Medical Microbiology
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Questions and Answers

What is the primary characteristic of the microbiota in the human body?

  • They are found only in the digestive tract.
  • They only exist in sick individuals.
  • All microbes are pathogenic.
  • They are regularly found at specific anatomical sites. (correct)
  • What is the typical ratio of bacteria and archaea to human cells in an average adult?

  • 10:1 (correct)
  • 10:100
  • 100:1
  • 1:1
  • Where are the majority of normal flora located in the human body?

  • In the mouth
  • On the skin
  • In the respiratory tract
  • In the gut (correct)
  • What can opportunistic pathogens do when a person is immunocompromised?

    <p>Take advantage of the weakened immune system (B)</p> Signup and view all the answers

    Which of the following describes a relationship where both organisms benefit?

    <p>Mutualism (A)</p> Signup and view all the answers

    What is primarily indicated when microorganisms are described as normal flora?

    <p>They do not typically cause diseases in healthy individuals. (A)</p> Signup and view all the answers

    What is a common characteristic of the normal flora found on human body surfaces?

    <p>They can become harmful if the host’s health declines. (A)</p> Signup and view all the answers

    Which anatomical site in the human body encompasses the largest area inhabited by normal flora?

    <p>Gut (D)</p> Signup and view all the answers

    What is the primary mechanism by which botulinum toxin affects muscle tissue?

    <p>It blocks the release of acetylcholine. (A)</p> Signup and view all the answers

    Which condition is most commonly associated with Campylobacter jejuni?

    <p>Bacterial gastroenteritis. (B)</p> Signup and view all the answers

    What type of toxins are endotoxins typically found in?

    <p>Gram-negative bacteria. (B)</p> Signup and view all the answers

    What effect do superantigen toxins have on the immune system?

    <p>Cause overdrive immune response. (A)</p> Signup and view all the answers

    Which of the following food items can lead to outbreaks of infant botulism?

    <p>Chili sauce. (A)</p> Signup and view all the answers

    What is a notable syndrome that can develop in 1 in 1000 cases of Campylobacter jejuni infections?

    <p>Guillain-Barré Syndrome. (B)</p> Signup and view all the answers

    What characteristic differentiates exotoxins from endotoxins?

    <p>Exotoxins are generally more toxic than endotoxins. (A)</p> Signup and view all the answers

    How do superantigens contribute to tissue damage?

    <p>By stimulating excessive immune cell activation. (B)</p> Signup and view all the answers

    What immune response does the body display due to Campylobacter jejuni LPS components?

    <p>Produces antibodies against bacterial sugars (A)</p> Signup and view all the answers

    What is a primary method of transmission for tuberculosis?

    <p>Via airborne droplets (B)</p> Signup and view all the answers

    What critical role does cell-mediated immunity play in tuberculosis?

    <p>It prevents active disease after infection (C)</p> Signup and view all the answers

    What characterizes multidrug-resistant tuberculosis (MDR TB)?

    <p>Resistant to both isoniazid and rifampin (A)</p> Signup and view all the answers

    Which of the following is NOT a recommended method to prevent the spread of tuberculosis?

    <p>Immediate antibiotic treatment for everyone (B)</p> Signup and view all the answers

    How is the treatment for tuberculosis typically characterized?

    <p>Requires combination therapies with multiple drugs (D)</p> Signup and view all the answers

    What structural feature contributes to the acid-fastness of mycobacteria?

    <p>Their waxy mycolic acid content (C)</p> Signup and view all the answers

    Which of the following factors differentiates the upper and lower respiratory tracts in terms of microbial colonization?

    <p>Differences in temperature and pH (C)</p> Signup and view all the answers

    What condition is primarily caused by the accumulation of acid-producing bacteria on teeth?

    <p>Dental caries (C)</p> Signup and view all the answers

    Which bacterium is most commonly associated with the formation of dental caries?

    <p>Streptococcus mutans (D)</p> Signup and view all the answers

    What is the primary function of the bacteria colonizing the human gastrointestinal tract?

    <p>To enhance food digestion and energy extraction (B)</p> Signup and view all the answers

    In which part of the digestive system is the microbial population largest?

    <p>Large intestine (B)</p> Signup and view all the answers

    What is a major factor contributing to the formation of dental plaque?

    <p>Saliva's glycoproteins facilitating bacterial adhesion (A)</p> Signup and view all the answers

    Which of the following best describes anaerobic bacterial species in the oral cavity?

    <p>They grow extensively in thick dental plaque. (A)</p> Signup and view all the answers

    What role do mucous membranes play in bacterial infection risk?

    <p>They provide a favorable environment for bacterial growth. (A)</p> Signup and view all the answers

    How do bacteria influence the human body beyond digestion?

    <p>By contributing to nutrient absorption and immune function. (C)</p> Signup and view all the answers

    What happens to microbes when they pass quickly through the stomach?

    <p>Some may survive if they are in food particles. (A)</p> Signup and view all the answers

    What is dental plaque primarily composed of?

    <p>Living bacteria and their byproducts in a matrix (A)</p> Signup and view all the answers

    Which process eliminates microbes from the large intestine?

    <p>Desquamation and peristalsis (A)</p> Signup and view all the answers

    What is the primary source of microorganisms in the oral cavity after birth?

    <p>Colonization from the surrounding environment (B)</p> Signup and view all the answers

    Which of the following statements about sugar and bacteria is accurate?

    <p>Sugar is fermented to produce lactic acid. (D)</p> Signup and view all the answers

    How does the body counteract the microbial population within the large intestine?

    <p>Through mechanisms like peristalsis and mucus movement. (A)</p> Signup and view all the answers

    What is the primary role of virulence factors in pathogens?

    <p>To assist in pathogen survival and promote pathogenicity. (C)</p> Signup and view all the answers

    What does LD50 represent in the context of virulence?

    <p>The lethal dose that kills 50% of test subjects. (B)</p> Signup and view all the answers

    Which enzyme breaks down hyaluronic acid and aids bacterial invasion?

    <p>Hyaluronidase (C)</p> Signup and view all the answers

    How does coagulase function in terms of pathogen protection?

    <p>By forming a protective fibrin coating. (B)</p> Signup and view all the answers

    Which toxin directly damages the integrity of host cell membranes?

    <p>Cytolytic toxins (B)</p> Signup and view all the answers

    What is the function of siderophores in bacterial pathogens?

    <p>To grab iron and assist in bacterial growth. (C)</p> Signup and view all the answers

    Which characteristic differentiates highly virulent pathogens from less virulent ones in terms of LD50?

    <p>Lower LD50 indicates higher virulence. (C)</p> Signup and view all the answers

    How does the Diphtheria toxin impact host cells?

    <p>It prevents transfer of amino acids necessary for protein synthesis. (D)</p> Signup and view all the answers

    Which of the following best describes the role of fimbriae in bacterial pathogens?

    <p>To facilitate adherence to host tissues. (D)</p> Signup and view all the answers

    Which type of exotoxin is characterized by its ability to stimulate excessive immune responses?

    <p>Superantigen toxins (A)</p> Signup and view all the answers

    What component of the Gram-negative cell wall is considered a virulence factor?

    <p>Lipopolysaccharide (LPS) (B)</p> Signup and view all the answers

    What process allows bacteria to acquire virulence factors via genetic exchange?

    <p>All of the above (D)</p> Signup and view all the answers

    How do hemolysins affect red blood cells?

    <p>They degrade the integrity of red blood cells. (B)</p> Signup and view all the answers

    What is a key function of enterotoxins specifically in food-borne pathogens?

    <p>They promote growth of the bacteria in the gut. (A)</p> Signup and view all the answers

    What characterizes extensively drug resistant tuberculosis (XDR TB)?

    <p>Resistant to isoniazid, rifampin, fluoroquinolone, and at least one injectable second-line drug. (C)</p> Signup and view all the answers

    Which age groups are more susceptible to infectious diseases?

    <p>Very young individuals and the elderly. (D)</p> Signup and view all the answers

    What is the role of the immune memory in the immune system?

    <p>To enhance the body's ability to recognize and respond to specific antigens. (D)</p> Signup and view all the answers

    Which factor does NOT contribute to a compromised host's susceptibility to infection?

    <p>Regular exercise. (C)</p> Signup and view all the answers

    What is the main purpose of vaccination?

    <p>To prepare the immune system to recognize specific pathogens. (D)</p> Signup and view all the answers

    What is required for herd immunity to be effective?

    <p>Vaccination of a significant portion of the population to protect vulnerable groups. (B)</p> Signup and view all the answers

    What is a key challenge in creating new flu vaccines each year?

    <p>Flu viruses can mutate, requiring updated vaccines. (B)</p> Signup and view all the answers

    Which of the following is NOT a component of specific immunity?

    <p>Phagocyte-driven innate immunity. (A)</p> Signup and view all the answers

    What condition is associated with a higher risk of TB infection?

    <p>Compromised immune function due to other conditions. (D)</p> Signup and view all the answers

    What is a common misconception about herd immunity?

    <p>The entire population must be vaccinated for herd immunity. (A)</p> Signup and view all the answers

    Flashcards

    Normal Flora

    Microorganisms that live on the body surfaces of healthy individuals.

    Microbiota

    Microbes regularly found at a given anatomical site.

    Human Body Microbes

    The human body is a diverse environment with specific niches where microbes reside. Most are benign.

    Microbes in the Gut

    A high concentration of microbes occurs in the gut, having a large surface area for microbes to occupy

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    Commensalism/Mutualism

    Describes the way microbes interact within the normal flora. Either bacteria or people benefit without direct harm or assistance.

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    Opportunistic Pathogens

    Microbes that may cause disease under specific circumstances, such as when immune systems are weakened or damaged.

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    Microbes on Skin

    A considerable but smaller microbial community lives on the skin.

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    Microbial Abundance

    Microbial count vastly outnumbers human cells.

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    Dental Plaque Formation

    Microbes in the mouth attach to teeth and gums, forming a sticky layer called dental plaque.

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    Acid Production & Caries

    Some bacteria in plaque produce acid that can dissolve tooth enamel, leading to cavities (caries).

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    Streptococcus mutans

    A type of bacteria commonly associated with tooth decay.

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    Oral Microbiota

    Community of microorganisms in the mouth.

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    Gastrointestinal Tract

    The digestive tract, including the stomach, small intestine, and large intestine.

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    Stomach Microbes

    Most microbes are killed in the acidic environment of the stomach.

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    Large Intestine Microbes

    Contains the largest microbial population in the body, mostly anaerobic bacteria.

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    Mucous Membranes & Infection

    Mucous membranes are surfaces where bacteria can easily enter the body; causing potential infection.

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    Microbial Biofilm

    A complex community of microorganisms in a sticky matrix.

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    Anaerobic Bacteria

    Bacteria that don't require oxygen to survive.

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    Bacterial Benefit

    Bacteria can help break down food and provide energy.

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    Pathogen

    An organism that causes disease.

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    Peristalsis

    Muscle contractions that move food through the digestive system.

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    Desquamation

    Shedding of cells or tissues.

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    Botulism

    A serious illness caused by the toxin produced by Clostridium botulinum bacteria. It can cause muscle weakness, paralysis, and even death.

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    Botulinum Toxin

    A neurotoxin produced by Clostridium botulinum bacteria that prevents the release of acetylcholine, a neurotransmitter essential for muscle contraction, leading to muscle paralysis.

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    Infant Botulism

    A form of botulism that affects infants under one year old, usually from consuming honey or other contaminated foods containing spores of Clostridium botulinum.

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    Superantigen Toxins

    Toxins that stimulate an excessive immune response by activating a large number of immune cells, leading to inflammation and tissue damage.

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    Endotoxins

    Toxins found in the cell wall of certain gram-negative bacteria. They are released when the bacteria die.

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    Campylobacter jejuni

    A common foodborne pathogen, primarily found in poultry, that can cause gastroenteritis and in rare cases, Guillain-Barré syndrome, a paralytic disorder.

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    Guillain-Barré Syndrome

    A rare but serious autoimmune disorder that attacks the nervous system, leading to paralysis. It can be triggered by infections, including Campylobacter jejuni.

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    Gastroenteritis

    An inflammation of the stomach and intestines, often caused by bacteria, viruses, or parasites. It can lead to diarrhea, vomiting, abdominal cramps, and fever.

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    LPS Mimicry

    Certain bacteria, such as Campylobacter jejuni, have LPS components that resemble human gangliosides, sugars found in the nervous system. This resemblance can lead the immune system to mistakenly attack human cells, often causing serious complications.

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    Autoimmune Reactions

    The immune system, designed to target foreign invaders, can sometimes misidentify self-components as threats. This leads to an autoimmune reaction where the body attacks its own tissues, often caused by cross-reactivity with bacterial mimics.

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    Aerosol Transmission

    Many infectious diseases spread through aerosols, tiny particles suspended in the air. These particles, carrying pathogens, are inhaled and can infect others.

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    Respiratory Tract Niche

    The respiratory system, including the upper and lower airways, offers distinct environments. Different pathogens thrive in specific niches based on factors like temperature, airflow, and pH.

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    Tuberculosis Pathogen

    Mycobacterium tuberculosis causes Tuberculosis, a serious infectious disease. The bacteria is characterized by its waxy cell wall containing mycolic acid, making it 'acid-fast' under microscopy.

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    Tuberculosis Transmission

    Tuberculosis is spread primarily through airborne droplets. When an infected person coughs, sneezes, or speaks, these droplets, containing bacteria, can infect others.

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    Tuberculosis Treatment

    Tuberculosis is treated with a combination of antimicrobial drugs, often including isoniazid or rifampin. Treatment usually requires a long regimen, typically nine months, to ensure eradication of the bacteria.

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    Multidrug-Resistant TB (MDR TB)

    MDR TB occurs when the tuberculosis bacteria develops resistance to at least two of the most potent TB drugs, isoniazid and rifampin. This makes treatment more challenging and often requires alternative therapies.

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    XDR TB

    A rare form of MDR TB that is resistant to isoniazid, rifampin, any fluoroquinolone, and at least one of three injectable second-line drugs.

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    MDR TB

    Multidrug-resistant tuberculosis, resistant to at least isoniazid and rifampin.

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    Risk Factors for Infection

    Factors that increase the likelihood of getting infected with TB. These include compromised immune systems, age, stress, diet, lifestyle choices, and genetics.

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    Compromised Host

    An individual with a weakened immune system, more susceptible to infection.

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    Specific Immunity

    The immune system's ability to recognize and target specific pathogens like TB, providing protection.

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    Immune Memory

    Once the immune system encounters and defeats a pathogen, it remembers it, enabling a faster and stronger response in the future.

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    Immunization

    The process of introducing weakened or inactivated pathogens (vaccines) into the body to stimulate an immune response without causing disease.

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    Herd Immunity

    A significant portion of the population is immune, reducing the spread of a disease, protecting those who cannot be vaccinated.

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    Disease Eradication

    The complete elimination of a disease from the world.

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    Why new flu vaccine each year?

    Flu viruses constantly mutate, requiring new vaccines each year to provide effective protection against the latest strains.

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    Coli contact

    The interaction between the surface of a pathogen and the surface of a host cell, often the first step in infection.

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    Virulence factors

    Traits or mechanisms that enable a pathogen to cause disease, such as toxins, enzymes, or structures for attachment.

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    Invasion

    The process by which a pathogen enters and spreads throughout the host's body, often via the bloodstream or lymphatic system.

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    LD50

    The lethal dose 50, the amount of a pathogen that kills 50% of a test group.

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    Highly virulent pathogens

    Pathogens that require a relatively small number of cells to cause death in a test group.

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    Hyaluronidase

    An enzyme produced by some pathogens that breaks down hyaluronic acid, a substance that cements animal cells together, allowing pathogens to spread.

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    Coagulase

    An enzyme that allows bacteria to coat themselves with fibrin, a protein involved in blood clotting, which helps protect them from the immune system.

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    Mobile genetic elements

    Segments of DNA that can move within or between genomes, often carrying genes for virulence factors.

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    Siderophore

    A molecule secreted by certain bacteria that binds iron, a vital nutrient for bacterial growth.

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    Enterotoxin

    A toxin that affects the small intestine, causing diarrhea, vomiting, and other symptoms.

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    Cytolytic toxins

    Toxins that damage cell membranes, leading to cell lysis (bursting) and death.

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    Hemolysins

    Cytolytic toxins that specifically break down red blood cells, producing a clear zone around bacterial colonies on blood agar plates.

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    AB toxins

    Toxins composed of two subunits: a binding subunit (B) that attaches to a host cell receptor and a toxic subunit (A) that enters the cell and causes damage.

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    Diphtheria toxin

    An AB toxin that inhibits protein synthesis by ribosylating elongation factor 2 (EF-2), a key protein for translation.

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    Study Notes

    Medical Microbiology BS2002 Lecture 9

    • Lecture presented by A/Prof Yann Boucher, SCELSE, Public Health, NUS
    • Email address: [email protected]

    Pippi and Scientific Pedigree

    • Carl Woese, just shy of Nobel, Father of Archaea
    • Norm Pace, NAS member, Father of 16S
    • Ford Doolittle, NAS member, Father of LGT
    • Yann Boucher, Dog owner, Father of new Vibrio species,

    Meet your Prof

    • Images depicting various locations and activities

    Medical Microbiology - Human Body Diversity

    • Human body is a diverse environment
    • Specific niches exist
    • Most microbes are benign
    • Application of ecological principles is important
    • Many interactions between humans and normal microbial flora
    • Microbiota: microbes regularly found at a given anatomical site

    Normal Flora

    • Microorganisms living on body surfaces of healthy individuals
    • ~10^14 bacteria and archaea in average adult (about 10^13 human cells)
    • Most in the gut (400 m² surface)
    • Skin (2 m²)
    • Mouth
    • Respiratory tract
    • Urogenital tract
    • Many normal flora are opportunistic pathogens
    • Commensalism or mutualism

    Mouth

    • Microbes adhere to gums and teeth
    • Not removed by brushing
    • Acid contributes to dental plaque, caries, gingivitis, and periodontal disease
    • Oral cavity is colonized by microorganisms from the surrounding environment within hours following birth

    Oral Microbes and Bacteria

    • Bacteria colonize tooth surfaces by attaching to glycoproteins deposited by saliva
    • Extensive growth of oral microbes results in a thick bacterial layer (dental plaque)
    • Anaerobic species produce high concentrations of acid that decalcifies tooth enamel (dental caries): Streptococcus mutans

    Gastrointestinal Tract

    • Stomach: most microbes are killed by acidic conditions
    • Some survive if pass through quickly
    • Some survive in food particles
    • Small intestine: few organisms
    • Large intestine: largest microbial population of body (10^13 to 10^14 microbial cells) eliminated by peristalsis, desquamation, and movement of mucus
    • Replaced rapidly due to rapid doubling times
    • Most microbes are anaerobes

    Bacteria Associated with Mucous Membranes

    • Mucous membranes are frequent sites of infection due to a favorable environment for bacterial growth

    Major Bacteria Present (Table 28.2)

    • Data presented in the shown table

    Bacteroides

    • Colonizes exfoliated host cells, food particles, and sloughed mucus
    • Rapidly eliminated if not attached
    • Adheres to particles in the gut, not the gut itself
    • Degrades complex carbohydrates along with methanogens for energy

    Bacteroides and Obesity

    • Human gut: has 10-100 trillion bacteria that break down food (sugar polymers)
    • Obese people have less Bacteroides and more Firmicutes
    • Bacteroides populations increase as obese people lose weight
    • Bacteria-free mice infected with microbial population from guts of obese mice become obese
    • Microbes determine how many calories can be extracted and absorbed

    Why?

    • Firmicutes have numerous enzymes that break down "indigestible" carbohydrates.

    Innate Resistance to Infection

    • Nonspecific barriers prevent colonization of the host by most pathogens
    • Lysozyme in tears and other secretions dissolve cell walls
    • Normal flora compete with pathogens
    • Rapid pH change inhibits microbial growth
    • Flushing of urinary tract prevents colonization
    • Blood proteins inhibit microbial growth
    • Mucus and phagocytes prevent colonization
    • Stomach acidity inhibits microbial growth
    • Normal flora compete with pathogens

    Deaths by Cause, Circa 2017

    • Worldwide mortality data from 2017 presented (see chart)

    Worldwide Deaths Due to Infectious Diseases, 2002

    • Worldwide mortality data from 2002 presented (see chart) and various causative agents are detailed. This data is used to demonstrate the importance of disease data

    Transmission Routes

    • Person-to-person: airborne, direct contact, sexually transmitted
    • Zoonotic and vector-borne
    • Soil-borne
    • Waterborne
    • Foodborne

    Terms of Pathogenicity

    • Attenuation: the decrease or loss of virulence
    • Toxicity: ability of an organism to cause disease through toxin production; toxins can travel to the host's sites
    • Invasiveness: ability of pathogen to grow in host tissue inhibiting host function; causes damage without producing toxin.
    • Many pathogens use a combination of toxins, invasiveness, and virulence factors to enhance pathogenicity

    Pathogenesis

    • Pathogens use various strategies to establish virulence
    • Exposure to pathogens
    • Adherence to skin or mucosa
    • Invasion through epithelium
    • Colonization and growth
    • Produce virulence factors
    • Toxicity (local or systemic)
    • Invasiveness (original site and distant sites)
    • Tissue damage and disease

    Adherence of Pathogen

    • Pathogen gains access to host tissues and multiplies before damage can be done
    • Infectious bacteria and viruses often adhere specifically to epithelial cells
    • Interactions between pathogen surfaces and host cell surfaces facilitate adherence

    Major Adherence Factors

    • Factors such as capsules/slime layers, adherence proteins, lipoteichoic acid, fimbriae (pili) facilitate the attachment of microbial pathogens

    Invasion

    • Starts at the site of adherence
    • May spread throughout the host via the circulatory or lymphatic systems
    • Availability of nutrients is important to pathogen growth
    • Pathogens may grow locally at site of invasion or throughout the body

    Virulence

    • Estimated from experiments using LD50 (lethal dose 50): dose of agent that kills 50% of animals in test group

    Virulence

    • Highly virulent pathogens: little difference in number of cells between LD50 and LD100
    • Moderately virulent pathogens may show greater difference in number of cells between LD50 and LD100.

    Virulence Factors

    • Enzymes enhance virulence by breaking down or altering host tissue for nutrient access
    • Hyaluronidase breaks down hyaluronic acid, protecting pathogens from host defense mechanisms
    • Coagulase allows bacteria to be coated with fibrin
    • Virulence factors can be encoded by bacteriophages, plasmids, and transposons

    Virulence Factors: Salmonella

    • LPS (Lipopolysaccharide) is found in gram-negative cell walls and is present in food-borne pathogens
    • O-specific polysaccharide
    • Iron uptake using siderophores
    • Virulence plasmid only in pathogenic strains
    • Fimbriae for adherence
    • Enterotoxin affects the small intestine

    Exotoxins

    • Proteins released from pathogenic organism as it grows
    • Categories include:
      • Cytolytic toxins
      • AB toxins
      • Superantigen toxins

    Cytolytic Toxins

    • Work by degrading cytoplasmic membrane integrity
    • Causing host cell lysis and death
    • Hemolysins

    Example; Staphylococcal α-toxin

    • Makes a pore in cell membranes for cell death by causing leakage of intracellular components

    AB Toxins

    • Consist of A and B subunits
    • Work by binding to host cell receptor (B subunit) and transfer a damaging agent (A subunit) across the cell membrane

    Diphtheria Toxin

    • Catalyzes ADP-ribosylation of elongation factor 2 (EF-2)
    • Prevents transfer of amino acids to growing peptide chain in ribosome

    Botulism (Clostridium botulinum)

    • Botulinum toxin blocks the release of acetylcholine to muscle tissue resulting in a permanent relaxed state
    • The toxins can be from food and cause paralysis and death

    Botulism cases (graph)

    • Time-series data showing outbreaks, mostly food-borne, and especially infant botulism.

    Superantigens

    • Stimulate large numbers of immune cells
    • Result in extensive inflammation and tissue damage.
    • Antigens mediate interaction with over 5% of lymphocyte pool

    Endotoxins

    • Lipopolysaccharide (LPS) portion of cell wall of certain gram-negative bacteria
    • Generally less toxic than exotoxins

    Campylobacter jejuni endotoxins

    • Food-borne pathogen of poultry
    • Most common cause of bacterial gastroenteritis
    • 1 in 1,000 people develop Guillain-Barré Syndrome
    • Paralytic disorder

    C. jejuni LPS components

    • Mimic human gangliosides (host sugars) causing immune system to attack own sugars

    Airborne Pathogens

    • Aerosols are important for person-to-person transmission
    • Most pathogens survive poorly in air
    • Respiratory infections, Different pathogens

    Respiratory Tract Colonization

    • Upper and lower respiratory tracts differ in their environments (temperature, air flow, pH).
    • This favors different microbes to colonize the respiratory tract

    Tuberculosis

    • Caused by Mycobacterium tuberculosis
    • Hansen's disease (leprosy) caused by Mycobacterium leprae
    • Acid-fast because of the waxy mycolic acid content of their cell walls.

    Tuberculosis (Incidence and Transmission)

    • Worldwide infectious disease of humans
    • Incidence is increasing.
    • Transmitted by airborne droplets
    • Cell-mediated immunity plays critical role

    Tuberculosis (Treatment)

    • Prevent by hospitalization of patients, face masks of healthcare workers
    • Treatment usually requires a nine-month regimen of isoniazid or rifampin to affect mycolic acid in mycobacteria
    • Direct observed therapy is popular to assure compliance and reduce risk

    Tuberculosis (MDR and XDR)

    • Multidrug-resistant (MDR-TB): resistant to isoniazid and rifampin
    • Extensively drug-resistant (XDR-TB): MDR-TB resistant to isoniazid, rifampin, fluoroquinolones, and injectable drugs

    Risk Factors of Infection

    • Compromised Host: one or more resistance mechanisms are inactive
    • Age: factor for determining susceptibility to infectious diseases
    • Stress: predisposes healthy individuals
    • Diet and lifestyle choices
    • Genetic Conditions can compromise a host

    Specific Immunity

    • Complex, multi-pathway systems; innate immunity (phagocytes), T-cell immunity, and antibody-mediated immunity
    • Immune system recognizes organism, person becomes immune, resulting in immune memory

    The Immune System

    • Complex and diverse to cover

    Immunization

    • Inoculation with attenuated or killed pathogens or chemically modified exotoxin-vaccination
    • Immune system recognizes specific antigens - may mutate
    • Why we need new flu vaccine each year: more likely with viral than bacterial diseases

    Herd Immunity

    • In a context of vaccines, it protects vulnerable individuals that cannot be vaccinated; blocking transmission
    • In a context of illness, a sufficient number of population is immunized

    Disease Eradication (Polio and Measles)

    • Polio and measles need to be eradicated in populations with vaccination, but vaccination campaigns may be compromised.

    Reported Cases (Measles)

    • Data plotted in time series to show reported cases of measles.

    Reported Cases (Polio)

    • Data provides a graph showing the prevalence of polio cases.

    Polio Virus in Wastewater

    • Discovery extending virus's presence in NYC

    Additional Information (Table 33.9)

    • Table of factors encoded by bacteriophages, plasmids, and transposons

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