MICR3011 Notes INTRODUCTION Ancient Greek physicians treated the individual NOT the disease Blood heart Phlegm

egm brain Black bile spleen Yellow bile liver Middle Ages

New religious doctrines Causes of disease = visitations from divine providence Great plagues attributed to - Supernatural causes - Influence of undesirable people Increase trade > greater movement of people Crusades + warfare Growth of cities = crowding + lack of sanitation spread of disease - Result: plague, typhus, leprosy common Treatments - Bleeding - Purging - Emetics - Diaphoretics - Stimulation of the nervous system

Renaissance Era Treatments: chemists used heavy metals - Antimony, mercury - Cure = good luck - Harmful Operations = great risk of infection - Mortality rate 80% - Pus > normal reaction to surgery Universities = scientific basis for teaching 17th + 18th Centuries Changes in religious, political + cultural doctrines (scientific methods accepted) Surgical + scientific instruments improved - Eg. Microscope (Anton van Leeuwenhoek) Industrial revolution Scientific exploration of disease; cleanliness + sanitation Hospital-trained experts Common diseases: throat infections, scarlet fever, diphtheria, TB, smallpox 1796 Jenners smallpox vaccine 19th Century

Cholera in Europe Public Health Services sewage systems; reticulated water Register of Births, Deaths & Marriages

Koch Identified tubercle bacillus & cholera Vibrio Basic principles of modern diagnostic microbiology Studied bacteria Investigated human + animal diseases Vaccines Antisepsis

Pasteur -

Lister -

Last Century

World War I 1918 influenza pandemic, cause? Study of infectious diseases & chemotherapy Antimicrobial era - Dyes, heavy metals - Sulphonamides - Penicillin, streptomycin Antibiotic resistance developed World War II 1980: Smallpox dead! - Signs + symptoms distinctive = effective isolation - Patients not contagious during incubation period - No other host for virus - Single serotype - Other poxviruses shared antigens - WHO 10 year global eradication program Vaccine effective Required only one administration Isolation policy for patients until last scab separated

Todays problems Antimicrobial resistance Major infection diseases - HIV/AIDS, tuberculosis + malaria - Keep people in poverty CLINICAL MICROBIOLOGY Classical view of Infectious Disease Bacteria classified as commensals OR pathogens If microbe DOES NOT CAUSE DISEASE - Commensal = normal flora: present at site without causing pathology If microbe SOMETIMES CAUSES DISEASE - Host = carrier - Host is colonised If microbe CAUSES DISEASE - Host is infected Staphylococcus aureus Site as normal flora

- Skin > can spread person-to-person - Nose > colonises nose then spreads to skin - Vagina Beneficial for - Competition: space + nutrients - Non-pathogenic strains prime immune system Characteristics of microbe - G+ve clusters - Facultative anaerobe - Complete haemolysis - Coagulase +ve - Capsule - Toxins: exfoliative + enterotoxins (strain specific) Diseases caused - Pyogenic superficial infections - Surgical wound infections - Osteomyelitis (inflammation of bone) - Systemic blood infections - Impetigo - Ritters disease

Escherichia coli Site as normal flora - Colonises GIT - Most numerous aerobic microbe in large intestine - Can spread anal-oral Beneficial for - Produces vitamin K for human well-being Characteristics of microbe - G-ve rod - Enteric = bile tolerant - Facultative aerobe - Lactose fermenter Diseases caused - Most are ENDOGENOUS - UTIs - Enteric infections - Abdominal wound infection - Pneumonia - Meningitis in neonates - Strain dependent!