School of Community

and Health Sciences

Microbes of clinical importance

micro-organisms

We have more of these than any other cell type in (on) our
body!
survive in extremes
micro-organisms are universal

• survive in extremes
• Some organisms able to make spores
• involved in producing medicines, and vitamins
• destroy rubbish
• make cheese, wine
• colonise our surfaces
• regulate the immune system (hygiene hypothesis)
Table 22.1a
Table 22.1b
Bacteria

• prokaryotes
• tend to be larger, and classed according to shape
Cocci (round)
rod (oval)
Spiral (curved)
• have 2 names eg Escherichia coli
bacterial cell wall

• gram positive bacteria have a thicker cell wall, and take

up gram stain (→ purple)
• gram negative organisms have a thinner wall, and to not
take up gram stain (→ red)
viruses

• classed as DNA, RNA or retroviruses

• genetic material protected by envelope
• enter host cell, and take over functioning, release viral
proteins, finally destroy cell
• cause AIDS, common cold, rabies, chicken pox, small
pox, herpes and some cancers
types of outbreak

• sporadic
• endemic
• epidemic
• Pandemic

Health protection agency

CDC
virulence and pathogenicity

Virulence is the power of an organism to overcome host

defences and to produce disease
Measured by the number required to cause disease
• ID50
• LD50

Pathogenicity is the ability to make one ill

portal of entry

• mucous membranes of respiratory or GI tract

• skin (particularly a break)
• parenteral route
adherence

most organisms need to adhere to host tissue, adhesins or

ligands on surface of cell, often on pili or flagella
most are glycoproteins or lipoprotiens
bind to specific receptors on host, most are sugars
Enzymes

Some organisms can increase virulence by releasing extra

cellular enzymes (exoenzymes)
• coagulases
• kinases
• hyaluronidase breaks down hyaluronic acid
• collagenase
• IgA protease
antigenic variation

alter surface antigens, often by altering gene expression

Bacterial damage to host cell 1

• using host nutrients

iron needed by most bacteria, but is tightly bound to
transport proteins (eg transferrin) so bacteria →
sidrephore
Cell unable to use iron, that may be even be toxic
bacterial damage to host cell 2

• direct damage
host cell usually rupture, releasing pathogen and also
inducing inflammatory response
Bacterial damage to host cell 3

• production of toxins → fever, CVS disturbance, diarrhoea,

shock, inhibition protein synthesis, destroy blood vessels
and cells, destroy nervous system → spasms
• may be exotoxins or endotoxins
Bacterial damage to host cell 4

• hypersensitivity reactions
pathogenic properties of viruses 1

cytopathic (cytocidal) effects

• prevent production of macromolecules
• cells release lysosomes
• inclusion bodies
• antigenic changes → host response
• infected cells adjacent to each other fuse to form giant
cell, called syncitium
• production of interferons
• chromasomal change (mostly broken) in host cell,
oncogenes can be activated
• contact inhibition may be over-ridden (cells become
transformed)
So that was OK!

• Cannot predict next outbreak

• Biggest concern is that it will merge with another eg H1N5