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"In developed countries, 90 percent of documented infections in hospitalized patients are caused by bacteria. These cases probably reflect only a small percentage of the actual number of bacterial infections occurring in the general population, and usually represent the most severe cases. In developing countries, a variety of bacterial infections often exert a devastating effect on the health of the inhabitants. Malnutrition, parasitic infections, and poor sanitation are a few of the factors contributing to the increased susceptibility of these individuals to bacterial pathogens. The World Health Organization has estimated that each year, 3 million people die of tuberculosis, 0.5 million die of pertussis, and 25,000 die of typhoid. Diarrheal diseases, many of which are bacterial, are the second leading cause of death in the world (after cardiovascular diseases), killing 5 million people annually. Many bacterial diseases can be viewed as a failure of the bacterium to adapt, since a well-adapted parasite ideally thrives in its host without causing significant damage. Relatively nonvirulent (i.e., well-adapted) microorganisms can cause disease under special conditions - for example, if they are present in unusually large numbers, if the host's defenses are impaired, (e.g., AIDS and chemotherapy) or if anaerobic conditions exist. Pathogenic bacteria constitute only a small proportion of bacterial species; many nonpathogenic bacteria are beneficial to humans (i.e. intestinal flora produce vitamin K) and participate in essential processes such as nitrogen fixation, waste breakdown, food production, drug preparation, and environmental bioremediation. This textbook emphasizes bacteria that have direct medical relevance.
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