LECTURE NOTE 9

4 PATHOLOGY

BASIC MEDICAL SCIENCES

Microorganisms

Bacteria

Bacteria are ubiquitous, free-living organisms consisting of one biological cell

(unicellular). They constitute a large domain of prokaryotic microorganisms found
everywhere on earth. They have cell membrane but lacks major organelles.

There are two types of microorganisms: beneficial microorganisms (digestion, preventing

the invasion of disease-causing bacteria, fermentation and the synthesis of essential
nutrients and vitamins) and non-beneficial microorganisms (infectious ones).

Bacteria can be classified based on shape into 4:

1. Bacillus (rods), 2. Coccus (spheres), 3. vibrio and 4. Spirillum (spirals or helixes).

Bacteria are prokaryotic organisms that carry their genetic information in a double-
stranded circular molecule of DNA. Some species also contain small circular plasmids of
additional DNA. The cell cytoplasm contains ribosomes and there is a cell membrane in
all species except Mycoplasma, a complex cell wall. External to the cell wall, some bacteria
have capsules, flagella, or pili. Bacteria normally reproduce by binary fission. Under the
proper conditions, some bacteria can divide and multiply rapidly. Consequently, some
infections require only a small number of organisms to cause potentially overwhelming
infection.

Bacteria can also be classified based on staining into 2:

1. Staining: Gram-positive or 2. Gram-negative

This is based on the characteristics of their cell wall, as seen under a microscope after
stains have been administered, a procedure called Gram staining. This was developed in
1882 by Hans Christian Gram. Most bacteria fall into one of these two categories. One of
the main differences between gram-positive and gram-negative organisms is that gram-
negative bacteria tend to produce an endotoxin that can cause tissue destruction, shock,
and death. The two classes of bacteria differ in their antibiotic susceptibilities as well, and
different types of antibiotics are effective against them.

Bacteria are also classified based on need for oxygen into 2:

1.Aerobic or 2. Anaerobic,

This based on their growth responses in the presence and absence of oxygen

Bacteria can be classified based on scientific names:

Bacteria, like other living things, are classified by genus (based on having one or several
similar characteristics) and, within the genus, by species. Their scientific name is genus
followed by species (for example, Clostridium botulinum). Within a species, there may
be different types, called strains. Strains differ in genetic makeup and chemical
components. Sometimes certain drugs and vaccines are effective only against certain
strains.

Mode of actions

Each species of bacteria has a predilection to infect certain organs and not others. eg.
Neisseria meningitidis normally infects the meninges of the central nervous system, it is
not, however, a cause of skin infection.

Diseases can be caused by the

• Destruction of the host cells by the organism

• Host immune response to the infection. Antibiotics may be of little or no use when
the disease manifestations are a result of the body's attempts to rid itself of the
bacteria. The systemic inflammatory response syndrome (SIRS), usually caused by
a bacterial infection, is an overwhelming inflammatory response to infection,
manifested by the release of large numbers of cytokines (TNF-alpha, interleukins
and NF-KB) and presenting with signs of infection and early signs of
hemodynamic instability. If allowed to progress, SIRS patients can go on to
develop sepsis, with multiorgan failure and death. Once the cascade of events has
begun, even the strongest antibiotics are often powerless to stop this progression.
The immune response is the way in which your body recognizes and defends itself
against bacteria, viruses, and other substances that are foreign and harmful. It is
the job of the immune system to protect our bodies from harmful invaders by
recognizing and responding to antigens.
Bacteria defence

Bacteria have many ways of defending themselves.

• Formation of Biolfilm
• Capsule: Some bacteria are enclosed in a protective capsule which helps prevent
white blood cells from ingesting the bacteria (such bacteria are described as
encapsulated).
• Outer membrane: Under the capsule, gram-negative bacteria have an outer
membrane that protects them against certain antibiotics. When disrupted, this
membrane releases endotoxins. Endotoxins contribute to the severity of symptoms
during infections with gram-negative bacteria.
• Spores: an inactive (dormant) form of bacteria. Spores can enable bacteria to
survive when environmental conditions are difficult. When conditions are
favorable, each spore germinates into an active bacterium.
• Flagella: Long, thin filaments that protrude from the cell surface and enable
bacteria to move. Bacteria without flagella cannot move on their own.
• Antibiotic Resistance: Some bacteria are naturally resistant to certain antibiotics.
Other bacteria develop resistance to drugs because they acquire genes from other
bacteria that have become resistant or because their genes mutate. The genes that
encode for drug resistance can be passed to following generations of bacteria or
sometimes even to other species of bacteria.

Localization of bacteria

Bacteria can be found in soil, water, plants, animals, radioactive waste, deep in the
earth's crust, arctic ice and glaciers, and hot springs.

Functions of bacteria

1. provide nutrients like nitrogen and phosphorus to plants

2. provide growth hormones to plants.
3. decomposing dead organic matter,
4. fermentation process
5. they contribute to soil structure and the cycles of nature.
Examples of bacteria include

• Campylobacter pylori.
• Clostridium perfringens.
• E. coli.
• Listeria.
• Norovirus.
• Salmonella.
Factors affecting bacteria growth and development

• Warmth
• moisture
• pH levels
• oxygen levels
• nutrients
• light
• temperature

Diseases caused by bacteria

• tuberculosis - mycobacterium tuberculosis

• typhoid – salmonella typhi
• tetanus - clostridium tetani
• plague – yersinia pestis
• pertussis – Bordetella pertussis
• leprosy – mycobacterium leprae
• cholera,
• diphtheria,
• bacterial meningitis,
• Lyme disease,
 • gonorrhea,
• syphilis
• pneumonia

Treatment of bacteria infections

Antibiotics, vaccine, heat or temperature

Antibiotic resistance

Antibiotic resistance is one of the biggest threats to global health, food security, and
development today. Antibiotic resistance can affect anyone, of any age, in any country.
Antibiotic resistance occurs naturally, but misuse of antibiotics in humans is accelerating
the process. A growing number of infections – such as pneumonia, tuberculosis,
gonorrhoea, and salmonellosis – are becoming harder to treat as the antibiotics used to
treat them become less effective. Antibiotic resistance leads to longer hospital stays,
higher medical costs and increased mortality.
Fungi

Fungi are any group of spore-producing, eukaryotic organisms feeding on organic

matter, including molds, yeast, mushrooms, and toadstools. Yeast, is about 1,500 species
of single-celled fungi, most of which are in the phylum Ascomycota, only a few being
Basidiomycota. Yeasts are found worldwide in soils and on plant surfaces and are
especially abundant in sugary mediums such as flower nectar and fruits. Molds include
all species of microscopic fungi that grow in the form of multicellular filaments, called
hyphae. Molds can thrive on any organic matter, including clothing, leather, paper, and
the ceilings, walls and floors of homes with moisture management problems.
Fungi cellular components

Structure of a fungi
Mushroom

Types of fungi
Fungi growth pattern
Benefits of fungi
Diseases caused by fungi

Aspergillosis.
Blastomycosis.
Candidiasis.
Candida auris.
Coccidioidomycosis.
C. neoformans Infection.
C. gattii Infection.
Fungal Eye Infections

Treatment of fungi

Antifungal drugs

Factors affecting fungi growth and development

• Warmth
• moisture
• pH levels
• oxygen levels
• nutrients
• light
• temperature

Antifungal resistance

Antifungal resistance occurs when fungi no longer respond to antifungal drugs. Only
three types of antifungal drugs currently exist, so antifungal resistance can severely limit
treatment options. Some types of fungi, like Candida auris, can become resistant to all
three drug types.
Virus

Viruses are small obligate intracellular parasites, which by definition contain either a
RNA or DNA genome surrounded by a protective, virus-coded protein coat. Viruses may
be viewed as mobile genetic elements, most probably of cellular origin and characterized
by a long co-evolution of virus and host.

Characteristics of a virus

• Non-living structures.
• Non-cellular.
• Contain a protein coat called the capsid.
• Have a nucleic acid core containing DNA or RNA (one or the other - not both)
• Capable of reproducing only when inside a HOST cell.
Diseases caused by virus

• AIDS.
• Common cold.
• Ebola.
• Genital herpes.
• Influenza.
• Measles.
• Chickenpox and shingles.
• Coronavirus disease 2019 (COVID-19)

Treatment of viral infections

1. Antiviral drugs can ease symptoms and shorten how long people are sick with
viral infections like the flu and Ebola. They can rid your body of these viruses.
Viral infections like HIV, hepatitis and herpes are chronic.
2. Vaccine.

Resistance of virus to treatment

Reduced susceptibility detected using laboratory tests can be a sign of potential antiviral
drug resistance in clinical settings. Typically, flu virus is called resistant after sufficient
evidence was gathered to prove a lack of antiviral effect of a particular antiviral
medication in patients infected with such virus.
Parasites

A parasite is an organism that lives on or in a host organism and gets its food from or at
the expense of its host. There are three main types of parasites that can cause disease in
humans:

1. protozoa, 2. helminths, and 3. ectoparasites.

Host
Classifications of parasites
Types

There are three main types of parasites that can cause disease in humans: protozoa,
helminths, and ectoparasites
Growth pattern of parasites

E.g., Mosquito
Symptoms of parasitic infections
Vital signs

There are four main vital signs:

1. body temperature

Temperature is the degree of hotness or coldness of the body. It can be measured using a
thermometer. It can be taken from various parts of the body such as mouth, armpit, anus,
scrotum, cranium, vagina, groin, etc. The average body temperature is 37.5 degree
Celsius.

2. blood pressure

Blood pressure is affected by blood volume. There are two types. Systolic (120) and
diastolic (80). It can be measured using a sphygmomanometer. It is taken around the
brachial artery. Unit is mm/Hg.
 3. pulse pressure and pulse rate (heart rate)

Pulse pressure is the difference between systolic and diastolic blood pressure. 120-80
which is 40. It can be measure by palpation over the radial artery. The pulse rate may
fluctuate and increase with exercise, illness, injury, and emotions. While the Pulse rate in
adults ranges from 60 to 100 beats per minute with an average of 72 beats per minute.
 4. breathing rate

Respiratory rate - The normal respiration rate for an adult at rest is 12 to 20 breaths per
minute.