Bacterial
Pathogenesis
Dr. Mohamed Taha
Associate professor of Microbiology
and Immunology
Dr. Shokri Mohsen
Lecturer of Microbiology and
Immunology
Bacterial
Pathogenesis
• Refers to the process by
which bacteria cause
disease in a host organism.
• It involves the mechanisms
and strategies that bacteria
employ to colonize, evade
the host's immune defenses,
and ultimately lead to the
development of disease
symptoms.
Types of Bacteria
Saprophytic Bacteria:
Bacteria that live freely in nature on decaying
organic matter, in soil, or in water.
Parasitic Bacteria:
Bacteria that live in/on a living host, either an
animal or human.
a) Pathogenic
b) Commensal
c) Opportunistic
Pathogenic Bacteria
Definition: Pathogenic bacteria are infectious agents that can cause disease in any
susceptible host.
Disease Causation: They have the ability to cause disease regardless of the host's immune
system status, affecting individuals with both strong and compromised immune responses.
Association with Disease: Pathogenic bacteria are typically found in the host only in
connection with the presence of a specific disease.
Host Susceptibility: any susceptible host can be affected by pathogenic bacteria,
emphasizing their broad range of potential hosts.
Salmonella typhi: Causes typhoid fever, a pathogenic bacterium with the capability to induce
disease in susceptible hosts.
Commensal bacteria
Definition: Commensal bacteria are organisms that live on or inside another organism (host) without causing
harm.
Beneficial Role: They contribute positively to the host's health by aiding in the digestion of vitamins and
outcompeting harmful pathogens for nutrients.
Locations: Found on both external and internal surfaces of the body, such as the skin, gastrointestinal tract, and
mucous membranes.
Non-Harmful Relationship: Unlike pathogenic bacteria, commensals typically do not cause diseases in healthy
individuals.
Immune System Regulation: Commensal bacteria play a crucial role in the development and regulation of the
host's immune system.
Skin Microbiota: Bacteria on the skin's surface that contribute to maintaining a healthy skin environment.
Opportunistic bacteria
Definition: Opportunistic bacteria are potentially infectious agents that typically do not cause disease in healthy
individuals but can become pathogenic under certain conditions.
Common Presence: They are usually present in the body without causing disease in individuals with a functional
immune system.
Immunological Response Impact: They can cause infectious diseases when the host's immunological response
is low or compromised, making the individual more susceptible to infections.
Host Resistance Alteration: Opportunistic bacteria exploit conditions where the host's resistance is altered,
such as immunosuppression, leading to an increased risk of infection.
Staphylococcus aureus: Known to cause infections, especially in hosts with compromised immune systems.
Cycle of infection
Reservoir of • This is the source where the infectious agent resides and
reproduces. It could be humans, animals, insects, or the
Infectious Agent: environment.
• The pathogen needs a way to leave the reservoir to infect a new
Portal of Exit: host. Common portals of exit include respiratory droplets, bodily
fluids, and skin lesions.
• The pathogen is transmitted from the reservoir to a susceptible
Transmission: host. This can occur through direct contact, airborne particles,
contaminated food or water, or vectors like mosquitoes.
• The pathogen enters the new host through specific entry points,
Portal of Entry: such as mucous membranes, respiratory tract, digestive tract, or
breaks in the skin.
Cycle of infection
Susceptible Host:
• The host must be susceptible to the pathogen and lacking effective immune defenses.
Factors influencing susceptibility include the individual's immune status, overall health, and
genetic predisposition.
Establishment and Multiplication:
• Once inside the new host, the pathogen establishes itself and begins to multiply. This
stage may or may not lead to clinical symptoms.
Outcome:
• The outcome can vary. The host's immune response may successfully eliminate the
infection, or the pathogen may overcome the host's defenses, leading to disease.
Portal of Exit (Again):
• If the pathogen causes disease, it will exit the host through specific portals, completing
the cycle and potentially infecting new reservoirs or hosts.
The carrier
• A carrier is a person or animal that carries and can
transmit a pathogen to others without necessarily
being visibly ill.
• Carriers may be asymptomatic.
• Some carriers may have a subclinical or latent
infection, where the pathogen is present and may
be replicating, but the individual does not develop
noticeable symptoms.
• Examples: Typhoid Mary is a historical example of
a carrier. She carried and transmitted the bacteria
causing typhoid fever without showing symptoms
herself.
Types of Carriers:
Convalescent Carriers: Chronic Carriers:
Healthy Carriers:
Individuals who have Individuals who
Individuals who carry
recovered from the continue to carry the
the pathogen without
disease but continue to pathogen for an
ever developing the
carry and shed the extended period,
associated disease.
pathogen. sometimes for life.
Virulence Factors:
Microorganisms possess virulence factors, which are specific characteristics or
molecules that enhance their ability to cause disease.
Virulence is encoded by genes carried on plasmids, phages, pathogenicity islands;
which are mobile genetic elements that can be inserted in the bacterial chromosome.
Examples include toxins, adhesins, and invasins.
Virulence Factors:
Toxin
Adherence Colonization Invasiveness
Production
Immune Antigenic Biofilm Intracellular
Evasion Variation Formation Survival
Quorum
Sensing
Adherence
Adherence is the initial attachment or binding of bacteria to host
cells or tissues via adhesins. This is the first essential step before
colonization.
Common sites of bacterial adherence include mucosal surfaces
like the gastrointestinal, urogenital and respiratory tracts which
are exposed to the external environment.
Specific adhesins on bacterial surfaces interact with
complementary receptor molecules on host cells, enabling
adhesion.
Adherence
Examples are fimbriae, afimbrial adhesins, membrane
proteins etc.
Adhesion factors provide bacteria an opportunity to
persist on host surfaces and resist mechanical
clearance mechanisms like peristalsis.
Once adhered, bacteria may go on to colonize by
proliferating locally on the attachment site.
Colonization implies successful adhesion and growth.
Colonization
Colonization refers to the inhabitation and multiplication of
microbes on or within a host without necessarily causing
illness or damage.
Once adhered, bacteria may go on to colonize by
proliferating locally on the attachment site. Colonization
implies successful adhesion and growth.
Colonization often depends on a bacterial strain's ability
to access nutrients from the host, evade immune
responses and compete with the existing microbiota.
Colonization Vs Infection
Invasiveness
Invasive bacteria can enter host cells or penetrate mucosal
surfaces, spreading from the initial infection site.
Invasiveness is facilitated by bacterial enzymes, including
collagenase and hyaluronidase, which degrade
components of the extracellular matrix.
Invasion is followed by inflammation, which can be
pyogenic (involving pus formation) or granulomatous,
depending on the organism.
Pyogenic inflammations contain mostly neutrophils, while
granulomatous lesions contain fibroblasts, lymphocytes,
and macrophages.
Toxin Production
Toxins are substances
produced by bacteria, fungi, The ability to produce toxins
and other microorganisms enhances the pathogen's
that can cause harm to the virulence, contributing to the
host organism by damaging severity of the associated
cells or disrupting normal disease.
physiological functions.
Types of Toxins:
Exotoxins:
• These are proteins released by living bacteria into the surrounding
environment.
• Exotoxins can be highly potent and often target specific cell types or
tissues.
• Examples include botulinum toxin and diphtheria toxin.
Endotoxins:
• These are lipopolysaccharides (LPS) found in the outer membrane of
the cell wall of Gram-negative bacteria.
• Endotoxins are released when the bacteria die and can elicit strong
immune responses, contributing to the symptoms of infection.
EXOTOXINS ENDOTOXINS
Composition Proteins secreted by both gram- Lipopolysaccharides integral to
positive and gram-negative gram-negative bacterial cell walls
bacteria
Toxicity Highly toxic; small amounts can be Indirect toxicity causing fever,
lethal (e.g., tetanus exotoxin). shock, hypotension, and thrombosis
(septic shock).
Action Target specific host cells with Indirect effects through activation of
Mechanism identifiable effects (e.g., diphtheria macrophages, cytokine release,
toxin blocks protein synthesis) complement activation, and
coagulation cascade.
Pathogenicity can be carried by pathogenic Released during bacterial cell lysis;
strains via genetic elements contribute to septic shock.
Immune Evasion
Bacteria have developed various strategies to evade detection
and elimination by the host immune system in order to establish
infection.
Capsules and slime layers formed by some bacteria make it
difficult for opsonic proteins and antibodies to access surface
antigens.
Lipopolysaccharide (LPS) masks outer membrane and other
antigens in Gram-negative bacteria from immune recognition.
Antigenic Variation
Antigenic variation refers to the ability of bacteria to periodically switch
the antigenic characteristics of surface proteins/structures recognized
by the host immune system.
This enables the bacteria to evade antibody-mediated immune clearance
and establish persistent/recurring infections.
Common examples are variable outer membrane proteins (VOPs) in
Neisseria gonorrhoeae, pilin antigenic variation in Neisseria meningitidis.
Biofilm Formation
Bacteria attach to surfaces, such as medical devices, tissues, or natural structures,
forming a biofilm. This initial attachment is facilitated by adhesion molecules on the
bacterial surface.
Microorganisms in a biofilm produce a slimy extracellular matrix, primarily
composed of polysaccharides, proteins, and DNA. This matrix helps anchor the
bacteria to the surface and provides structural support to the biofilm.
Biofilms often consist of diverse microbial communities, including different species
of bacteria, fungi, and other microorganisms. This diversity can enhance the
resilience and adaptability of the biofilm.
Biofilm formation is associated with chronic infections, as the protective nature of
the biofilm allows bacteria to persist and resist eradication by the host immune
system or antimicrobial agents.
Quorum Sensing
Quorum sensing is a sophisticated communication mechanism used by bacteria and some
other microorganisms to coordinate their behavior in response to changes in population
density.
This signaling system enables bacteria to sense and respond collectively to environmental
conditions.
Bacteria release chemical signaling molecules called autoinducers into their surrounding
environment. As the bacterial population density increases, the concentration of these
molecules also rises.
Quorum sensing has been associated with antibiotic resistance in some bacterial species.
Coordinated behavior allows bacteria to adapt collectively to antibiotic exposure,
enhancing their chances of survival.
Intracellular survival
Intracellular survival refers to the ability of certain microorganisms, such
as bacteria or parasites, to live and replicate inside the cells of a host
organism.
Important intracellular pathogens include bacteria like Mycobacterium
tuberculosis (which causes tuberculosis).
Intracellular pathogens hijack the host cell's machinery for their own
replication. They utilize cellular resources, such as nutrients and energy,
to facilitate their survival and reproduce within the host.
Some intracellular pathogens create specialized structures, like
vacuoles or inclusion bodies, to shield themselves from host cell
defenses. These structures provide a protected environment for the
pathogen to thrive.
Thank You
