chapter 13 microbe human interactions

condition, penetrate, tissues, multiply

• colonization, infection, disease

  • infection - a … in which pathogenic microorganisms …. host defenses, enter the …., and …..

deviation, infections, diet, genetics, aging

• colonization, infection, disease

  • disease - any .. from health

    • factors that can cause disease:

      • …

      • …

      • ..

      • ..

disruption, tissues, organs

• colonization, infection, disease

  • infectious disease - … of … or … caused by microbes or their products

cumulative, damage, tissues, organs, disease

• colonization, infection, disease

  • pathologic state - …. effects of infection …

    • disruption of … and …

    • results in ….

deeper, tissues, rarely

• colonization, infection, disease

  • resident biota - colonize … in the …

    • always there and … cause harm

upper, tissues, lost, pathogens

• colonization, infection, disease

  • transient biota - colonize in the …. layers of the ….

    • can be … easily

    • may include ….

organism, disease

• colonization, infection, disease

  • pathogen - … that is capable of causing ….

human, resident

• colonization, infection, disease

  • holobiont - the … plus all of the … biota

already, normal, introduced, sterile, uti

• colonization, infection, disease

  • endogenous infection

    • caused by biota … in the body

    • can occur when … biota is .. to a site that was previously …

      • ex. e. coli entering the bladder, resulting in a ….

skin, upper, gi, breast

• human microbiome project

  • sites known to harbor normal microbiota

    • ….. membranes

    • …. respiratory tract

    • … tract, mouth

    • …. milk

lower, placenta, amniotic, fetus

• human microbiome project

  • additional sites now though to harbor some normal microbiota (or their dna)

    • lungs (…. respiratory tract)

    • …

    • … fluid

    • …

brain, bloodstream

• human microbiome project

  • sites where dna from microbiota has been detected

    • ….

    • ….

development, organs, overgrowth, harmful, intruder, steady, displaced

• human microbiome project

  • benefits of normal biota

    • influence the …. of …

    • prevent the … of … microorganisms

  • microbial antagonism

    • the general antagonistic effect good microbes have against … microorganisms

    • microbes in a …., established relationship are unlikely to be … by incoming microbes

normal, utero, healthy, newborns, birth, colonized, vaginal

• human microbiome project

  • a growing number of doctors and scientists believe fetuses are seeded with … microbiota in …..

    • these microbes are important for … full term pregnancies and healthy …

  • we know exposure occurs during … when the baby becomes … with the mother’s …. biota

bacteria, sugars, cannot, healthy gut, necessary

• human microbiome project

  • breast milk contains around 600 species of … and … that babies … digest

    • sugars used by .. .. bacteria

    • breast milk may be … for maintaining a healthy gut microbiome in the baby

genetic, immunity, pregnancy, transplants, cancer

• when colonization leads to disease

  • age: the very young and the very old

  • …. defects in ….. and acquired defects in immunity

  • ….

  • surgery and organ ….

  • underlying disease: …., liver malfunction, diabetes

  • chemotherpy/immunosuppressive drugs

  • physical and mental stress

  • other infections

relationship, parasitic, infection, disease, capable, healthy, normal, compromised, established, not natural

• the progress of infection

  • pathogen

    • a microbe whose … with its host is …

    • results in … and …

  • true pathogens

    • … of causing disease in …. persons with .. immune system

  • opportunistic pathogens

    • cause disease when

      • the host’s defenses are …

      • when they become … in a part of the body that is .. … to them

degree, establish, host, damage, characteristic, structure, toxin, induction, injurious

• virulence

  • ….. of pathogenicity

  • indicated by a microbe’s ability to:

    • … itself in the …

    • cause ….

  • virulence factor

    • any … or … of the microbe that contributes to … production or …. of an …. host response

minimum, proceed, experimentally, smaller, dose, greater virulence

• the size of the inoculum

  • infectious dose (ID): a … number of microbes required for an infection to ….

    • determined … for many microbes

    • microbes with a … infectious …. have … …

characteristic, infection, skin, mucous membranes, outside, environment, person, animal, on, in, normal, silent

• becoming established: step 1 - portals of entry

  • a …. route taken by a microbe to initiate ….

  • usually through …. or … ..

  • exogenous: originating from …. the body

    • the …, another …. or …

  • endogenous: already existing … or …. in the body

    • …. biota or a previously … infection

nicks, abrasions, punctures, tough, few, penetrate, passageways, skin, digestive

• infectious agents that enter the skin

  • sites of entry

    • ….

    • …

    • …, some tiny and inapparent

  • intact skin is a very …. barrier that … microbes can ….

  • some infectious agents create their own … into the … using …. enzymes

food, drink, ingested, survive, enzymes, pH changes

• the gastrointestinal tract as portal

  • entry through …., …, or other … substances

    • adapted to …. digestive .. and abrupt … …

oral, nasal, continuous mucous, upper, sinuses, auditory, transferred, respiratory, size, small, deeply, larger

• the respiratory portal of entry

  • gateways to the respiratory tract

    • … cavity

    • … cavity

  • …. … membrane covering the … respiratory tract, …., and …. tubes

    • microbes often …. from one site to another

  • extent to which an agent is carried into the …. tract is based on its …..

    • …. cells are inhaled more … than …. ones

placenta, maternal, tissues, blood, developing, mother, diffusion, nutrients, gases, few, umbilical vein, tissues, perinatally, canal

• pathogens that infect during pregnancy and birth

  • the …. is an exchange organ

    • formed by …. and fetal …

    • separates the …. of the …. fetus from that of the …

    • permits … of dissolved …. and … to the fetus

    • a … microbes cross the placenta and are spread by the … …. into the fetal ….

    • other infections are transmitted …. as the child passes through the birth ….

fetus, neonate, toxoplasmosis, other, syphilis, rubella, cytomegalovirus, herpes simplex

• pathogens that infect during pregnancy and birth

  • TORCH: common infections of the …. and ….

    • ….

    • …. diseases: …

    • ….

    • …

    • … … virus

stable, tissues, dependent, binding, specific, both, limited, body, chemical, nearby, establishment, infection

• becoming established: step 2 - attaching to the host

  • adhesion

    • a process by which microbes gain a more … foothold on host …

    • …. on … between … molecules on … the host and pathogen

    • a particular pathogen is … to only those cells and organisms to which it can bind

    • once attached, a pathogen can invade … compartments

  • quorum sensing

    • …. communication between … bacteria critical to …. of ….

white, engulf, destroy, enzymes, chemicals, virulence, avoid phagocytes, circumvent

• becoming established: step 3 - surviving host defenses

  • phagocytes

    • …. blood cells that … and … pathogens by means of … and antimicrobial …

  • antiphagocytic factors

    • …. factor used by pathogens to … ….

    • …. some part of the phagocytic process

structures, products, capabilities, invade, establish, degree, damage

• step 4 - causing disease

  • virulence factors

    • …., ….. or …. that allow a pathogen to cause infection in the host

    • adaptations that a microbe uses to …. and … itself in a host

    • determine the … of tissue … that occurs

pathogenic bacteria, fungi, protozoa, worms, tissues, dissolve, barriers, spread, deeper, mucinase, keratinase

• direct damage via enzymes

  • exoenzymes

    • secreted by … .., .., …, and …

    • break down and inflict damage on ….

    • …. host’s defense …. and promote the … of microbes into … tissues

  • examples

    • …

    • …

chemical, microbes, plants, animals, poisonous, living bacterial, infected, many, not actively, shed, outer, negative

• toxins: a potent source of cellular damage

  • toxin

    • a specific … product of …, …, and some … that is … to other organisms

  • exotoxin

    • secreted by a … … cell to the … tissues

    • …. types

  • endotoxin

    • … … secreted

    • …. from the … membrane

    • only found in gram … bacteria

minute

• exotoxins

  • toxic in …. amounts

high

endotoxin - toxic in …. doses

type, blood, liver, tnf, fever

exotoxin - effects on the body

specific to a cell …. (…, …..); induces .. production resulting in ….

systemic, fever, inflammation

endotoxin - effects on the body

…; …., …

small proteins

exotoxin - chemical composition

… …

lipopolysaccharide, wall

endotoxin - chemical composition

…. of cell ….

stimulate

exotoxin - immune response

… antitoxins

does not stimulate

endotoxin - immune response

… antitoxin

no

exotoxin - fever stimulation

…. fever

yes

endotoxin - fever stimulation

…. fever

live

exotoxin - manner of release

secreted from … cell

shedding, during lysis

endotoxin - manner of release

released by cell via … or … ..

positive, negative

exotoxin - typical sources

a few gram … and gram ..

negative

endotoxin - typical sources

all gram …. bacteria

indirect, excessive, inappropriate, not, microorganisms, interplay, microbe, host

• inducing an injurious host reponse

  • many cases of microbial diseases are the result of ….. damage or the host’s … or .. response to a infection

    • pathogenicity is a trait …. solely determined by …

    • pathogenicity is a consequence of an …. between …. and ….

specific, boils, fungal skin, warts

• localized infection

  • microbe enters the body and remains confined to a …. tissue

    • ….

    • … …. infections

    • …..

several, tissue, bloodstream, measles, anthrax, histoplasmosis, nerves, cerebrospinal

• systemic infection

  • when an infection spreads to … sites and … fluids, usually in the …

    • viral: …

    • bacterial: ..

    • fungal: ….

  • infectious agents can travel by means of … or …. fluid

loose, local, tissues, tuberculosis, scarlet, localized, blood, target

• focal infection

  • exists when the infectious agent breaks .. from a … infection and is carried to other ….

    • examples

      • …

      • … fever

      • toxemia: infections remains …, toxins are carried through the … to the … tissue

several, simultaneously, poly, wound

• mixed infection

  • … agents establish themselves … at the infection site

  • …..microbial diseases: …. infections

initial, primary, another, different

• primary and secondary infections

  • primary infection

    • …. infection

  • secondary infection

    • occurs when a …. infection is complicated by … infection caused by a … microbe

rapidly, short, persist, long

• acute vs chronic infections

  • acute infections

    • come on …

    • have … lived effects

  • chronic infections

    • progress and …. over a … period of time

objective, observer, precise, symptoms, subjective, patient, disease, signs, symptoms

• signs and symptoms: warning signals of disease

  • sign

    • any … evidence of disease as noted by an ….

    • more … than …

  • symptom

    • .. evidence of disease as sensed by the ….

  • syndrome

    • a … identified or defined by a certain complex of … and …

earliest, accumulation, fluid, walled, collections, inflammatory cells, microbes, swollen lymph nodes

• signs and symptoms of inflammation

  • inflammation

    • … symptom of disease

    • edema

      • … of … in afflicted tissue

    • granulomas and abscesses

      • …. off … of … … and …. in the tissues

    • lymphadenitis

      • … … …

increase, white

• signs of infection in the blood

  • leukocytosis

    • ….. in the level of .. blood cells

decrease, white

• signs of infection in the blood

  • leukopenia

    • …. in the level of … blood cells

general, multiplying, blood, large

• signs of infection in the blood

  • septicemia

    • … state in which microbes are …. in the … and are present in … numbers

small, blood, not multiplying

• signs of infection in the blood

  • bacteremia

    • … numbers of bacteria are present in the … but .. …

viruses, blood, multiplying

• signs of infection in the blood

  • viremia

    • presence of … in the …, whether or not they are actively ….

infected, not, disease, no, not, sign

• infections that go unnoticed

  • asymptomatic, subclinical, or inapparent infections

    • host is … but does … manifest the ….

    • patient experiences … symptoms or disease and does … seek medical attention

    • most infections are attended by some sort of …

exit, secretion, excretion, discharge, sloughed

• vacating the host: step 5 - portals of exit

  • portal of exit

    • avenue for pathogens to … the host

    • …

    • …

    • …

    • … tissue

upper, lower, mucus, sputum, drainage, moist

• respiratory and salivary portals

  • escape media for pathogens that infect the … and … respiratory tract

    • ….

    • …

    • nasal …

    • other … secretions

outer, skin, scalp, shed, dust, skin, billion

• skin scales

  • the … layer of … and … is constantly being … into the environment

    • household … is composed of … cells

    • a single person can shed several .. skin cells a day

intestinal, irritation, intestinal, bowel, rapid, eggs, cysts, feces, public, drinking, fertilize

• fecal exit

  • some … pathogens cause … in the … mucosa that increases the motility of the …

    • resulting diarrhea provides a … exit for the pathogen

    • helminth worms release … and … through the …

    • feces containing pathogens are a … health problem when allowed to contaminate … water or when used to … crops

discharge, semen, urine

• urogenital tract

  • agents involved in STIs leave the host in vaginal … or …

  • pathogens that affect the kidney are discharged in the ….

vascular puncture, ticks, fleas, mosquitoes

• removal of blood or bleeding

  • blood has a portal of exit when it is removed or released through .. …

  • blood feeding animals are common transmitters of pathogens

    • …

    • …

    • ….

dormant, periodically, active, recurrent, long, permanent, organs, tissues

• the persistence of microbes and pathologic conditions

  • latency

    • a .. state of an infectious agent

    • during this state, a microbe can … become … and produce a … disease

  • sequelae

    • … term or … damage to … and ….

initial, appearance, first, earliest, symptoms, multiplies, high, greatest virulence, well established, decline

• 4 phases of infection and disease

  • incubation period

    • the time from .. contact with the infectious agent to the … of .. symptoms

  • prodromal period

    • when the … notable … of infection appear

  • period of invasion

    • infectious agent … at … levels, exhibits its .. .., and becomes .. .. in its target tissue

  • convalescent stage

    • patient responds to infection and symptoms ….

primary, natural, orginates, human, animal, soil, water, plants, reservoir, individual, object, acquired

• reservoirs: where pathogens persist

  • reservoir

    • .. habitat in the … world from which a pathogen …

    • …. or … carrier; …., …., or …

  • source

    • distinct from a ….

    • …. or … from which an infection is …..

individual, shelters, knowing

• carrier states

  • carrier

    • an … who inconspicuously … a pathogen can can spread it to other without ….

live, one, another, arthropods, actively, site, multiply, complete, not necessary, transport, without

• vectors

  • in epidemiology, a … animal that transmits an infectious agent from … host to ….

  • majority of vectors are …

  • biological vector

    • … participates in a pathogen’s life cycle

    • serves as a … in which the pathogen can …. or … its life cycle

  • mechanical vectors

    • … … to the life cycle of an infectious agent

    • merely … the pathogen … being infected

infected, not infected

• 2 types of vectors

  • biological vector - ….

  • mechanical vectors - …

animals, humans, dead, not, natural, close, humans, animals, animal, outdoor, greatest

• zoonosis

  • an infection indigenous to … but also transmissible to ..

  • human is the … end host and does … contribute to the … persistence of the microbe

  • spread of disease is promoted by … associations of … with …

  • people in … oriented or … professions are at …. risk

soil, water, air, saprobic, little, opportunists, regular

• nonliving reservoirs

  • microbes have adapted to nearly every habitat in the biosphere

    • …, …, …

    • most are … and cause … harm to humans

    • some are …

    • a few are … pathogens

infected, another, establish, host, communicable, direct, not, transmission

• acquisition and transmission of infectious agents

  • communicable disease

    • occurs when an … host can transmit the infectious agent to … host and … infection in that ….

  • contagious

    • the agent is highly …, especially through … contact

  • noncommunicable

    • does … arise through … of the infectious agent from host to host

population, one, individual, another, parent, offspring, ovum, sperm, placenta, milk

• horizontal vs vertical transmission

  • horizontal

    • disease is spread through a …. from …. infected …. to …

  • vertical

    • transmission from … to … via …., …, … or ….

inanimate, commonly, humans, transmit

• indirect spread by vehicles: fomites

  • vehicle

    • any .. material … used by … that can … infectious agents

inanimate, harbors, transmit, not, continuous source

• indirect spread by vehicles: fomites

  • fomite

    • an …. object that … and … pathogens

    • … a … … of infection

fecal, inadequate, hygiene, contaminates, handling, unsuspecting, ingests

• indirect spread by vehicles: fomites

  • oral-fecal route

    • … carrier with … personal …., …. food during ….., and an …. person …. it

water, soil, temporarily, humans, indoor, support, suspension, disposal, droplet, aerosols

• water, soil, and air as vehicles

  • … and …. harbor microbes that can sicken humans

    • can also become .. contaminated with pathogens that come from …

  • air

    • … air can serve as a …. medium for the …. and … of respiratory pathogens via … nuclei and …

dried, mucus, saliva, mouth, nose, suspensions, dust, moisture, live

• droplet nuclei and aerosols

  • droplet nuclei

    • …. microscopic residues created when microscopic pellets of … and … are ejected from the … and …

  • aerosols

    • ….. of fine …. or …. particles in the air that contain … pathogens

lower, patients, caregivers, environment

• hospitals as a source of disease

  • medical asepsis

    • practices that …. the microbial load in …., …., and the hospital ….

procedures, sterile

• hospitals as a source of disease

  • surgical asepsis

    • ensuring all surgical …. are conducted under …. conditions

proper, procedures, hospital, tracking, outbreaks, breaches, asepsis, training, aseptic

• hospitals as a source of disease

  • infection control officer

    • implements … practices and ….. throughout the …

    • charged with

      • …. potential …..

      • identifying …. in …

      • … other health care workers in …. technique

essential, etiologic, standard, causation, scrutiny, anthrax, proofs, criteria

• using koch’s postulates to determine etiology

  • …. aim of the study of infection and disease is determining the … agent (causative agent)

• robert koch

  • developed a … for determining … of disease that stood the test of scientific ….

  • determined the causative agent of …

  • koch’s postulates

    • a series of … that established classic … for etiologic studies

effects, community, frequency, distribution, populations, notifiable, authorities, voluntary

• epidemiology: study of disease in populations

  • epidemiology

    • .. of diseases on the …

    • involves the study of the … and … of disease and distribution of disease and other health related factors in defined …

  • reportable diseases

    • … diseases

    • by law, some diseases must be reported to …

    • other diseases are reported on a … basis

track, nationwide, public, weekly, cdc, world, tabulation, control

• centers for diseases control and prevention

  • responsible for keeping … of infectious diseases ….

  • part of the U.S. … health service

  • morbidity and mortality report: a … notice of diseases published by the …

  • the cdc shares its stats on disease with the … health organization for worldwide … and ….

total, existing, population

• epidemiological stats

  • prevalence of disease

    • ….. number of … cases with respect to the entire ….

measures, new, period, case, morbidity

• epidemiological stats

  • incidence of disease

    • … the number of … cases over a certain time …

    • also known as … or … rate

measures, deaths, population, disease

• epidemiological stats

  • mortality rate

    • …. the number of … in a … due to a certain ….

single, common, single, over, period

• epidemics

  • point source epidemic

    • one in which the infectious agents came from a …. source

  • common source epidemic

    • result from .. exposure to a … source of infection that can occur … a … of time

communicable, person, person, over, population, spread, continents

• epidemics

  • propagated epidemic

    • results from an infectious agent that is … from … to … and is sustained … time in a …

  • pandemic

    • …. of an epidemic across ….

first, investigation, steady, long, geographic, occasional, irregular, random

• more epidemiological terms

  • index case

    • the …. patient found in an epidemiological …

  • endemic

    • an infectious disease that exhibits a relatively … frequency over a … time period in a particular …. locale

  • sporadic disease

    • … cases are reported at … intervals in … locales

intentional, threatened, toxins, living, death, disease, humans, livestock, plants, higher, biotechnology, genetic

• bioterrorism vs agroterrorism

  • bioterrorism

    • … or … use of microorganisms or .. from .. organisms to cause .. or .. in …, …, or …

    • stakes are much … with the advancement of ….

      • … altercation of bioterroism agents could cause devastating scenarios

decimate, agricultural, food, damage, no, surveillance, policies

• bioterrorism vs agroterrorism

  • agroterrorism

    • use of microorganisms to … the … industry

    • targets the … supply to exert ….

      • …. documented cases have occurred

      • many government agencies are conducting … and developing … to prohibit this scenario