Synonym | Infectiology, infectious medicine, ID |
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Significant diseases | Infections, e.g. osteomyelitis, pneumonia, tuberculosis, COVID-19, HIV/AIDS, influenza, also public health issues e.g. epidemics, antimicrobial resistance, bioterrorism |
Significant tests | Gram staining, microbiological cultures (including blood cultures), serological tests, genotyping, polymerase chain reaction (PCR), medical imaging |
Specialist | Infectious diseases specialist, Infectiologist, Infectionist |
Glossary | Glossary of medicine |
Infectious diseases (ID), also known as infectiology, is a medical specialty dealing with the diagnosis and treatment of infections. An infectious diseases specialist's practice consists of managing nosocomial (healthcare-acquired) infections or community-acquired infections. [1] An ID specialist investigates and determines the cause of a disease (bacteria, virus, parasite, fungus or prions). Once the cause is known, an ID specialist can then run various tests to determine the best drug to treat the disease. [2] While infectious diseases have always been around, the infectious disease specialty did not exist until the late 1900s after scientists and physicians in the 19th century paved the way with research on the sources of infectious disease and the development of vaccines. [3] [4] [5]
Infectious diseases specialists typically serve as consultants to other physicians in cases of complex infections, and often manage patients with HIV/AIDS and other forms of immunodeficiency. [6] [7] Although many common infections are treated by physicians without formal expertise in infectious diseases, specialists may be consulted for cases where an infection is difficult to diagnose or manage. They may also be asked to help determine the cause of a fever of unknown origin. [6] [8]
Specialists in infectious diseases can practice both in hospitals (inpatient) and clinics (outpatient). In hospitals, specialists in infectious diseases help ensure the timely diagnosis and treatment of acute infections by recommending the appropriate diagnostic tests to identify the source of the infection and by recommending appropriate management such as prescribing antibiotics to treat bacterial infections. For certain types of infections, involvement of specialists in infectious diseases may improve patient outcomes. [9] In clinics, specialists in infectious diseases can provide long-term care to patients with chronic infections such as HIV/AIDS.[ citation needed ]
Infectious diseases are historically associated with hygiene and epidemiology due to periodic outbreaks ravaging countries, especially in the cities before the advent of sanitation, but also with travel medicine and tropical medicine, as many diseases acquired in tropical and subtropical areas are infectious in nature. [10]
Western innovations for treating infectious diseases originated in Ancient Greece, and before infectious disease was even conceptualized, a Greek Physician named Hippocrates formed the Hippocratic Corpus. Included in this collection of 70 documents was a text that contained illness-causing infectious diseases. This text, called the Epidemiai volumes, played a key role in forming the western approach to infectious disease. A physician during the Roman empire, Galen of Pergamon, also made great impacts on the western perception of infectious disease with his multiple treatises. [4] These treatises gave insight into the Antonine Plague which we now recognize as smallpox based on the description in Galen's treatises. [11]
Between the 16th and 18th centuries, medical professionals were educating more people, learning more from their research, and gaining access to information from other professionals in the field due to the use of printers like Gutenberg and the mass production of medical books. These books, now in the hands of many, included observations of infectious diseases. Such as syphilis, malaria, and smallpox. In the late 18th century we start to see vaccinations forming and the first vaccination for smallpox was established. Although there were records of individual infectious diseases spread out over medical documents, a combined perception of infectious disease as an area of medicine did not exist at that time.
During the 19th century, modern medicine began to develop and the sources of infectious diseases became more clear. Robert Koch, a German physician who studied pathogens, discovered three major pathogens that were the cause of Anthrax, Tuberculosis, and Cholera. [4] Louis Pasteur was a pioneer in the creation of vaccines for infectious diseases, one being a vaccine for Anthrax. He also developed the germ theory of infectious diseases which influenced Joseph Lister to practice methods during surgery that reduce the growth of pathogens that cause infectious disease. [5] Although infectious disease started to become a more collective concept in the 19th-century it was not considered a medical specialty until the 1970s due to a number of newly discovered diseases and vaccines. [3]
When diagnosing, a medical professional must first determine if a patient has an infectious disease or another condition not caused by infection but exhibits similar symptoms. Once the illness is confirmed to be caused by an infection, Infectious diseases specialists employ a variety of diagnostic tests to help identify the pathogen that is causing an infection. Common tests include staining, culture tests, serological tests, susceptibility tests, genotyping, nucleic acid-base test, and polymerase chain reaction. Seeing as samples of bodily fluid or tissue are used in these tests, a specialist will have to distinguish between the non-disease-causing bacteria and disease-causing bacteria inhabiting the body to effectively identify and treat the infection. [2]
Staining is a method of testing that uses a special dye to change the color of pathogens and a microscope to view them. The change in color helps doctors distinguish the pathogen from its surrounding and identify what it is. This method is only successful with large and plentiful pathogens present. Therefore, this method is unsuccessful with viruses because they can not be viewed under a microscope due to their small size. Staining has more of an effect on bacteria where a violet colored stain is used, this is called gram staining. If the bacteria appears blue it is considered gram positive and if it appears red it is gram negative. [2]
Culture tests are done when there is not enough of the pathogen to be seen through other tests. ID specialists will grow the pathogen in the lab until they have enough to work with. Although cultures work on some pathogens, such as the bacteria that causes strep throat, it is ineffective on many others, such as syphilis. A test to identify the pathogen, such as staining, would take place after culture tests.
Susceptibility tests are done by ID specialists to discover which antimicrobial drug would be most effective at killing the pathogen. Cultures can also be used as a form of susceptibility testing by adding the drug to the cultured pathogens and observing whether or not it kills the pathogen and how much of the drug is needed to kill it.
Nucleic acid-base tests are used to detect genetic material. For pathogens that can't be cultured, ID specialists can identify them by looking for specific DNA or RNA. Polymerase chain reaction (PCR), a type of nucleic acid-base test, is similar to culture tests in that genes from the pathogen are duplicated. This method is mainly used when a specific pathogen is suspected.
Infectious diseases specialists employ a variety of antimicrobial agents to help treat infections. The type of antimicrobial depends on the organism that is causing the infection. Antibiotics are used to treat bacterial infections; antiviral agents treat viral infections; and antifungal agents treat fungal infections.[ citation needed ]
Occupation | |
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Names | Doctor, Medical Specialist, Infectious diseases Consultant |
Occupation type | Specialty |
Activity sectors | Medicine |
Description | |
Education required | Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.) or Bachelor of Medicine, Bachelor of Surgery (M.B.B.S./MBChB) |
Fields of employment | Hospitals, Clinics |
In the United States, infectious diseases is a subspecialty of internal medicine and pediatrics. [12] In order to "sit" for the infectious diseases' board certification test (administered by the American Board of Internal Medicine, or the American Board of Pediatrics), physicians must have completed their residency (in internal medicine, or pediatrics), then undergo additional fellowship training (for at least two, or three years, respectively). The exam has been given as a subspecialty of internal medicine since 1972 and as a subspecialty of pediatrics since 1994. [13] [14]
Antimicrobial resistance (AMR) occurs when microbes evolve mechanisms that protect them from the effects of antimicrobials. All classes of microbes can evolve resistance to the point that one or more drugs used to fight them are no longer effective. Fungi evolve antifungal resistance, viruses evolve antiviral resistance, protozoa evolve antiprotozoal resistance, and bacteria evolve antibiotic resistance. Together all of these come under the umbrella of antimicrobial resistance.
An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable disease, is an illness resulting from an infection.
Pathology is the study of disease and injury. The word pathology also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in the context of modern medical treatment, the term is often used in a narrower fashion to refer to processes and tests that fall within the contemporary medical field of "general pathology", an area that includes a number of distinct but inter-related medical specialties that diagnose disease, mostly through analysis of tissue and human cell samples. Idiomatically, "a pathology" may also refer to the predicted or actual progression of particular diseases, and the affix pathy is sometimes used to indicate a state of disease in cases of both physical ailment and psychological conditions. A physician practicing pathology is called a pathologist.
In biology, immunity is the state of being insusceptible or resistant to a noxious agent or process, especially a pathogen or infectious disease. Immunity may occur naturally or be produced by prior exposure or immunization.
Bloodstream infections (BSIs) are infections of blood caused by blood-borne pathogens. The detection of microbes in the blood is always abnormal. A bloodstream infection is different from sepsis, which is characterized by severe inflammatory or immune responses of the host organism to pathogens.
Klebsiella pneumoniae is a Gram-negative, non-motile, encapsulated, lactose-fermenting, facultative anaerobic, rod-shaped bacterium. It appears as a mucoid lactose fermenter on MacConkey agar.
Mycoplasma pneumonia is a form of bacterial pneumonia caused by the bacterium Mycoplasma pneumoniae.
A blood culture is a medical laboratory test used to detect bacteria or fungi in a person's blood. Under normal conditions, the blood does not contain microorganisms: their presence can indicate a bloodstream infection such as bacteremia or fungemia, which in severe cases may result in sepsis. By culturing the blood, microbes can be identified and tested for resistance to antimicrobial drugs, which allows clinicians to provide an effective treatment.
Bacillary dysentery is a type of dysentery, and is a severe form of shigellosis. It is associated with species of bacteria from the family Enterobacteriaceae. The term is usually restricted to Shigella infections.
Moraxella catarrhalis is a fastidious, nonmotile, Gram-negative, aerobic, oxidase-positive diplococcus that can cause infections of the respiratory system, middle ear, eye, central nervous system, and joints of humans. It causes the infection of the host cell by sticking to the host cell using trimeric autotransporter adhesins.
Pasteurella is a genus of Gram-negative, facultatively anaerobic bacteria. Pasteurella species are nonmotile and pleomorphic, and often exhibit bipolar staining. Most species are catalase- and oxidase-positive. The genus is named after the French chemist and microbiologist, Louis Pasteur, who first identified the bacteria now known as Pasteurella multocida as the agent of chicken cholera.
Antibiotic sensitivity testing or antibiotic susceptibility testing is the measurement of the susceptibility of bacteria to antibiotics. It is used because bacteria may have resistance to some antibiotics. Sensitivity testing results can allow a clinician to change the choice of antibiotics from empiric therapy, which is when an antibiotic is selected based on clinical suspicion about the site of an infection and common causative bacteria, to directed therapy, in which the choice of antibiotic is based on knowledge of the organism and its sensitivities.
A sputum culture is a test to detect and identify bacteria or fungi that infect the lungs or breathing passages. Sputum is a thick fluid produced in the lungs and in the adjacent airways. Normally, fresh morning sample is preferred for the bacteriological examination of sputum. A sample of sputum is collected in a sterile, wide-mouthed, dry, leak-proof and break-resistant plastic-container and sent to the laboratory for testing. Sampling may be performed by sputum being expectorated, induced, or taken via an endotracheal tube with a protected specimen brush in an intensive care setting. For selected organisms such as Cytomegalovirus or "Pneumocystis jiroveci" in specific clinical settings a bronchoalveolar lavage might be taken by an experienced pneumologist. If no bacteria or fungi grow, the culture is negative. If organisms that can cause the infection grow, the culture is positive. The type of bacterium or fungus is identified by microscopy, colony morphology and biochemical tests of bacterial growth.
Clinical pathology is a medical specialty that is concerned with the diagnosis of disease based on the laboratory analysis of bodily fluids, such as blood, urine, and tissue homogenates or extracts using the tools of chemistry, microbiology, hematology, molecular pathology, and Immunohaematology. This specialty requires a medical residency.
In microbiology, the minimum inhibitory concentration (MIC) is the lowest concentration of a chemical, usually a drug, which prevents visible in vitro growth of bacteria or fungi. MIC testing is performed in both diagnostic and drug discovery laboratories.
Medical microbiology, the large subset of microbiology that is applied to medicine, is a branch of medical science concerned with the prevention, diagnosis and treatment of infectious diseases. In addition, this field of science studies various clinical applications of microbes for the improvement of health. There are four kinds of microorganisms that cause infectious disease: bacteria, fungi, parasites and viruses, and one type of infectious protein called prion.
Pathogenic bacteria are bacteria that can cause disease. This article focuses on the bacteria that are pathogenic to humans. Most species of bacteria are harmless and are often beneficial but others can cause infectious diseases. The number of these pathogenic species in humans is estimated to be fewer than a hundred. By contrast, several thousand species are part of the gut flora present in the digestive tract.
Gonorrhoea or gonorrhea, colloquially known as the clap, is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. Infection may involve the genitals, mouth, or rectum. Infected men may experience pain or burning with urination, discharge from the penis, or testicular pain. Infected women may experience burning with urination, vaginal discharge, vaginal bleeding between periods, or pelvic pain. Complications in women include pelvic inflammatory disease and in men include inflammation of the epididymis. Many of those infected, however, have no symptoms. If untreated, gonorrhea can spread to joints or heart valves.
Corynebacterium striatum is a bacterium that is a member of the Corynebacterium genus. It is classified as non-diphtheritic. The bacterium is a gram-positive prokaryote that assumes a 'club-like' morphology, more formally known as a corynebacteria structure. It is non-lipophilic and undergoes aerobic respiration and is also a facultative anaerobe it is catalase negative and oxidase positive glucose and sucrose fermenter.
The following outline is provided as an overview of and topical guide to concepts related to infectious diseases in humans.