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When an infection becomes disseminated throughout the body, we call it a systemic infection . For example, infection by the varicella-zoster virus typically gains entry through a mucous membrane of the upper respiratory system. It then spreads throughout the body, resulting in the classic red skin lesions associated with chickenpox . Since these lesions are not sites of initial infection, they are signs of a systemic infection.

Sometimes a primary infection , the initial infection caused by one pathogen, can lead to a secondary infection by another pathogen. For example, the immune system of a patient with a primary infection by HIV becomes compromised, making the patient more susceptible to secondary diseases like oral thrush and others caused by opportunistic pathogens. Similarly, a primary infection by Influenzavirus damages and decreases the defense mechanisms of the lungs, making patients more susceptible to a secondary pneumonia by a bacterial pathogen like Haemophilus influenzae or Streptococcus pneumoniae . Some secondary infections can even develop as a result of treatment for a primary infection. Antibiotic therapy targeting the primary pathogen can cause collateral damage to the normal microbiota, creating an opening for opportunistic pathogens (see Case in Point: A Secondary Yeast Infection ).

A secondary yeast infection

Anita, a 36-year-old mother of three, goes to an urgent care center complaining of pelvic pressure, frequent and painful urination, abdominal cramps, and occasional blood-tinged urine. Suspecting a urinary tract infection (UTI) , the physician requests a urine sample and sends it to the lab for a urinalysis. Since it will take approximately 24 hours to get the results of the culturing, the physician immediately starts Anita on the antibiotic ciprofloxacin. The next day, the microbiology lab confirms the presence of E. coli in Anita’s urine, which is consistent with the presumptive diagnosis. However, the antimicrobial susceptibility test indicates that ciprofloxacin would not effectively treat Anita’s UTI, so the physician prescribes a different antibiotic.

After taking her antibiotics for 1 week, Anita returns to the clinic complaining that the prescription is not working. Although the painful urination has subsided, she is now experiencing vaginal itching, burning, and discharge. After a brief examination, the physician explains to Anita that the antibiotics were likely successful in killing the E. coli responsible for her UTI; however, in the process, they also wiped out many of the “good” bacteria in Anita’s normal microbiota. The new symptoms that Anita has reported are consistent with a secondary yeast infection by Candida albicans , an opportunistic fungus that normally resides in the vagina but is inhibited by the bacteria that normally reside in the same environment.

To confirm this diagnosis, a microscope slide of a direct vaginal smear is prepared from the discharge to check for the presence of yeast. A sample of the discharge accompanies this slide to the microbiology lab to determine if there has been an increase in the population of yeast causing vaginitis. After the microbiology lab confirms the diagnosis, the physician prescribes an antifungal drug for Anita to use to eliminate her secondary yeast infection.

  • Why was Candida not killed by the antibiotics prescribed for the UTI?
  • List three conditions that could lead to a secondary infection.

Transmission of disease

For a pathogen to persist, it must put itself in a position to be transmitted to a new host, leaving the infected host through a portal of exit ( [link] ). As with portals of entry, many pathogens are adapted to use a particular portal of exit. Similar to portals of entry, the most common portals of exit include the skin and the respiratory, urogenital, and gastrointestinal tracts. Coughing and sneezing can expel pathogens from the respiratory tract. A single sneeze can send thousands of virus particles into the air. Secretions and excretions can transport pathogens out of other portals of exit. Feces, urine, semen, vaginal secretions, tears, sweat, and shed skin cells can all serve as vehicles for a pathogen to leave the body. Pathogens that rely on insect vectors for transmission exit the body in the blood extracted by a biting insect. Similarly, some pathogens exit the body in blood extracted by needles.

Portals of exit: eye (tears), needle,  mammary glands (milk, secretions), placenta (transmission to fetus), vagina (secretions, blood), urethra (urine), broken skin,  broken skin (blood), skin (flakes), nose (secretions), mouth (saliva, sputum), ear (earwax), urethra (urine, semen, secretions), anus (feces).
Pathogens leave the body of an infected host through various portals of exit to infect new hosts.

Key concepts and summary

  • Koch’s postulates are used to determine whether a particular microorganism is a pathogen. Molecular Koch’s postulates are used to determine what genes contribute to a pathogen’s ability to cause disease.
  • Virulence , the degree to which a pathogen can cause disease, can be quantified by calculating either the ID 50 or LD 50 of a pathogen on a given population.
  • Primary pathogens are capable of causing pathological changes associated with disease in a healthy individual, whereas opportunistic pathogens can only cause disease when the individual is compromised by a break in protective barriers or immunosuppression.
  • Infections and disease can be caused by pathogens in the environment or microbes in an individual’s resident microbiota .
  • Infections can be classified as local , focal , or systemic depending on the extent to which the pathogen spreads in the body.
  • A secondary infection can sometimes occur after the host’s defenses or normal microbiota are compromised by a primary infection or antibiotic treatment.
  • Pathogens enter the body through portals of entry and leave through portals of exit . The stages of pathogenesis include exposure , adhesion , invasion , infection , and transmission .

Fill in the blank

A(n) __________ pathogen causes disease only when conditions are favorable for the microorganism because of transfer to an inappropriate body site or weakened immunity in an individual.

opportunistic

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The concentration of pathogen needed to kill 50% of an infected group of test animals is the __________.

LD 50

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A(n) __________ infection is a small region of infection from which a pathogen may move to another part of the body to establish a second infection.

focal

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Cilia, fimbriae, and pili are all examples of structures used by microbes for __________.

adhesion

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Questions & Answers

what is the size of virus
Beatrice Reply
What is the difference between TVC and Bioburden test
Mohamed
?
Mohamed
structure of bacteria and 10 types
Jennifer Reply
what is accidental host?
Domingo Reply
what is endomembrane system
Ikpi Reply
what is human anatomy
Ikpi
okay. Go ahead and ask
Blessing Reply
Industrial microbiology mcq
mohamed
Okay. What's your question?
Blessing
life arises from living matter or live organism.
Swami Reply
yes
sildra
I think live matter arises from non living matter
sildra
I dont think so...can u explain with an example
Manya
living maters made by non living matters
sildra
non living matters like stones? rocks?
Manya
eno
sildra
no
sildra
then?
Manya
cells are made by C N O minerals etc
sildra
I mentioned these as non living maters
sildra
that's all
sildra
cells are made up of those things but they originate from living things..
Manya
ok
sildra
Ok..good chat:-)
Manya
where are you from
sildra
thanks
sildra
India...u?
Manya
Tamil nadu
sildra
I am from Maharashtra
Manya
what about your studies
sildra
completed bsc.. preparing for msc entrance...wbu?
Manya
same
sildra
are you microbiologist
sildra
yes i am
Manya
good
sildra
what s the scope for micro in ur state?
Manya
did you find your college to higher studies
sildra
have to give an entrance exam for every college here...so lets c
Manya
food industries, medical lab, vaccine industries ,etc
sildra
hoping for pune University...wbu?
Manya
great!
Manya
is that centeral University right
sildra
what is your namr
sildra
hello
Udhaya
Hi
Maruf
Family kindly help me with this question? 1) Shortlist the configurative measurements of the following human anatomical ranges of÷ - Blood ( haemeglobin) in both male and female - Haematocytes in both male and female - Hepatocytes in both male and female - Lymphocyte / T. Lymphocytes in both male
Gifted
My names are Gift Mwale and am a Zambian. Kindly help me with this research which goes like this... 1) Shortlist the configurative measurements of the following human anatomical ranges of ÷ - Blood ( haemeglobin) in both male and female - Hepatocytes in both male and female - Haematocytes in both
Gifted
please what is the full meaning for TCDS
UDEME
from a single cell
Freedom
tcds means transcranial direct current stimulation...in this small electric currents are given to brain( specific parts) to help increase brain performance or to help with depression.. current should be in range 0.5-2.0mA
Manya
what's underlying disease relating unsanitary diet microorganism with the highest rate of epidemology solution and efficacy leading molecules elucidated structural solutions
feven
please can anybody talk about brain tumour and its cure.
BELLO Reply
enlargement of the thyroid gland resulting in over production of hormone.
Kamal Reply
What can u say on Thyroid Cancer?
Abdulkareem
Please, talk about the thyroid cancer.
BELLO
explain the Grave's disease
John Reply
what is cell
Avi Reply
is unit of life
Kamaluddeen
Ok
mohamed
who is an industrial microbiologist
Cynthia Reply
I want to know the biochemical composition of bacteria
Josh Reply
It contains peptidoglcon, DNA nd RNA
Asiya
what are Carrier protein
Ikpi
bacteriophage disadvantage
Momina Reply
disease due to __________ abnormalities are termed primary immunodeficiencies
Tayee Reply
Some primary immunodeficiencies are due to a defect of a single cellular or humoral component of the immune system.
Prince
Examples of primary immunodeficiencies include: chronic granulomatous disease, X-linked agammaglobulinemia, selective IgA deficiency etc
Prince
thank you
Nana
explain microbial mutation
Emerald
what is mutation
Cynthia Reply
alteration in genetic makeup
UDEME

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Source:  OpenStax, Microbiology. OpenStax CNX. Nov 01, 2016 Download for free at http://cnx.org/content/col12087/1.4
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