The meaning of microbial exposure, infection, colonisation, and disease in clinical practice

Liise Anne Pirofski, Arturo Casadevall

Research output: Contribution to journalComment/debatepeer-review

39 Scopus citations


The basic lexicon of infectious diseases includes the terms exposure, infection, colonisation, and disease, which are used to describe the clinical states in which the presence of a microbe in a host is suspected or discovered. Therefore, the lexicon is used to articulate an implied association between a host and a microbe. However, since it is often difficult to use the available clinical and diagnostic tools to discriminate the different ways in which microbes can exist in a host, the lexicon is often used in an ambiguous and imprecise manner. Another factor contributing to imprecise use of the lexicon is that microbial factors are often held responsible for disease pathogenesis. This relegates the part that the host plays in microbial pathogenesis to an exception, which leads to the need for qualification and modification of the terminology of infectious diseases. Recently, we proposed the "damage-response framework" to incorporate the contributions of both the host and the microbe in microbial pathogenesis in a synthesis whereby host damage was used as the common denominator to describe the outcome of the host-microbe relation. In this article, we illustrate how the application of the damage-response framework to clinical infectious diseases can clarify and make more precise the terminology used to convey the outcome of microbial infection in clinical practice.

Original languageEnglish (US)
Pages (from-to)628-635
Number of pages8
JournalLancet Infectious Diseases
Issue number10
StatePublished - Oct 1 2002
Externally publishedYes

ASJC Scopus subject areas

  • Infectious Diseases


Dive into the research topics of 'The meaning of microbial exposure, infection, colonisation, and disease in clinical practice'. Together they form a unique fingerprint.

Cite this