How Bacteria Causes Disease and How Infections Spread Flashcards

1
Q

What are commensals

A

These are bacteria that are colonised in a healthy host and do not cause disease

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2
Q

What are opportunistic pathogens

A

Pathogens that tend to cause disease when the opportunity arises caused by disturbance in the homeostasis between host and commensal

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3
Q

Give examples of opportunities for infection that opportunistic bacteria might take advantage of

A
  • In immunocompromised hosts
  • When they get to sites where they don’t normally live
  • Antibiotics and other therapies
  • Dietary imbalances
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4
Q

Give examples of pathogenic bacteria that can be spread due to asymptomatic carriage

A
  • Staphylococcus Aureus in the nose
  • Streptococcus Pneumoniae in the respiratory tract
  • Salmonella typhi in the gut or the gall bladder
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5
Q

How can the normal flora help prevent infection

A

The bacteria competes with pathogens for colonisation and invasion by undesirable, exogenous organisms

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6
Q

What is Virulence

A

This is the quantitative ability of a pathogenic microorganism to cause disease

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7
Q

What microbial factors influence virulence

A
  • Transmissibility
  • Infectivity
  • Invasiveness/Toxicity
  • Ability to evade host defences
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8
Q

What host factors influence virulence

A
  • Age
  • Genetic factors
  • General host defences and local host defences
  • Immunodeficiency
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9
Q

What are some exogenous sources of infection

A
  • Person to person
  • Animal pathogens may spread to humans - zoonosis
  • Human can be infected by organisms in the environment
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10
Q

Define an endemic infection

A

Always present in a population at a more or less constant level though the level may be cyclic

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11
Q

Define an epidemic infection

A

Higher than normal level in the population usually much higher than the endemic level and usually short term

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12
Q

Define an outbreak infection

A

Localised increase in incidence of a disease e.g. e.coli food poisoning

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13
Q

Define a pandemic infection

A

An epidemic spreading between continents

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14
Q

What is horizontal and vertical infection transmission

A

Horizontal - Transmission or organism between individuals

Vertical - Transmission from mother to offspring in utero/around birth

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15
Q

How can vertical spread of congenital infections occur and give examples of infections that can be spread by each pathway

A
  • From mother’s bloodstream and by crossing the placenta e.g. syphilis, rubella, toxoplasmosis
  • May be acquired shortly before or during delivery e.g. Herpes simplex, hepatitis B virus
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16
Q

Name some modes of transmission for infections

A
  • Respiratory spread
  • Faecal-oral spread
  • Via the skin or mucous membranes
  • Blood
  • Fomites - inanimate object that can carry and transmit microorganisms
  • Zoonoses
  • Sexual transmission
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17
Q

What is cellulitis and what is it often caused by

A

A spreading infection of the soft tissues, most commonly caused by streptococcus pyogenes, getting into a small abrasion of the skin

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18
Q

What is erythema and oedema

A

Erythema - reddening

Oedema - swelling

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19
Q

What are some infections that can spread by faecal-oral spread

A

Salmonella spp.
Shigella spp.
Hepatitis A

20
Q

How can blood borne transmission occur

A
  • Needles
  • Direct transmission
  • Insects like mosquitos and fleas
21
Q

What is a Nosocomial infection

A

Hospital Acquired infection

22
Q

What are the most common types of nosocomial infection

A
  • Urinary tract infections
  • Wound/skin and soft tissue infections
  • respiratory tract infections
23
Q

How can spread of infection in hospitals be minimised

A
  • Isolating patients with known resistant organisms if at all possible
  • Sensible adherence to sensible infection control policies - isolating patients in side rooms if required
  • Handwashing between patients
24
Q

What affects how easily an infection can spread

A
  • Ability to survive
  • Ability to find alternative host
  • Shedding capacity
  • Infectivity
  • Virulence
  • Ability to evade immune response
25
What respiratory infections can be spread by shedding
- Influenza - Measles - M. tuberculosis
26
What skin-contact infections can be spread by shedding
- Herpes Simplex | - Staphylococcus aureus
27
What facial-oral infections can be spread by shedding
- Salmonella typhimurium | - Hepatitis A
28
What is infectivity
This is the ability of an infection to enter, multiply and survive in host
29
What factors do infections need to be able to resist outside the host
- Drying - UV - Water - Soil
30
What are some ways that invading organisms can attach themselves to host tissues to colonise the body
- Neisseria gonorrhoea adheres to the genital mucosa by fimbriae - Giardia laamblia attaches to the jejunal mucosa by a special sucking disc - Influenza virus attaches to host cells by its hemagglutinin antigen
31
How do respiratory bacteria overcome host immune defences
They secrete an IgA protease which degrades host immunoglobulin
32
How does streptococcus pyogenes
Expresses protein A which binds host immunoglobulin preventing opsonisation and complement activation
33
How can organisms avoid destruction by host phagocytes
- Streptococcus pneumonia has a polysaccharide capsule which inhibits uptake by polymorphs - Some organisms e.g. mycobacterium tuberculosis can survive inside host macrophages
34
What kinds of enzymes can pathogens express to damage the host
``` Coagulase (s.aureus) Proteases Lipases Nucleases Glycosidases ```
35
What kind of bacteria release exotoxins
Gram positive bacteria
36
What kind of bacteria release endotoxins
Gram negative bacteria
37
Name some properties of exotoxins
- Highly toxic, acts at specific target sites - Neutralised by antitoxin - Often destroyed by heat
38
Name some types exotoxin
Streptococccal erythrogenic toxin - can lead to scarlet fever S. Aureus enterotoxin = diarrhoea Vibrio cholera enterotoxin = stimulates adenyl cyclase = watery diarrhoea
39
Describe the morphology of vibrio cholerae
- Curved bacterium rod-shaped - Gram-negative - Motile
40
How do endotoxins damage the host
They cause the host cells to produce IL-1 and TNF causing fever and shock
41
Where are endotoxins found
Found int he outer later of gram negative bacteria cell walls
42
What steps should you go through in the diagnosis process
- History - Clinical examination - Laboratory investigations - Others as needed - x rays an dat
43
What general questions should you ask when asking for patient history
- Travel - Contact with animals and infected people - Food - Drugs - Symptoms and duration
44
What ways can pathogens be detected for certain
Culture - gold standard - Microscopy - Immunofluorescence - Colorimetric - Nucleic acid extraction/pCR amplification/ sequencing tech.
45
What do you need to look for in a general serological diagnosis
at least 4x rise in antibody titre in acute infection or presence of IgM
46
Why do you look for IgM in general serological diagnosis
It is the first antibody to appear in response to initial exposure to antigen
47
When is serology particularly useful in diagnosis
In viral infections or when it is hard to grow the presumptive bacteria