INFECTION & INFECTIOUS

PROCESS
By ONKAR PANDEY
16MEC24004
SJC BANGALORE
 INFECTION AND INFECTIOUS
PROCESS
1. Infection. Classification of
infections
2. Sources of infection in Man
3. Methods of transmission of
infection
4. Factors predisposing to
microbial pathogenicity
5. Types of infectious diseases
 Microcolonies

Infection is the
lodgement and
multiplication of
Biofilms of the different organism in the
types of bacteria tissue of host
Classification of infections
1. Primary infection: Initial infection with organism in host.
2. Reinfection: Subsequent infection by same organism in a host (after
recovery).
3. Superinfection: Infection by same organism in a host before
recovery.
4. Secondary infection: When in a host whose resistance is lowered by
preexisting infectious disease, a new organism may set up in
infection.
 Classification of infections
5. Focal infection: It is a condition where due to infection at localized sites
like appendix and tonsil, general effects are produced.
6. Cross infection: When a patient suffering from a disease and new infection
it set up from another host or external source.
7. Nosocomial infection: Cross infection occurring in hospital.
8. Subclinical infection: It is one where clinical affects are not apparent.
Causative agents of infections
• Saprophytes: They are free living organisms which
fail to multiply on living tissue and so are not
important in infectious disease.
• Parasites: They are organisms that can establish
themselves and multiply in hosts. They may be
pathogens or commensal. Pathogens are those
which are capable of producing disease in a host.
On the contrary commensal microbes can live in a
host without causing any disease.
Sources of infection in Man

Man: Man is himself a common source of infection from a patient or

carrier. Healthy carrier is a person harboring pathogenic organism
without causing any disease to him. A convalescent carrier is one
who has recovered from disease but continues to harbor the
pathogen in his body.
Anthroponosis
Sources of infection in Man

Animals: Infectious diseases transmitted from animals to man are

called zoonosis. Zoonosis may be bacterial, (e.g. Plague from rat),
rickettsial, (e.g. Murine typhus from rodent), viral, (e.g. Rabies from
dog), protozoal, (e.g. Leishmaniasis from dogs), helminthic, (e.g.
Hydatid cyst from dogs) and fungal (zoophilic dermatophytes from
cats and dogs).
Sources of infection in Man
Insects: The diseases caused by insects are
called arthropod borne disease. Insects
like mosquitoes, fleas, lice that transmit
infection are called vector. Transmission
may be mechanical (transmission of
Dysentery or typhoid bacilli by housefly)
and these are called mechanical vector.
They are called biological vector if
pathogen multiplies in the body of vector,
e.g. Anopheles mosquito in Malaria.
 Sources of infection in Man
Some vectors may acts as reservoir host,
(e.g. ticks in Relapsing fever and
Spotted fever).
Soil: Spores of tetanus bacilli, Gas-
gangrene infection remain viable in soil
for a long time.

Clostridium tetani
 Sources of infection in Man
Water: Vibrio cholerae,
infective hepatitis virus
(Hepatitis A and Hepatitis
E) may be found water.
Food: Contaminated food
may be source of
infection. Presence of
pathogens in food may
be due to external
contamination, (e.g. food
poisoning by
Staphylococcus).
Methods of transmission of infection
• Contact (sexual intercourse):
syphilis, gonorrhea.

• Inhalation: influenza, tuberculosis,

smallpox, measles, mumps, etc.
 Methods of transmission of
infection
• Ingestion: cholera (water), food
poisoning (food) and dysentery (hand
borne).
• Inoculation: tetanus (infection), rabies
(dog), arbovirus (insect) and serum
hepatitis, i.e. Hepatitis B (infection).

Human hand
contaminated with
colonies of
bacteria (blue/pink
patches)
 Methods of transmission of
infection
• Congenital: syphilis,
rubella,
toxoplasmosis,
cytomegaloviruses

Eight week old fetus

attached to its placenta by
the umbilical cord
 Methods of transmission of infection
• Insects: they act as
mechanical vector (dysentery
and typhoid by housefly) or
biological vector (malaria) of
infectious disease
• Jatrogenic and laboratory
infections: infection may be
transmitted during
procedures
Characters of pathogens

• Bacteria should be able to enter the body.

• Organism should be able to multiply in the tissue.
• They should be able to damage the tissue.
• They must be capable to resist the host defense.
Pathogenecity is referred to the ability of
microbial species to produce disease.
Virulence is referred to the ability of microbial
strains to produce disease.
 Factors of Virulence
• Adhesion: The initial event in the pathogenesis of many infections is the
attachment of the bacteria to body surfaces. This attachment is specific
reaction between surface receptors and adhesive structures on the surface
of bacteria (adhesins).
Adherence of bacteria
Factors of Virulence

•Invasiveness is the ability of organism to

spread in a host tissue after establishing
infection. Less invasive organisms cause
localized lesion. Highly invasive organisms
cause generalized infection (septicemia).
•Toxigenicity. Bacteria produce two types
of toxins – exotoxins & endotoxins
Factors of Virulence - Exotoxins
• Heat labile protein.
• Diffuse readily into the surrounding medium.
• Highly potent, e.g. 3 kg botulinum can kill all the
inhabitants of world.
• They are generally formed by Gr+ bacteria and also by Gr-
organisms like Shigella, V.cholerae, E.coli.
• Exotoxin is specifically neutralized antitoxin.
• Can be separated from culture by filtration.
• Action is enzymatic and it has specific tissue affinity.
• Specific pharmacological effects for each exotoxin.
• Cannot cause pyrexia in a host.
• Can be toxoided.
Modification of Toxin to Toxoid

Toxin
Toxoid

chemical
modification

toxin moiety antigenic determinants

Factors of Virulence - Endotoxins

• Endotoxin (lipid a portion of lypopoly-saccharide) has biological

activities causing fever, muscle proteolysis, uncontrolled
intravascular coagulation and shock.
• These may be mediated by production from mononuclear cells of IL-
1, probably IL-6.
 Characters of Endotoxins
• Proteins polysaccharide lipid complex heat stable.
• Forms part of cell wall (don’t diffuse into the medium).
• Obtained only by cell lysis.
• They have no enzymatic action.
• Effect is non-specific action.
• No specific tissue affinity.
• Active only in large doses 5 to 25 mg.
• Weakly antigenic.
• Neutralization by antibody ineffective.
• Cannot be toxoided.
• Produce in Gram negative bacteria.
Factors of Virulence
• Communicability is the ability of parasite to spread from one host to
another. It determines the survival and distribution of organism in a
community.
• Coagulase (S.aureus) which prevents phagocytosis by forming fibrin
barrier around bacteria.
• Fibrinolysin promotes the spread of infection by breaking down the
fibrin barrier in tissues.
Factors of Virulence
• Hyaluronidase split hyaluronic acid (component of connective
tissue).
• Leucocidins damage polymorphonuclear leucocytes.
• Ig A1 proteases: split IgA and inactivates its antibody activity.
• Hemolysin is produced by some organisms capable of destroying
erythrocytes.
 Factors of Virulence. Bacterial
appendages
Capsulated bacteria
like Pneumococcus,
K.pneumoniae and
H.influenzae stand
phagocytosis

Surface antigen, e.g. Vi-antigen of S. typhi and K-

antigen of E.coli resisted phagocytosis and lytic
activity of complement.
Infecting dose
• The minimum infection dose (MID) or minimum lethal dose (MLD) is the
minimum number of organism required to produce clinical evidence of
infection or dearth of susceptible animal.

•Route of infection
• Vibrio cholerae is effective orally. No effect when it is introduced
subcutaneously.
• Streptococci can initiate infection whatever be the mode of entry.
 Types of infectious diseases
• Infectious diseases may be localized or
generalized. Localized infections may be superficial
or deep-seated.
• Circulation of bacteria in the blood is known as
bacteremia (viruses – virusemia).
 Types of infectious diseases
• Septicemia is the condition where bacteria circulate and multiply in the
blood, form toxic products and cause swinging type of fever.
• Pyemia is a condition where pyogenic bacteria produce septicemia with
multiple abscesses in the internal organs such as the spleen, liver and
kidney.
Types of infectious diseases
• Depending on the spread of infectious disease in the community they
may be classified into different types.
• Endemic diseases are ones that are constantly present in a particular
area. Typhoid fever is endemic in most parts of India. An epidemic
disease is one that spreads rapidly, involving many persons in an area at
the same time. Influenza causes annual winter epidemics in the cold
countries.
Types of infectious diseases
• A pandemic is an epidemic that spreads through many
areas of the world involving very large numbers of
persons within a short period (Influenza, cholera,
plaque).
• Epidemics vary in the rapidity of spread. Waterborne
disease such as cholera and hepatitis may cause
explosive outbreaks, while disease, which spreads by
person-to-person contact evolve more slowly.
 Stages of infectious disease
•Incubation period – no symptoms.
•Prodromal period – mild and generalized
symptoms (fever, weakness, headache).
•Invasive stage – symptoms specific to the
disease.
•Decline stage – symptoms subside.
•Convalescence – no symptoms, health
returns to normal.
 Biofilms
• Biofilms form when bacteria adhere to surfaces in aqueous
environments and begin to excrete a slimy, glue-like
substance that can anchor them to all kinds of material
(metals, plastics, medical implant materials and, human or
animal tissue).

Hundreds of microbial biofilm colonize the human mouth,

causing tooth decay and gum disease.
Quorum Sensing
Many groups of bacteria can communicate - by
releasing and detecting chemical pheromones to
gauge their population density - the molecular
structure of a key protein in this interbacterial
communication has been solved.
Quorum sensing provides an explanation for why some
disease-causing virulence factors are not expressed during
the early stages of encounter with the human host
 Characteristics of biofilm
• A biofilm can contain a single species of bacteria or several species.
• Genetic studies confirm that bacteria switch on different genes, depending
on whether they're living as free-floating microbes or clustering as biofilms.
• Biofilm bacteria can be up to 1000 times more resistant to antimicrobial
stress (e.g. antibiotics and disinfectants) than free-swimming bacteria of
the same species.
• Plaque is a biofilm on the surfaces of the teeth which secretes acids that
destroy teeth and gums

Dental plaque as
seen under a
scanning electron
microcroscope
5 stages of P.aeruginosa biofilm development
1, initial attachment; 2, irreversible attachment;
3, 4 - maturation ; 5, dispersion.
 These
communities
represent a
higher order
Living bacteria of structure
and function
than is found
when bacteria
are grown in
broth culture

Biofilm communities are responsible for much of the

biological activity attributed to bacteria in the wide range
of habitats occupied by these biochemically complex
microorganisms