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Discussion Question

1- Discussion Question: A 41-year-old female presents to the doctor’s office you work at complaining of a sore throat and headache. Upon examination, she is diagnosed with a virus that is currently prevalent in the area she works. She is told to rest and drink liquids until the virus has run its course. She becomes irate and tells you she wants an antibiotic.

How could you explain to her why she does not need an antibiotic?

What are some alternatives you could consider for a patient who demands an antibiotic?

2- 3 paragraph 3 sentences each

3- APA style

4- 2 references not older than 2015

Chapter

0:
Mechanisms of Infectious Disease

Terminology Involved in the Study of Infectious Disease #1

Host—any organism capable of supporting the nutritional and physical growth requirements of another organism

Infectious disease—the disease state brought about by the interaction with another organism

Colonization—the presence and multiplication of a living organism on or within the host

Microflora—bacteria inhabiting exposed surfaces of the body

Virulence—the disease-inducing potential

Terminology Involved in the Study of Infectious Disease #2
Pathogens—microorganisms so virulent that they are rarely found in the absence of disease
Saprophytes—free-living organisms obtaining their growth from dead or decaying organic material from the environment

Terminology Involved in the Study of Infectious Disease #3
Mutualism: an interaction in which the microorganism and the host both derive benefits from the interaction
Commensalism: an interaction in which colonizing bacteria acquire nutritional needs and shelter but the host body not affected
Parasitic relationship: only the infecting organism benefits from the relationship
If the host sustains injury or pathologic damage, the process is called an infectious disease.

Agents of Infectious Disease
Prions
Viruses
Bacteria
Rickettsiaceae
Chlamydiaceae
Fungi
Parasites

Viruses
Smallest pathogens
Have no organized cellular structure
Consist of a protein coat surrounding a nucleic acid core of DNA or RNA
Are incapable of replication outside a living cell

Microorganisms
Eukaryotes (Fungi)
Contain a membrane-bound nucleus
Prokaryotes (Bacteria)
The nucleus is not separated.

Classification of Bacteria
According to the microscopic appearance
According to staining of the cell
Gram-positive organisms: stained purple by a primary basic dye (usually crystal violet)
Gram-negative organisms: not stained by the crystal violet but are counterstained red by a second dye (safranin)

Parasites
Types
Protozoa
Helminths
Arthropods
Method of Infecting
These members of the animal kingdom infect and cause diseases in other animals.
These animals then transmit disease to humans.

Rickettsiaceae, Anaplasmataceae, Chlamydiaceae, Coxiella
Organisms that combine the characteristics of viral and bacterial agents to produce disease in humans
Are obligate intracellular pathogens like the viruses
Produce a rigid peptidoglycan cell wall
Reproduce asexually by cellular division
Contain RNA and DNA similar to the bacteria

Question #1
Which of the following pathogens does not fit the typical description of an organism?
Viruses
Bacteria
Rickettsiaceae
Chlamydiaceae
Fungi
Parasites

Answer to Question #1
A. Viruses
Rationale: Viruses have no organized cellular structure.

Classification of Infectious Disease
Incidence
Portal of entry
Source (mode of transmission)
Symptoms
Disease course
Site of infection
Virulence factors

Epidemiology (Terminology)
Epidemiology: the study of factors, events, and circumstances that influence the transmission of infectious diseases among humans
Incidence: the number of new cases of an infectious disease that occur within a defined population
Prevalence: the number of active cases at any given time

Incidence of Disease
Endemic disease: found in a particular geographic region
The incidence and prevalence are expected and relatively stable.
Epidemic: Abrupt and unexpected increase in the incidence of disease over endemic rates
Pandemic: Spread of disease beyond continental boundaries

Portals of Entry
Penetration
Direct contact
Ingestion
Inhalation

Source of an Infectious Disease
Location
Nosocomial: develop in hospitalized patients
Community acquired: acquired outside of health care facilities
Host
An object or substance from which the infectious agent was acquired
May be endogenous or exogenous

Symptomatology
Specific: reflects the site of infection (e.g., diarrhea, rash, convulsions, hemorrhage, pneumonia)
Nonspecific: can be shared by a number of diverse infectious diseases (e.g., symptoms such as fever, myalgia, headache)
Obvious: predictable patterns (e.g., chickenpox and measles)
Covert: may require laboratory testing to detect (e.g., hepatitis or increased white blood cell count)

Disease Course in Infection
Incubation period
Prodromal stage
Acute stage
Convalescent stage
Resolution stage

Factors Influencing the Site of an Infectious Disease
Type of pathogen
Portal of entry
Competence of the host’s immunologic defense system

Question #2
Is the following statement true or false?
The symptoms of an infection are always obvious and apparent.

Answer to Question #2
False
Rationale: Symptoms may be covert or nonspecific in presentation.

Types of Antimicrobial Agents
Antibacterial agents
Antiviral agents
Antifungal agents
Antiparasitic agents

Drug Resistance
Bacterial resistance mechanisms
Inactivate antibiotics
Genetically alter antibiotic binding sites
Bypass antibiotic activity
Changes in the bacterial cell wall
Antiviral resistance mechanisms
Nucleoside analogs
Protease inhibitors
Need for combination or alternating therapy with multiple antiretroviral agents

Intravenous Immunoglobulin and Cytokine Therapy
Supplementing or stimulating the host’s immune response so that the spread of a pathogen is limited or reversed
Pathogen-specific antibodies given to the patient as an infusion to facilitate neutralization, phagocytosis, and clearance of infectious agents above and beyond the capabilities of the diseased host

Criteria for Diagnosis of an Infectious Disease
The recovery of a probable pathogen or evidence of its presence from the infected sites of a diseased host
Accurate documentation of clinical signs and symptoms (symptomatology) compatible with an infectious process

Techniques for Laboratory Diagnosis of an Infectious Agent
Culture
Serology or detection of characteristic antigens
Genomic sequences or metabolites produced by the pathogen

Categories of Virulence Factors
Toxins
Adhesion factors
Evasive factors
Invasive factors

Nonpharmacological Intervention
Surgical interventions
Providing access to an infected site by antimicrobial agents (drainage of an abscess)
Cleaning of the site (debridement)
Removing infected organs or tissue (e.g., appendectomy)

Question #3
Is the following statement true or false?
Surgical therapy is used in tandem with antibiotic treatment in some cases of severe infection.

Answer to Question #3
True

Antibiotic Mechanisms
Interference with a specific step in bacterial cell wall synthesis
Inhibition of bacterial protein synthesis
Interruption of bacterial nucleic acid synthesis
Interference with normal bacterial metabolism

Classification of Antibiotic Action
Bactericidal—if it causes irreversible and lethal damage to the bacterial pathogen
Bacteriostatic—if its inhibitory effects on bacterial growth are reversed when the agent is eliminated

Classification and Target Site of Antibacterial Agents
Penicillins: cell wall
Cephalosporins: cell wall
Monobactams: cell wall
Aminoglycosides: ribosomes
Tetracyclines: ribosomes
Macrolides: ribosomes
Sulfonamides: folic acid synthesis
Glycopeptides: ribosomes
Quinolones: DNA synthesis

Weapons of Bioterrorism #1
Category A Agents
Plague
Tularemia
Smallpox
Hemorrhagic fever viruses
Category B Agents
Agents of food-borne and water-borne diseases
Agents of zoonotic infections

Weapons of Bioterrorism #2
Category B Agents (cont.)
Viral encephalitides
Toxins from castor bean
Category C Agents
Mycobacterium tuberculosis
Nipah virus and hantavirus
Tick-borne and yellow fever viruses
Cryptosporidium parvum

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