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Bacterial persistence and expression of disease

G J Domingue1, H B Woody

  • 1Department of Urology, Tulane University School of Medicine, New Orleans, Louisiana 70112, USA. domingue@mailhost.tcs.tulane.edu

Clinical Microbiology Reviews
|April 1, 1997
PubMed
Summary

Difficult-to-culture bacteria can persist in the body, causing chronic infections and diseases. Understanding these dormant bacterial forms is crucial for patient care and redefining diagnostic criteria for mysterious illnesses.

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pathogenesis

Background:

  • Experimental and clinical evidence suggests difficult-to-culture and dormant bacteria contribute to infection latency and pathogenicity.
  • Persistent bacteria can adopt diverse forms and functions within a host environment, differing significantly from free-living states.

Purpose of the Study:

  • To review the diverse forms and functions of individual bacteria, linking them to patient care.
  • To correlate basic biology of persistent bacteria with disease expression, focusing on latency and chronicity mechanisms.
  • To present cases of idiopathic conditions potentially caused by cryptic bacteria.

Main Methods:

  • Review of experimental studies on host-bacterium interactions.
  • Analysis of data correlating persistent bacteria biology with disease.
  • Case series illustrating idiopathic conditions linked to cryptic bacteria.
  • Utilizing Polymerase Chain Reaction (PCR) to identify nonculturable bacilli.

Main Results:

  • Most bacteria exposed to adverse host environments can assume aberrant forms.
  • Wall-defective bacterial forms can survive and persist in a latent state, causing disease.
  • PCR identified previously nonculturable bacilli in Whipple's disease and bacillary angiomatosis.

Conclusions:

  • Persistent, dormant bacteria are implicated in infection latency and chronic diseases.
  • The concept of wall-defective forms explains bacterial survival and pathogenicity in certain infections.
  • Molecular data may necessitate redefining Koch's postulates for nonculturable, dormant bacterial pathogens.

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