Jan Potempa
Molekularne postawy infekcyjnych chorob
bakteryjnych
A small bacterium weighs as little as 0.000,000,000,01 gram,
A blue whale weighs about 100,000,000 grams.
Yet a bacterium can kill a whale&
Microbes, not macrobes, rule the world.
Bernard Dixon
Philosophers and theologians
may glorify humans as the
crown of creation, but
bacteria view humans more
accurately as the proverbial
free lunch
Death rates for the 10 leading
causes of death in the USA
Influenza and
Heart diseases
pneumonia
Cancer
Tuberculosis
Gastroenteritis
Stroke
Heart diseases Accidents
Influenza and
Stroke
pneumonia
Kidney diseases Diabetes
Cirrhosis of
Accidents
the liver
Cancer
Suicide
1900
1990
Infant diseases Atherosclerosis
Diphtheria
Homicide
0 100 200 0 100 200
Deaths per 100,000 population
Deaths per 100,000 population
1. Improved nutrition, sanitation
and living conditions
2. Vaccination
3. Introduction of
antibiotics into
widespread clinical use
Problems with Antibiotics
" No that highly profitable products
" Harder to find and more expensive to
develop
" Appearence of antibiotic resistant strains
Death rates for the 10 leading
causes of death in the USA
Heart diseases Heart diseases
Cancer Cancer
Infectious diseases
Stroke
Accidents
Stroke
Influenza and
Accidents
pneumonia
Diabetes Diabetes
Cirrhosis of Cirrhosis of
the liver the liver
Suicide Suicide
Atherosclerosis 1990 Atherosclerosis
2000
Homicide Homicide
0 150 300 0 150 300
Deaths per 100,000 population Deaths per 100,000 populati
Main reasons for increased
incidents of infectious
diseases
Emergence of new pathogens
Reclassification of some chronic
Legionnaires disease caused by Legionella
conditions as the infectious
pneumophilia
disease
Lyme disease caused by Borrelia burgdorferai
Helicobacter pylori and ulcer disease
Wide spread antibiotic resistance
among pathogenic bacteria
" Given the millions of years humans had
coexisted with microbs on the planet it was
assumed that any microorganism capable
to causing disease would surely have
donne so by now.
1) Bacteria can change their genetic makeup very
rapidly to take advantage of new opportuneities
2) Changes of human practices:
- the widespread use of air-conditioning
- appearance of crowded intensive care wards
Ancient History Takes a Toll on
Today s Human Health
Earth formed
Humans
Dinosaurs
Protozoa
Microorganisms
Trilobites
4.0
4.5 3.5
3.0
2.5
2.0
1.5
1.0
0.5
0
Stabilization of crust
Oxygen
atmosphere
forming
Some bacteria capable of causing disease have developped strategies for
evading phagocytosis or surviving inside phagocytic cells
The human body,
which is composed of
1013 cells
is a home for 1014 bacterial cells
Public Health Issues that Have Brought
Bacterial Infections Once Again to the Forefront
" Emerging infectious diseases
" Increasing problems with large outbrakes
 food-borne and water-borne infections
 hospital-acquired (nosocomial) infections
 bioterrorism
 microbiota shift diseases
 antibiotic resistance
Emerging and Reemerging
Infectious Diseases
Changes in human activities can create new opportunities
for bacteria to cause disease
New-new diseases: diseases caused by previously
unidentified bacteria that have only recently entered the
human population
New-old diseases: diseases caused by newly recognized
bacteria that have been around for a long time
Old-new diseases: diseases caused by well known
pathogens that were thought to have been eliminated but
have recently reappeared
Old-old diesases: diseases caused by long-known
bacteria that have remained high in incidence but can be
classified as emerging in the sense that public and the
media are only now begining to notice them
New-new diseases: diseases caused by previously
unidentified bacteria that have only recently entered the
human population
Lyme disease and Legionnaires disease
Lyme disease
1) Ixodes ticks, the vector of disease, infected with the
spirochete Borrelia burgdorferi
2) A deer population explosion in the 1980-1900 period
3) Humans in areas infested with White-footed mice and
White-tailed deer carrying Ixodus ticks
White-tailed White-footed
deer carrying mice infected
Ixodus ticks with Borrelia
burgdorferi
Humans who
are infected
Humans who
are bitten by
ticks
USA: 5,000 reported cases of Lyme disease per year
Legionnaires disease
" Legionella pneumophila: Gram-negative
bactria living free in soil and water
" Air-conditioning systems in hospital and
hotels
" Legionnaires conference in a Philadelphia
hotel
" Ventilator pneumonia
New-old diseases: diseases caused by
newly recognized bacteria that have been
around for a long time
" Food-borne diesese caused by
Campylobacter sp.
 C. jejuni
 C. coli
" Cat scratch disease
 Bartonella hanselae
" Trench fever
 Bartonella quintana
Old-new diseases: diseases caused by well
known pathogens that were thought to have been
eliminated but have recently reappeared
" Tuberculosis in North America
 One-third of the word s population is infected with
Mycobacterium tuberculosis and tuberculosis renains one of the
leading causes of infectious disease death worldwide
 Difficult to comply with multiantibiotic, long therapy
 Multidrug-resistant tuberculosis
" Cholera in South America
 Outbrakes in 1991-1992
" Antibiotic resistant bacteria
 Staphylococcus aureus
 Streptococcus pneumoniae
 Enterococcus sp.
" Bloody diarrhea (dysentery) caused by E. coli O157:H7
strain
Old-old diesases: diseases caused by long-known
bacteria that have remained high in incidence but can be
classified as emerging in the sense that public and the
media are only now begining to notice them
" Bacterial sexually transmited diseases
 Chlamydia trachomatis: a cause of a cervical
infection that is asymptomatic in about 2/3 of
infected woman. It causes urethitis in man.
Infection of the fallopian tubes can result in
clousure of the tubes  infertile / actopic
pregnency
 Gonorrhea (Neisseria gonorrhoeae)
Food-Borne and Water-Borne
Infections
" The integrity of the food and water supplies is a
non-negotiable issue
" E. coli O157:H7 outbrake and contaminated
hamburgers, undercooked meat, radish sprouts,
apple juice
" Water-borne infections and vegetarian food
" Salmonellosis (750 cases) in Vasco County in
Oregon (Salmonella enterica serovar
Typhimurium)
Modern Medicine as a Source of
New Diseases
" Transplanted patients and patients
receivivg cancer chemotherapy have
suppressed immune system
" Patients with cathers and prostatics
" Oportunistic pathogens
 Pneumonia and respirators
 Mouth-wash and Burkholderia cepacia (a soil
bacterium)
Microbiota Shift Diseases
" Diseases that are not caused by a single
bacterial pathogen, but rather by a shift in
bacterial population of some part of the human
body
 Bacterial vaginosis, a result of a shift in the vaginal
microbiota from a predominantly Gram-positive
population (Lactobacillus sp.), to a population of
Gram-negative anaerobes (a fishy odor)
 Vaginosis and preterm births
 Vaginosis and a high risk of contracting HIV infections
Genomics
" http://microbialgenome.org/
" Unidentified reading frames (urfs)
" B. burgdorferi  lack genes corresponding
to the iron-containing proteins
Bioterrorism
" Germ warfare
" Bacillus anthracis
" Yesinia pestis
" Clostridium botulinum
New Respect for Prevention
" A treatment-based approach to controlling
infectious diseases
" Vaccinations
" Antibiotic prophylactic
" Prevention, effective and inexpensive way
keeping infectious disease out of human
population
Making Hospitals Safe for
Patients
" An infection control program
" Communication among medical personnel
" Costs associated with antibiotic-resistant
bacterial infections
And Now for the Really Good News-
You ve Got a Bacterial Infection
Disease Suspected microbe
Periodontal disease Porphyromonas and other oral bacteria
Atheriosclerosis Chlamydia pneumoniae
Low-birth-weight babies Bacterial vaginosis
Cerebral palsy (same cases) Placental infections
Rheumatoid arthritis Unknown
Crohn s disease Mycobacterium spp.