Primary Infection Reinfection • Secondary Infection, • Focal infection, • Cross infection, • Nosocomial infections • Iatrogenic infection
  17. 17. Source of Infections • Endogenous infection •Exogenous infections
  18. 18. Clinical Presentations • In apparent infection subclinical Infection • In apparent infection, • Atypical infections • Latent infections
  19. 19. Source of Infection • • • • • • Humans from patient or carrier A healthy carrier Convalescent carrier Temporary carrier Contact carrier Paradoxical carrier
  20. 20. Source of Infections • • • • • • Animals Insects vectors Mechanical vector Biological vector Soil and water Food
  21. 21. MODES OF COMMUNICABLE DISEASE TRANSMISSION • Direct Transmission • Indirect Transmission Dr.T.V.Rao MD 22
  22. 22. Modes of Transmission • Direct contact • Indirect contact • Droplet transmission • Hands • Vector-borne • Nosocomial Dr.T.V.Rao MD 23
  23. 23. Transmission of Patho •Direct contact •Indirect contacts •Air •Objects •Vectors
  24. 24. Modes of Transmission Direct transmission Indirect transmission Direct contact Airborne Droplet spread Vehicle borne Vector borne
  25. 25. DIRECT TRANSMISSION • Immediate transfer of the disease agent by direct contact between the infected and the susceptible individuals • Occurs through such acts as touching, biting, kissing, sexual intercourse, or by direct projection (droplet spread) by coughing or sneezing within a distance of one meter • Examples of diseases for which transmission is usually direct are AIDS, syphilis, gonorrhea, and the common cold Dr.T.V.Rao MD 26
  26. 26. INDIRECT TRANSMISSION • May be one of three types: air-borne, vehicle-borne, or vector-borne • Air-borne transmission -- transmission of microbial aerosols to a suitable port of entry, usually the respiratory tract – Microbial aerosols are suspensions of dust or droplet nuclei made up wholly or in part by microorganisms -may be suspended and infective for long periods of time – Examples of air-borne diseases include tuberculosis, influenza, Histoplasmosis,MD Legionellosis and Dr.T.V.Rao 27
  27. 27. INDIRECT TRANSMISSION (cont’d.) • Vehicle-borne transmission -- contaminated materials or objects (fomites) serve as vehicles, nonliving objects by which communicable agents are transferred to a susceptible host – The agent may or may not have multiplied or developed on the vehicle – Examples of vehicles include toys, handkerchiefs, soiled clothes, bedding, food service utensils, and surgical instruments Dr.T.V.Rao MD 28
  28. 28. INDIRECT TRANSMISSION (cont’d.) • Also considered vehicles are water, milk, food (e.g., common vehicles), or biological products such as blood, serum, plasma, organs and tissues • Almost any disease can be transmitted by vehicles, including those for which the primary mode of transmission is direct, such as dysentery and hepatitis
  29. 29. Causing an Infection • Endogenous – disease originates within the body. Ex: metabolic disorders, congenital abnormalities, tumors. • Exogenous – disease originates outside the body. Ex: chemical agents, electrical shock, trauma. • Nosocomial – acquired by an individual in a health care facility (workers to patient). – Many are antibiotic resistant, life-threatening. • Opportunistic – occur when the body’s defenses are weak. Ex: pneumonia w/AIDs.
  30. 30. Signs & Symptoms of Infection • • • • • • Redness Swelling Tenderness Warmth Drainage Red streaks leading away wound Dr.T.V.Rao MD from 31
  31. 31. Development of Infection: Clinical Signs and Symptoms • Local signs – Inflammation – Purulent exudate if bacterial infection; serous exudate if viral – Tissue necrosis – Lymphadenopathy – Respiratory effects • Systemic signs – Fever, fatigue, headache, nausea Dr.T.V.Rao MD 32
  32. 32. Generalized Stages of Infection 1. Entry of Pathogen – Portal of Entry 2. Colonization – Usually at the site of entry 3. Incubation Period – Asymptomatic period – Between the initial contact with the microbe and the appearance of the first symptoms Dr.T.V.Rao MD 33
  33. 33. Generalized Stages of Infection 4. Prodromal Symptoms – Initial Symptoms 5. Invasive period – Increasing Severity of Symptoms – Fever – Inflammation and Swelling – Tissue Damage – Infection May Spread to Other Sites – Acme (Fastigium) Dr.T.V.Rao MD 34
  34. 34. Factors predisposing pathogenicity • Pathogenicity means ability of the microbe to produce disease or tissue injury • Virulence • May undergo variation
  35. 35. Virulence and Pathogenicity • Pathogenicity: capacity of microbes to cause disease • Virulence: degree of pathogenicity of specific microbe – Based on: • • • • Invasive qualities Toxic qualities Presence of pile or fimbriae for adhesion Ability to avoid host defenses (mutate) Dr.T.V.Rao MD 36
  36. 36. Virulence Factors and Toxins State of the Host Immune System • Number of Pathogenic Cells encountered by the Host • – Infectious Dose Dr.T.V.Rao MD 37
  37. 37. Virulence Factors and Toxins • Enzymatic Virulence Factors – Examples: • Coagulase (Staphylococcus aureus) • Streptokinase (Streptococcus pyogenes) • Hyaluronidase (Many pathogens) • Collagenase (Many pathogens) • Leukocidin (Many pathogens) • Hemolysin (Many pathogens) Dr.T.V.Rao MD 38
  38. 38. Virulence Factors and Toxins • Adhesion Factors – Examples: • Protein A (Staphylococcus aureus) • Protein M (Streptococcus pyogenes) Dr.T.V.Rao MD 39
  39. 39. Virulence Factors • Virulence factors help bacteria to (1) invade the host, (2) cause disease, and (3) evade host defences. The following are types of virulence factors: • Adherence Factors: Many pathogenic bacteria colonize mucosal sites by using pili (fimbriae) to adhere to cells.
  40. 40. Virulence Factors • Invasion Factors: Surface components that allow the bacterium to invade host cells can be encoded on plasmids, but more often are on the chromosome. • Capsules: Many bacteria are surrounded by capsules that protect them from opsonisation and phagocytosis
  41. 41. Virulence Factors and Toxins • Exotoxins – A type of bacterial toxin with the following properties: • May be produced by either gram-positive or gramnegative bacteria • Is secreted by the bacteria • The action of the exotoxin does not necessarily require the presence of the bacteria in the host • Most exotoxins are peptide or protein • Most exotoxins are heat sensitive (exception: enterotoxin of Staphylococcus aureus) Dr.T.V.Rao MD 42
  42. 42. Virulence Factors and Toxins • Exotoxins (cont.) – Classes of exotoxins: Neurotoxic, cytotoxic, or enterotoxic exotoxins • Neurotoxins: Interfere with proper synaptic transmissions in neurons • Cytotoxins: Inhibit specific cellular activities, such as protein synthesis • Enterotoxins: Interfere with water reabsorption in the large intestine; irritate the lining of the gastrointestinal tract Dr.T.V.Rao MD 43
  43. 43. Virulence Factors and Toxins • Endotoxins – A type of bacterial toxin having the following properties: • Produced only by gram-negative bacteria • Endotoxins are a component of the gram-negative cell wall • The action of endotoxin requires the presence of the bacteria in the host. The endotoxin may be released from the cell wall as the cells die and disintegrate Dr.T.V.Rao MD 44
  44. 44. Virulence Factors and Toxins • Endotoxins (cont.) • Endotoxin is composed of Lipid A: Part of the lipopolysaccharide layer • Mode of action: Irritation/inflammation of epithelium, GI irritation, capillary/blood vessel inflammation, hemorrhaging Dr.T.V.Rao MD 45
  45. 45. Endotoxins • Endotoxins: The lipopolysaccharide endotoxins on Gramnegative bacteria cause fever, changes in blood pressure, inflammation, lethal shock, and many other toxic events.
  46. 46. Mechanism of Endotoxin activity
  47. 47. Exotoxins • Exotoxins: Exotoxins include several types of protein toxins and enzymes produced and/or secreted from pathogenic bacteria. Major categories include cytotoxins, neurotoxins, and enterotoxins.
  48. 48. Exotoxins • Exotoxins, unlike the lipopolysaccharide endotoxin, are protein toxins released from viable bacteria. They form a class of poisons that is among the most potent, per unit weight, of all toxic substances. Most of the higher molecularsized exotoxin proteins are heat labile; however, numerous low molecular-sized exotoxins are heat-stable peptides. Unlike endotoxin, which is a structural component of all Gram-negative cells, exotoxins are produced by some members of both Gram-positive and Gram-negative genera.
  49. 49. Exotoxins • The functions of these exotoxins for the bacteria are usually unknown, and the genes for most can be deleted with no noticeable effect on bacterial growth. In contrast to the extensive systemic and immune-system effects of endotoxin on the host, the site of action of most exotoxins is more localized and is confined to particular cell types or cell receptors.
  50. 50. Exotoxin and Endotoxins
  51. 51. Exotoxins • Tetanus toxin, for example, affects only intern uncial neurons. In general, exotoxins are excellent antigens that elicit specific antibodies called antitoxins. Not all antibodies to exotoxins are protective, but some react with important binding sites or enzymatic sites on the exotoxin, resulting in complete inhibition of the toxic activity (i.e., neutralization).
  52. 52. Exotoxins • Endotoxin is comprised of toxic lipopolysaccharide components of the outer membrane of Gram-negative bacteria (see Ch. 2). Endotoxin exerts profound biologic effects on the host and may be lethal. Because it is omnipresent in the environment, endotoxin must be removed from all medical supplies destined for injection or use during surgical procedures.
  53. 53. Exotoxins • The term endotoxin was coined in 1893 by Pfeiffer to distinguish the class of toxic substances released after lysis of bacteria from the toxic substances (exotoxins) secreted by bacteria. Few, if any, other microbial products have been as extensively studied as bacterial endotoxins. Perhaps it is appropriate that a molecule with such important biologic effects on the host, and one produced by so many bacterial pathogens, should be the subject of intense investigation.
  54. 54. Other Factors • Plasmids • Bacteriophages • Compatibility
  55. 55. Other Bacterial factors • Coagulase • Fibrinolysin • Hyaluronidase • Other enzymes
  56. 56. Bacterial Appendages • Biofilms • Free floating bacteria come in contact with medical devices and attach to them with pili
  57. 57. Infecting Dose •Minimum infective dose •Minimal lethal dose
  58. 58. Types of Infectious diseases • Bacteraemia • Septicaemia • Pyemia
  59. 59. Other types • Endemic disease • Epidemic disease • Pandemic disease • Sporadic diseases
  60. 60. Hospital acquired infections • Infection which was neither present nor incubating at the time of admission • Includes infection which only becomes apparent after discharge from hospital but which was acquired during hospitalisation (Rcn, 1995) • Also called nosocomial infection Dr.T.V.Rao MD 63
  61. 61. Basic steps in Prevention of Infection • There are possible treatment and prevention to stop the infection cycle. This is through adequate hygiene, sanitary environment maintenance and health education. Dr.T.V.Rao MD 64
  62. 62. Antimicrobial agents In Infection • Anti-infective drugs such as antibiotics, antiviral, antifungal and ant tubercular drugs suppress infection. It can be administered by mouth, topically or intravenously depending on the infection extent and severity. Sometimes, if drug resistance is known, multiple drugs are used to stop drug resistance and increase drug effectiveness. Antibiotics only work for bacterial infection and have no effect on viral ones. Dr.T.V.Rao MD 65

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