Lecture: colonization and infections

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VASUpharm14
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Lecture: colonization and infections
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2010-10-03 22:17:52
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im too cool
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ibhs: richard ... (this is insane!! ... TMI o.o ) lol good luck! 524 exam 1
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  1. context: superorganism
    how are humans superorganisms or ecosystems
    contains human cells AND virus, fungi, protozoa, and mostly bacteria
  2. context: superorganism
    human body has >501 species/organism
    broken into what species
    • a. 1 species of human : 10 trillion human cells
    • b. 500 species of bacteria : 100 trillion bacterial cells (2-3 lbs of bacterial cells) -
    • the mouth has billions, skin is 10X more than mouth, GI has 1000X more than mouth
    • (mouth < skin < GI)
  3. 5 locations of normal flora
    • 1. skin
    • 2. GI tract
    • 3. respiratory tract
    • 4. female reproductive tract
    • 5. urinary tract
    • NOTE: location is key!
  4. context: 5 locations of normal flora
    skin
    everywhere
  5. context: 5 locations of normal flora
    GI tract
    oropharynx and large intestines (high) > small intestines (med) > stomach (low)
  6. context: 5 locations of normal flora
    respiratory tract
    • oropharynx (high)
    • lungs (none)
  7. context: 5 locations of normal flora
    female reproductive tract
    • vaginal canal (high)
    • uterus (none)
  8. context: 5 locations of normal flora
    urinary tract
    • urethra (low)
    • bladder (none)
  9. symbiosis means living together
    when is it good and when is babaddd to the bone
    • good = colonization
    • bad = infection
  10. context: symbiosis
    good = colonization
    • In normal flora with commensalism: microbes benefit, host unharmed
    • ex: microbes on skin
    • In normal flora/beneficial flora with mutualism: microbes and host benefits
    • ex: microbes in intestines assist with vitamin K
  11. context: symbiosis
    bad = infection
    • In normal/harmful flora (OPPORTUNISTIC pathogens) with pathogenic.
    • ex: microbes in mouth can cause cavities
    • In exogenous pathogens from exposure with parasitism: microbes benefit, host is harmed
    • ex: most viruses
  12. 5 Sources of healthy flora for a newborn (a fetus is sterile and has no bacteria at all)
    • 1. vaginal canal - lactobacillus (increase during pregnancy)
    • 2. hands - lactobacillus, E. coli, bifidobacteria
    • 3. nipples - bifidobacteria
    • 4. mother's mouth - streptococci, Neisseria
    • 5. everyone else
    • Normal Flora in 1-2 years
  13. 3 different reasons for diversity of normal flora
    • 1. diversity with different locations - bacteria adapted for specific areas (via receptors, nutrients, pH)
    • 2. diversity with different ages - bacteria change throughout lifetime (due to exposure, hormones, diet, lifestyle)
    • 3. diversity with different individuals - not everyone has the same flora (due to genes: gender, race, polymorphisms)
  14. 3 reasons to love normal flora/3 benefits of flora (or else you'll be dead in 2 weeks! and animals will die by 10 salmonella bacteria vs 1 million with flora)
    • 1. inhibit invasion by pathogens (compete for attachment sites, create non-optimal pH)
    • 2. inhibit colonization by pathogens (compete for nutrients, secrete bacteriocidal/static substances)
    • 3. sources of vitamins (some synthesize B vitamins, vitamin K)
  15. C section vs vaginal delivery for infants getting flora
    • C section: higher risk of asthma
    • lower in : lactobacillus until day 10, bifidobacteria until day 30, B fragilis until day 180
  16. Formula vs breastmilk
    • breastmilk fed tend to have better health
    • nipples have flora not in formula
    • breastmilk has nutrients/compounds not in formula (gut bacteria adjust to nutrition source)
  17. 3 alterations to flora that can be dangerous!
    • 1. antibiotics: 20% of users will develop antibiotic-associated diarrhea (to clean out tube from things that shouldn't be there, but too much can cause dehydration), increased risk of intestinal bacterial infection by clostridium difficile
    • 2. mouthwash: cancer patients that use mouthwash have increased mucositis (inflammation of mucous membranes of G.I. tract
    • 3. Douching: women who douche have higher rates of: vaginal irritation, vaginal infections, uterine infections
  18. Hygiene Hypothesis
    • immune systems aren't being challenged by disease and dirt early in life, so the body's natural defenses overreact to small irritants such as pollen.
    • so less dirty environmental exposures show up as those with possible asthma/allergies unlike dirty environments with those who have mild immune reactions.
    • SO: less likely for asthma if:
    • 1. born vaginally
    • 2. more siblings or pets
    • 3. day care first year (exposure, kids are germy)
  19. How to get an infection?
    4 steps
    • 1. adherence - attaches to host biomolecule (receptor) like to protein, carbohydrate, lipid
    • 2. invasion - may release enzymes to: a) degrade "cement" with collagenase, hyaluronidase; b) decrease clotting of blood with streptokinase (streptococci), staphylokinase (staphylococci); c) lyse white blood cell with phospholipases; d) increase clotting of blood (coagulase)
    • 3. evasion - escape and/or survive phagocytosis by WBCs
    • 4. toxigenesis - secrete exotoxin (created bacteria) and release endotoxin (piece of bacteria)
  20. what is an "obligate" pathogen?
    • needs host to reproduce
    • viruses: all
    • bacteria: chlamydia, rickettsia
    • protozoa: plasmodium
  21. virulence
    • the relative ability of a pathogen to cause infection or disease
    • –High virulence (infectivity): a small amount can easily overcome defenses
    • –High virulence (morbidity): a pathogen that strongly compromises health
  22. 3 types of virulence under morbidity (vs infectivity)
    • 1. High virulence (morbidity)
    • ex: Anthrax, ebola, marsburg, mad cow prion
    • -Highly virulent pathogens are not that common, why?
    • 2. Diminishing virulence (morbidity)
    • ex: Syphilis first appeared in 1400s, worse then than now
    • 3. Strategic virulence (morbidity) - Symptomatic: cough, sneeze, diarrhea, open sores V.S. Asymptomatic: no real signs of infection
    • ex: HPV: 50% of all sexually active women will acquire it, 1% will show “warts”
  23. 2 sources of infection
    • 1. endogenous = opportunistic pathogens - compromised health (already sick, sleep deprived, stress will release high cortisol [glucocorticosteroid], medications that decrease defenses like glucocorticosteroids; compromised barriers - cuts, burns, catheters
    • 2. exogenous = transmitted pathogens - Exposure + Compromised Health/Barriers; Exposure to
    • High concentration; Exposure to High virulence (infectivity)
  24. context: 2 sources of infection
    endogenous = opportunistic pathogens
    • normal flora turns pathogenic 2 ways: 1. Increased concentration in normal location and 2. Presence
    • in abnormal location
    • Examples in 3 areas:
    • 1. mouth - Streptococcus mutans : an increase can cause cavities/caries
    • 2. pharynx - Streptococcus pneumoniae : if went to lungs (abnormal location) can cause pneumonia; Neisseria meningitidis : if went to brain membranes (abnormal location) can cause meningitis
    • 3. lower intestine - bacteriodes : if went to peritoneal cavity (abnormal location) can cause peritoneal infection; Escherichia coli : if went to urethra (abnormal location) can cause UTI
  25. context: 2 sources of infection
    exogenous = transmitted pathogens
    4 types of disease
    • 1. communicable disease (colds) - human to human through air, fluid, solids
    • 2. zoonotic disease (rabies) - animal to human through teeth and beaks
    • 3. vector disease (malaria) - insects to human through bugs and bites
    • 4. food/water-borne disease (Salmonella) - food and/or water through ingestion/exposure
  26. 2 places to get infection
    • 1. community acquired: disease from OUTSIDE of healthcare facility
    • 2. Nosocomial/hospital acquired/latrogenic: disease from INSIDE of healthcare facility
  27. context: 2 places to get infection: Nosocomial infections (vs. community acquired)
    4 common types:
    • 1. Urethra: Urinary Tract Infections –UTIs - (33%)
    • 2.Wound: Surgical wound infection (17%)
    • 3. Lungs: Lower RTI (pneumonia) (15%)
    • 4. Blood: Septicemia (14%) - crosses bloodstream. Infection in entire blood circulatory system.
  28. context: 2 places to get infection: Nosocomial infections (vs. community acquired)
    2 sections of most common infection pathogens
    • 1) 34% caused by these 3 gram-positive cocci: Staphylococcus aureus, Enterococcus spp (species), Coagulase-negative staphylococcus
    • 2) 32% caused by these 4 gram-negative bacilli: E. coli, enterobacter spp, klebsiella spp, Pseudomonas aeruginosa
  29. context: infection-related terminology (6)
    morbidity rate
    frequency of a disease
  30. context: infection-related terminology (6)
    mortality rate (death rate)
    frequency of death
  31. context: infection-related terminology (6)
    sporadic disease
    occurs occasionally
  32. context: infection-related terminology (6)
    endemic disease
    always present
  33. context: infection-related terminology (6)
    epidemic disease
    sudden/rare local outbreak
  34. context: infection-related terminology (6)
    pandemic disease
    sudden/rare global outbreak
  35. context: 16 common infections in U.S. (~900 human pathogens): bacterial/virus/protozoa/fungal/any type??
    Genital chlamydia
    bacteria
  36. context: 16 common infections in U.S. (~900 human pathogens): bacterial/virus/protozoa/fungal/any type??
    Gonorrhea
    bacteria
  37. context: 16 common infections in U.S. (~900 human pathogens): bacterial/virus/protozoa/fungal/any type??
    Salmonellosis
    bacteria
  38. context: 16 common infections in U.S. (~900 human pathogens): bacterial/virus/protozoa/fungal/any type??
    Syphillis
    bacteria
  39. context: 16 common infections in U.S. (~900 human pathogens): bacterial/virus/protozoa/fungal/any type??
    Whooping cough
    bacteria
  40. context: 16 common infections in U.S. (~900 human pathogens): bacterial/virus/protozoa/fungal/any type??
    Tuberculosis
    bacteria
  41. context: 16 common infections in U.S. (~900 human pathogens): bacterial/virus/protozoa/fungal/any type??
    Lyme disease
    bacteria
  42. context: 16 common infections in U.S. (~900 human pathogens): bacterial/virus/protozoa/fungal/any type??
    HPV
    virus
  43. context: 16 common infections in U.S. (~900 human pathogens): bacterial/virus/protozoa/fungal/any type??
    Herpes
    virus
  44. context: 16 common infections in U.S. (~900 human pathogens): bacterial/virus/protozoa/fungal/any type??
    Hepatitis A,B,C
    virus
  45. context: 16 common infections in U.S. (~900 human pathogens): bacterial/virus/protozoa/fungal/any type??
    AIDS
    virus
  46. context: 16 common infections in U.S. (~900 human pathogens): bacterial/virus/protozoa/fungal/any type??
    chickenpox
    virus
  47. context: 16 common infections in U.S. (~900 human pathogens): bacterial/virus/protozoa/fungal/any type??
    Trichomoniasis
    protozoa
  48. context: 16 common infections in U.S. (~900 human pathogens): bacterial/virus/protozoa/fungal/any type??
    Giardiasis
    protozoa
  49. context: 16 common infections in U.S. (~900 human pathogens): bacterial/virus/protozoa/fungal/any type??
    Tinea
    • fungal
    • ex: ringworm, athlete's foot, jock itch
  50. context: 16 common infections in U.S. (~900 human pathogens): bacterial/virus/protozoa/fungal/any type??
    Pneumonia
    any type

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