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Anti Viral & Infection
Anti Viral & Infection medicines
What is infections?
Invasion of the body by disease - causing organisms (pathogens, or germs)
that become established, multiply, and produce symptoms. Bacteria and viruses
cause most diseases, but diseases are also caused by other micro-organisms,
protozoans, and other parasites.
Most pathogens enter and leave the body through the digestive or respiratory
tracts. Polio, dysentery, and typhoid are examples of diseases contracted by
ingestion of contaminated foods or fluids. Organisms present in the saliva or
nasal mucus are spread by airborne or droplet infection; fine droplets or dried
particles are inhaled by others when the affected individual talks, coughs,
or sneezes. Diseases such as measles, mumps, and tuberculosis are passed on
in this way.
A less common route of entry is through the skin, either by contamination
of an open wound (as in tetanus) or by penetration of the intact skin surface,
as in a bite from a malaria-carrying mosquito. Relatively few diseases are transmissible
by skin-to-skin contact. Glandular fever and herpes simplex (cold sore) may
be passed on by kissing, and the group now officially bracketed as sexually
transmitted diseases (STDs) are mostly spread by intimate contact.
Bacteria are microscopic, single-celled organisms. Thousands of different
kinds of bacteria live throughout the world. Some live in the environment, and
others live on the skin, in the airways, in the mouth, and in the digestive
and genitourinary tracts of people and animals. Only a few kinds of bacteria
Bacteria are classified in several ways. One way is by their distinctive
shapes. Spherical bacteria are cocci, rod-like bacteria are bacilli, and spiral
or helical bacteria are spirochetes.
Another way bacteria are classified is by their color after a particular
chemical stain (Gram stain) is applied. Some bacteria stain blue and are called
gram-positive, whereas others stain pink and are called gram-negative. Gram-positive
and gram-negative bacteria differ in the kinds of infections they produce and
in the kinds of antibiotics that are likely to kill them.
Gram-negative bacteria have a unique outer membrane that prevents many drugs
from penetrating them, making gram-negative bacteria generally more resistant
to antibiotics than are gram-positive bacteria. The outer membrane of gram-negative
bacteria is also rich in molecules called lipopolysaccharides. If gram-negative
bacteria enter the bloodstream, their lipopolysaccharides can trigger high fever
and a life-threatening drop in blood pressure (see Bacteremia, Sepsis, and Septic
Shock: Introduction). For this reason, bacterial lipopolysaccharides are referred
to as endotoxins.
Gram-negative bacteria have a great facility for exchanging genetic material
(DNA) with other strains of the same species and even with different species.
Thus, if gram-negative bacteria undergo a genetic change (mutation) that produces
resistance to an antibiotic and then share DNA with another strain of bacteria,
the second (recipient) strain becomes resistant as well.
Gram-positive bacteria are usually slow to develop resistance to antibiotics.
Some gram-positive bacteria (for example, Bacillus anthracis and Clostridium
botulinum) produce potent poisons (toxins) that cause serious illness.
A third way of classifying bacteria is by their use of oxygen. Most bacteria
can live and grow in the presence of oxygen; these bacteria are called aerobes.
Bacteria that can tolerate only low levels of oxygen, or are poisoned by oxygen,
are called anaerobes. Anaerobes thrive in areas of the body that have low levels
of oxygen -- such as the intestine, decaying tissue, and wounds that are particularly
deep and dirty.
Hundreds of species of anaerobes normally live harmlessly on the skin and
mucous membranes (such as the lining of the mouth, intestine, and vagina); several
hundred billion bacteria may exist in a cubic inch of stool. Most anaerobic
infections arise from the body's own pool of bacteria.
Anaerobes tend to invade skin and muscle tissue that has been damaged by
injury or surgery -- particularly if the tissue has a poor blood supply. Spontaneous
infections sometimes develop in people who have certain cancers or a weakened
immune system. Also common are infections in the mouth. Anaerobes sometimes
cause chronic (but not acute) infections of the sinuses and middle ear. Anaerobic
infections tend to form collections of pus (abscesses). Severe anaerobic infections
often release gas into the surrounding tissue.
Bacteria cause different illnesses depending on the site and type of organism.
Respiratory tract infections are very common and affect all ages. Most are
due to viruses, infection-causing agents smaller than bacteria. Viral respiratory
infections are usually self-limiting and improve without antibiotics. Bacterial
infections causing sinusitis, pharyngitis (throat infection), and pneumonia
are common in children, the elderly and the immune-suppressed. The death rate
due to pneumonia in the elderly is about 15 percent.
Many foodborne illnesses are due to bacteria or the toxins they produce.
Food that is mishandled during a summer picnic or left out for several hours
allows the bacteria staphylococcus aureus to proliferate and produce a toxin
that causes severe nausea and vomiting. Helicobacter pylori is a bacterium that
infects the stomach lining in about 80 percent of people with peptic ulcers.
H. pylori is strongly associated with both the formation of ulcers and in delayed
healing. The exact mechanism for this is not fully known. Antibiotics are part
of the treatment for peptic ulcer.
Urinary tract infections occur when bacteria from the genital tract or perineal
area (between the genitals and anus) contaminate the urethra (urine passageway).
This occurs most commonly in sexually active women. In addition, incomplete
bladder emptying, for example, due to prostatic enlargement, allows bacteria
to accumulate. Women are prone to UTIs during pregnancy. Postmenopausal women
may develop incontinence and UTIs following hysterectomy.
Bacterial infections of membranes covering the brain and spinal chord (bacterial
meningitis) affect people of all ages, but mostly children less than 2 years
old. About 300 people die of meningococcal meningitis in the United States each
year and about 700 people due to pneumococcal meningitis. The American Academy
of Pediatrics recommends vaccination against two historically common causes
of child meningitis - H. influenzae and S. pneumonia - starting at 2 months
Sepsis is a leading cause of death mostly in the elderly or chronically ill
in the United States. Severe sepsis claims 215,000 lives each year - more than
breast, colon/rectal, pancreatic and prostate cancer combined. This complex
syndrome, characterized by an overwhelming systemic response to infection, strikes
hard and can rapidly lead to organ dysfunction and death.
Bacterial infection from virtually any site in the body can pass into the
bloodstream and cause sepsis. Fever, severe shaking (rigors), hypotension (low
blood pressure), coma and death can result if not quickly and properly treated.
Bacteria also cause endocarditis, which is an infection of the inside surface
of the heart chambers or valves.