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Types of Pathogens, Bacterial Infection and Antibiotic Therapy

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Types of Pathogens, Bacterial Infection and Antibiotic Therapy TYPES OF PATHOGENS, BACTERIAL INFECTION AND ANTIBIOTIC THERAPY Jassin M. Jouria, MD Dr. Jassin M. Jouria is a medical doctor, professor of academic medicine, and medical author. He graduated from Ross University School of Medicine and has completed his clinical clerkship training in various teaching hospitals throughout New York, including King’s County Hospital Center and Brookdale Medical Center, among others. Dr. Jouria has passed all USMLE medical board exams, and has served as a test prep tutor and instructor for Kaplan. He has developed several medical courses and curricula for a variety of educational institutions. Dr. Jouria has also served on multiple levels in the academic field including faculty member and Department Chair. Dr. Jouria continues to serves as a Subject Matter Expert for several continuing education organizations covering multiple basic medical sciences. He has also developed several continuing medical education courses covering various topics in clinical medicine. Recently, Dr. Jouria has been contracted by the University of Miami/Jackson Memorial Hospital’s Department of Surgery to develop an e-module training series for trauma patient management. Dr. Jouria is currently authoring an academic textbook on Human Anatomy & Physiology. ABSTRACT Antibiotic therapy, as part of a medical plan and lifesaving measure is a primary focus in terms of the general principles that clinicians must understand when selecting a course of pharmacology treatment for an infectious disease. This course is part two of a 2-part series on pathogens and antimicrobial therapy with a focus on general issues affecting antibiotic selection, the types of pathogens and diseases treated, and on specific antibiotics’ indication, administration and potential adverse effects. Antibiotic misuse and resistance is discussed. nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com 1 Policy Statement This activity has been planned and implemented in accordance with the policies of NurseCe4Less.com and the continuing nursing education requirements of the American Nurses Credentialing Center's Commission on Accreditation for registered nurses. It is the policy of NurseCe4Less.com to ensure objectivity, transparency, and best practice in clinical education for all continuing nursing education (CNE) activities. Continuing Education Credit Designation This educational activity is credited for 5 hours. Nurses may only claim credit commensurate with the credit awarded for completion of this course activity. Pharmacology content is credited for 1 hour. Statement of Learning Need The health literature has identified the inappropriate use of antimicrobial agents, as well as the evolving pathogenicity of varied types of organisms and rising problem of antimicrobial resistance. This is a critical learning topic for health clinicians, especially in the field of infectious disease as decisions are made to treat and educate patients to prevent and address an infectious disease process. Course Purpose To provide clinicians with knowledge of issues in antibiotic pharmacology and related preventive and life saving measures. nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com 2 Target Audience Advanced Practice Registered Nurses and Registered Nurses (Interdisciplinary Health Team Members, including Vocational Nurses and Medical Assistants may obtain a Certificate of Completion) Course Author & Planning Team Conflict of Interest Disclosures Jassin M. Jouria, MD, William S. Cook, PhD, Douglas Lawrence, MA, Susan DePasquale, MSN, FPMHNP-BC – all have no disclosures Acknowledgement of Commercial Support There is no commercial support for this course. Please take time to complete a self-assessment of knowledge, on page 4, sample questions before reading the article. Opportunity to complete a self-assessment of knowledge learned will be provided at the end of the course. nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com 3 1. A pathogen can broadly be defined as a a. bacteria that invades the body. b. viral infection. c. microorganism that has the ability to cause disease. d. bacterial infection. 2. True or False: Lactobacilli help the body destroy pathogens that make their way into the digestive system. a. True b. False 3. Potential ways that antibiotics interact with contraception pills is a. in the acidic environment of the stomach. b. in the liver during metabolism. c. normal flora in the bladder. d. normal flora in the lower lung. 4. _________ refers to a classification for the duration of pathogens. a. Communicable b. Aerobic c. Chronic d. Zoonotic 5. Antibiotic resistance is a natural phenomenon caused by a. the failure of patients to take their antibiotics as prescribed. b. the bacterial genome or genetic component constantly improves and changes with time. c. the failure of patients to seek medical treatment as soon as the infection symptoms appear. d. healthcare personnel prescribing the wrong antibiotics. nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com 4 Introduction Infectious diseases are responsible for approximately one-third of all fatal cases in the world, as against cancers and other medical conditions. In addition to ancient, life-threatening infectious diseases, such as tuberculosis and malaria, new infectious diseases are constantly emerging, which include diseases like AIDS (acquired immune deficiency syndrome), Avian flu, Swine flu, etc. These have already led to the death of 25 million people worldwide. To add to these woes, some diseases which were earlier thought to be the result of a cause other than bacterial infection are now thought to have a bacterial infection cause; for example, most gastric ulcers were believed to be caused by stress or spicy food, but now it has been proven that it is because of bacterial infections of the stomach caused by Helicobacter pylori. Also, infectious diseases are not spread equally across the planet and economically backward and poorer countries and communities suffer more as compared to developed countries. This is because of poor public sanitation and public health systems, lack of knowledge among the masses, which are further compromised by natural disasters or political upheavals. Some infectious diseases, however, occur exclusively between industrialized communities like Legionnaire’s disease that commonly spreads through air conditioning systems. Pathogens: An Overview Health scientists have long been both troubled and fascinated with infectious diseases. The earliest written descriptions of how to limit the spread of rabies date back more than 3,000 years. Since the middle of 1800s, physicians and scientists have struggled to identify the agents nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com 5 that cause infectious diseases, collectively termed as pathogens. More recently, the advent of microbial genetics and molecular cell biology has greatly enhanced our understanding of the causes and mechanisms of infectious diseases. It is now known that pathogens frequently exploit the biological attributes of their host’s cells in order to infect them. This understanding has provided new insights into normal cell biology, as well as strategies for treating and preventing infectious diseases.1 Pathogens are generally referred to as an invader that attacks the body. However, in reality, a pathogen, like any other organism, simply tries to live and procreate. A pathogen lives at the expense of the host organism, which is rich in nutrients, provides a warm, moist environment, and a constant temperature in which the organism can dwell and easily multiply. It is very convenient for many organisms to evolve and reproduce in such a favorable environment and so it is not surprising that every individual acquires some kind of infection.1-3,16 What Is a Pathogen? A pathogen can be defined as a microorganism that has the ability to cause disease. Since a pathogen is a microorganism that can cause pathological damage in a host, this immediately raises the question: What is it about the microorganism that enables it to cause disease or produce damage or how does a microorganism cause damage to the host? nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com nursece4less.com 6 In the 19th century, when germ theory was discovered, many of the major pathogenic organisms were encapsulated or toxigenic bacteria, and this suggested that there were inherent variations between pathogenic and non-pathogenic microbes; however, an organism could be attenuated in the laboratory, but virulence may be restored the moment it enters the host. Given this fact, it is obvious that a clear classification is problematic since a microbe may exist in pathogenic and non-pathogenic states. Types of Pathogens Pathogens are overabundant because they will simply survive anywhere. Most thrive in heat, whereas others prefer the cold. Some species need oxygen or human host, i.e., aerobic bacteria, whereas others do not, i.e., anaerobes. Pathogens that cause communicable diseases can be classified into different types based on multiple characteristics as follows.1-3,16 Route of Transmission Route of transmission in one-way pathogens can be categorized. Differing types of pathogens can infect by more than one route. Routes of transmission are highlighted below.
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