Introduction to infections
- Based on relationship to hosts,
microorganisms are classified as; Saprophytes and Parasites.
- SAPROPHYTES: The word is from Greek
“sapros” meaning decayed and “phyton” meaning plants.
- Free living microbes that subsist
on dead and decaying organic matter.
- They are found in soil and
water and are important for degradation of organic materials.
- They are incapable of
multiplying in living tissues which means they have less relevance for
infectious diseases.
- But, saprophytes like Bacillus
subtilis may infect devitalized host whose natural resistance is lowered. Such
infections are termed Opportunistic infections.
- PARASITES: can establish
themselves and multiply in hosts.
- Parasites are either pathogens
or commensals.
- PATHOGENS: From Greek words,
“pathos” meaning suffering and “gen” meaning produce which roughly translates
to “disease-producing”.
- COMMENSALS: From Latin words,
“com” meaning with and “mensa” meaning table. These parasites live together
with the host without causing any disease causing effects.
- However, many commensals behave
as “facultative pathogens” and can produce disease when resistance is lowered.
Classification of Infections
- Primary Infections: initial
infections with a parasite.
- Re – Infections: subsequent
infections by same parasite.
- Secondary Infections: new
parasite infects when resistance is lowered by presence of a previous one.
- Focal Infections: or focal
sepsis, infection or sepsis at a localized site like appendix or tonsils which
produces generalized effects.
- Cross infections:
When a patient is already suffering from a disease, a new infection is set up
from another host or another external source.
- Nosocomial
infections: Cross- infections occurring in hospitals are called as nosocomial infections.
The term is derived from the Greek work “nosocomion” meaning hospital.
- Iatrogenic
infections: refers to physician-induced infections resulting from
investigative, therapeutic or other procedures.
- Depending
on whether the source of infection is within or outside the host’s own body,
infections are classified as Endogenous or Exogenous.
- Endogenous-
source is outside host’s body; Exogenous- source is inside host’s own body.
- Based
on clinical effects, they may be classified as;
- In
apparent infection – clinical effects are not apparent. Also called as
“Sub-clinical infection”.
- Atypical
infection – The typical or characteristic clinical manifestations of the
particular infectious disease are not present.
- Latent
infection – Some parasites, following infections may remain in the tissues in a
latent or hidden form, proliferating and producing disease when the host
resistance is lowered.
Sources
of infection
Humans:-
- Commonest
source of infection
- Source
may be patient or a carrier
- Carrier
– A person who harbours the pathogenic microorganisms without suffering any ill
effect because of it.
- There
are several types of carriers;
- Healthy
carriers – One who harbours the pathogen but has never suffered from the
disease caused by the pathogen.
- Convalescent
carriers – One who has recovered from the disease and continues to harbour the
pathogen.
- Depending
on duration of carriage, carriers are classified as Temporary or Chronic.
- Temporary
carrier – Carriage lasts for less than six months.
- Chronic
carrier – Carriage may last for several years and sometimes even the rest of
one’s life.
- Contact
carrier – A person who acquires the infection from a patient.
- Paradoxical
carrier – A carrier who acquires it from another carrier.
Animals:-
- Act as
sources of human infection.
- Reservoir
hosts – The infection in animals may be symptomatic. These animals serve to
maintain the parasite in nature and act as the reservoir of human infections.
- Zoonoses
– Infectious diseases transmitted from animals to humans.
- Zoonotic
diseases may be;
- Bacterial
– Plague from rats, caused by Yersinia pestis which is an enterobacteriaceae.
- Viral –
Rabies from dogs, Lyssani viruses, Rabies virus, Australian Bat Lyssani.
- Protozoal
– Toxoplasmosis from cats, Toxoplasma gondii.
- Helminthic
– Hydatid disease from dogs, Echino coccosis – tapeworms (Echino coccus)
- Fungal
– Zoophilic dermatophytes from cats and dogs.
Insects:-
- Arthropod-borne
disease – The diseases caused by transmission of pathogens by blood sucking
insects.
- Vectors
– Insects such as mosquitos, ticks, mites, flies, fleas and lice that transmit
infections.
- Mechanical
vectors – When the transmission of pathogens by vectors is mechanical. For e.g.
Transmission of dysentery or typhoid bacilli by the domestic fly.
- Typhoid
bacilli – Salmonella typhi
- Dysentery
bacilli – Shigella sonnei, Shigella dysenteriae, Shigella flexneri
- Biological
vectors – When the pathogen multiplies or undergoes part of its developmental
cycle in the body of the vector.
- For
e.g. Aedes aegypti mosquito – Yellow fever
- Anopheles
mosquito – Malaria
- These
vectors transmit the infection only when the pathogen has multiplied in them
sufficiently or has undergone a developmental cycle.
- The
interval between the time of entry of the pathogen into the vector and the
vector becoming infective is called the extrinsic incubation period.
- Insects
also act as reservoir hosts, e.g. Ticks in relapsing fever and spotted fever.