MICROBIOLOGY

AND
IMMUNOLOGY
OPT 416
HS246
Dr MAIMUNAH MUSTAKIM
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LEARNING OBJECTIVES
AT THE END OF THE LESSON, STUDENTS ARE ABLE TO
IDENTIFY AND EXPLAIN/DESCRIBE:

I. How microorganisms interact with their hosts .

II. Characteristics of normal flora vs. pathogen.
III. Body sites of microbe-free.
IV. Principles of infectious diseases.
V. Reservoir of pathogens, portal of entry and exit of pathogens.
VI. Methods of microbial transmission.
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Natural relationship on man and microorganisms

— Forms of symbiotic relationships

◦ Mutualism
– Association in which both partners benefit
– Bacteria and synthesis of vitamins K and B in large
intestine
◦ Commensalism
– Association in which one partner benefits and other is
unharmed
– Flora living on skin
◦ Parasitism
– Association in which the microbe benefits at expense of
host
– Pathogenic infection
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HOST-MICROBES INTERACTION

Ø Microbes – pathogens / harmless.

Ø Benefits – resides on body surfaces –
normal microbiota / flora.
Ø Body fluids and tissues as source of
nutrients
Ø Immunocompromised individuals –
malnutrition, cancer, AIDS, diseases,
surgery, wounds, genetic defects –
exposed to opportunistic pathogens.
 Normal Microbiota (Flora)
Ø N o r m a l microbiota defined as
populations of microorganisms routinely
found growing on the body of healthy
individual
Ø Resident flora typically inhabit body sites
for extended periods (long term)
Ø Transient flora are temporary
• They form associations for a short
period and are replaced.
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MAIMUNAH MUSTAKIM (SEPT 2011) 8
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Normal human flora
 Normal Microbiota
• Protective role of normal microbiota
• Contributions include
• Protection against potentially harmful organisms
• Stimulate immune system
• If normal microbiota are killed or growth
suppressed, pathogens may colonize and cause
disease
• Example : Lactobacillus sp. (FGT) – suppress
growth of yeast Candida albicans – however
person on antibiotic treatment – normal bacterial
population (Lactobacillus sp.) will be inhibited –
therefore fungi will overgrow – cause disease -
candidiasis
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— Protection against potentially harmful organisms.
◦ Normal flora competitively exclude pathogens through:
1. Covering binding sites used for pathogenic
attachment - prevents invading microorganisms
from adhering to host cells
2. Consuming available nutrients – less nutrients
available for pathogens.
3. Producing toxic compounds:
i. Hair follicle - Propionibacterium sp –
degrade lipids from skin glands and
release fatty acids – inhibit growth of
pathogens.
ii. GIT – E.coli – synthesize colicins.
iii. FGT – Lactobacillus sp – produce
lactic acids – acidic pH – inhibit potential
disease-causing organisms.
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FGT MICROBIOTA
(Streptococci)
(Fusobacterium)
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— Stimulate immune system

1) Early and consistent exposure to certain
microbes in the gut – stimulates T cells –
preventing the immune system from
overacting to harmless microbes and
substances - prevent allergies.
2) Prime the adaptive immune system -
response increased against normal flora
that breaches body’s anatomical barriers
– May cross-react with pathogen
encountered later
 Anatomical Barriers as Ecosystem
• Skin and mucous membranes provide
anatomical barriers to infection
• Also supply foundation for microbial ecosystem
• Microbial community offers protection from
disease-causing organisms
•Intimate interaction between
microorganisms and human body is an
example of symbiosis
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— Dynamicnature of normal
Microbiota
◦ Normal flora established during birth
process
◦ Once established, composition of flora
is dynamic
– Changes in response to physiological
variation within the host
– Each member of flora ecosystem
influenced by presence and condition of
other members
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 Principles of Infectious Disease
• If colonized organisms have parasitic relationship
with host, the term infection applies
• Infection does not always lead to noticeable adverse
effects
• Termed subclinical or inapparent (unnoticed)
• Completely asymptomatic (no signs or symptoms)
• Infection that results in disease is termed infectious
disease
• Disease causes characteristic signs and symptoms
• Signs are effects that can be observed through examination
• Rash, puss formation and swelling.
• Symptoms are effects experienced by patient
• Pain and nausea.
 Principles of Infectious Disease
• One infectious disease may leave individual
predisposed to developing new disease
• Initial disease is termed primary infection
• Additional infections resulting from primary
infection are termed secondary infection
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 Principles of Infectious Disease

• Characteristics of infectious disease

• Disease that spreads from host to host termed
communicable or contagious
• Ease of spread partly determined by infectious dose
• Infectious dose is number of organisms required to
establish infection
• Diseases with small infectious dose more easily spread
than those requiring large numbers
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MICROBIAL DISEASE INCUBATION INFECTIOUS DOSE

(CAUSATIVE AGENT) - PERIOD
symptoms
Cholera (Vibrio cholerae) - 12 – 48 hrs Large numbers must be
diarrhea ingested to effect disease due
to sensitivity to stomach acid

Salmonellosis (S. enterica) – 6 – 72 hrs Bacteria sensitive to stomach

diarrhea, vomiting, fever acid –
large number required for
infection

Campylobacteriosis 1 – 5 days Small infecting dose.

(Campylobacter jejuni) – Only 500 organisms required
fever, vomiting, diarrhea, to initiate disease.
dysentry (bloody diarrhea)
 Principles of Infectious Disease
• Development of infectious disease:
• Disease progression follows several stages
• Incubation
• Time between introduction of organism to onset of
symptoms
• Incubation period depends on numerous factors
• Illness
• Follows incubation
• Individual experiences signs and symptoms of
disease
• Convalescence
• Period of recuperation (healing) and recovery
• Infectious agents may still be spread
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— Duration of symptoms
◦ Acute
– Symptoms have rapid onset and last only short
time
◦ Chronic
– Symptoms develop slowly and persist
◦ Latent
– Infection never completely eliminated
– Infection becomes reactive
 Principles of Infectious Disease
• Distribution of pathogen
• Infections often described according to distribution within
the body
• Localized
• Infection limited to small area
• Example = boil (bisul)
• Systemic or generalized
• Agent has spread or disseminated throughout the body
• Example = measles
• Toxemia
• Toxins circulating in blood
• Viremia
• Viruses circulating in blood
• Septicemia
• Acute life-threatening illness causes by infectious agent or its products
circulating in blood
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Microbial Reservoirs (Sources)

Reservoirs can be:

1. Human
2. Animal
3. Environment
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— Human reservoirs
◦ Infected humans most significant reservoirs
– Primarily of communicable diseases
– In some cases humans are only reservoir
– In this case disease is easier to control
◦ Human reservoirs as
– Symptomatic infections
– Obvious source of infectious agents
– Ideally infected individuals understand the importance of
precautions such as hand washing to inhibit transmission
– Asymptomatic carriers
– Individual harbors pathogen with no ill effects
– They may shed organisms intermittently for long periods of
time
– Some have asymptomatic infection
– More likely to move about spreading pathogen
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— Animal reservoirs
◦ Source of some pathogens
◦ Disease transmitted by non-human
animal reservoirs are termed zoonotic
– Disease often more severe in humans
than in normal animal
– Infection in humans is accidental
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— Environmental reservoirs
◦Some pathogens have
environmental reservoirs, which can
include
– Water
– Soil
◦ These pathogens difficult or nearly
impossible to eliminate
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— Portals of entry
◦ Pathogen must enter and colonize new
host
– Colonization is prerequisite for causing disease
◦ Route by which pathogen enters body is
termed portal of entry
◦ Major portals of entry include
– Eyes
– Ears
– Respiratory tract
– Broken skin
– Digestive tract
– Genitourinary tract
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— Portals of exit
◦ Microbes must leave one host in
order to be transmitted to another
– Organisms inhabiting intestinal tract are
shed in feces
– Organisms inhabiting respiratory tract
are expelled in respiratory droplets of
saliva
– Organisms of the skin are shed with
skin cells as they slough off
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MICROBIAL TRANSMISSION

— Transmission
◦ Successful pathogen must be passed from
reservoir to next susceptible host
◦ Transmission of pathogen via contact with
food, water or living agent is termed horizontal
transmission
◦ Transmission via transfer of pathogen from
mother to fetus or child through breast feeding
is termed vertical transmission
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— Contact
◦ Direct contact
– Occurs when one person physically touches another
– Can range from simple contact to intimate contact
– In some cases direct contact is primary route of
transmission
– Hands are main vehicle of contact transmission
– Hand washing physically removes organisms
– Important in preventing direct contact transmission
– Pathogens that do not survive for extended periods in
the environment usually spread by direct contact
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— Contact
◦ Indirect contact
– Involves transmission of pathogens via
inanimate objects or fomites
– Usually clothing, tabletops, doorknobs and
drinking glasses
– Organisms on hands or fingers of
carrier can be transferred to objects
and picked up by another individual
– Handwashing important control
measure
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— Contact
◦ Droplet transmission
– Microbe-laden (heavily loaded)
respiratory droplets generally fall to the
ground within three feet of release
– People in close proximity can inhale
infected droplets, spreading disease via
droplet transmission
– Droplet transmission considered direct
transmission because of the close
range required for transmission
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— Food and water

◦ Pathogens can be transmitted through contaminated
food and water
◦ Food can become contaminated in number of different
ways
– Organisms can originate with animal
– Organisms can be inadvertently added during food
preparation
– Cross-contamination occurs when organisms from
one food are transferred to another from an
improperly cleaned work surface
– Cutting boards and knives
– Sound food handling practices can prevent foodborne
transmission and disease
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— Food and water

◦ Waterborne disease outbreaks can involve
large numbers of people
– Due to the fact that municipal water is
distributed to large areas
◦ Prevention of waterborne diseases
requires chlorination and filtration of public
water sources and proper disposal of
sewage
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— Air
◦ Respiratory droplets can be transmitted through the air
– Smaller droplets dry in the air leaving one or two
organisms attached to dry material
– Creates droplet nuclei
– Droplet nuclei can remain suspended indefinitely in
presence of light air currents
◦ Airborne transmission is difficult to control
– Ventilation systems aimed at circulating air in
buildings
– HEPA (High-efficiency particulate air) filters
effective at removing airborne organisms
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Aerosol = liquid droplets dispersed in air

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— Vectors
◦ Any living organism that can carry a disease-
causing microbe
– Most common are arthropods
– Vector may carry organism internally or
externally
◦ Control of vector-borne disease directed at
controlling arthropod population
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