BACTERIAL PATHOGENESIS

Haroon
BS-MLT
KMU-IPMS
what is bacterial pathogenesis?
• Bacterial pathogenesis is the process by which
bacteria infect and cause disease in a host.
Basic Terminology
• Disease
Any deviation from a condition of good health and well-being
• Infectious Disease:
A disease condition caused by the presence or growth of infectious microorganisms or parasites.
• Pathogenicity
The ability of a microbe to cause disease.
• Virulence
The degree of pathogenicity in a microorganism

• Septicemia

Presence of an infectious agent in the bloodstream.

• Primary Infection
An infection that develops in an otherwise healthy individual.
• Secondary Infection
An infection that develops in an individual who is already infected with a
different pathogen.
• Acute Infection
An infection characterized by sudden onset, rapid progression, and often
with severe symptoms.
• Chronic Infection
An infection characterized by delayed onset and slow progression.
• Localized Infection
An infection that is restricted to a specific location or region within the body of the
host.
• Systemic Infection
An infection that has spread to several regions or areas in the body of the host.
• Clinical Infection
An infection with obvious observable or detectable symptoms.
• Subclinical Infection
An infection with few or no obvious symptoms
• Epidemiology
The study of the transmission of disease.
• Communicable Disease
A disease that can be transmitted from one individual to another.
• Noncommunicable Disease
A disease that is not transmitted from one individual to another.
• Endemic Disease
unexpected increase in the number of disease cases in a specific geographical area.

• Epidemic Disease
An endemic is a disease outbreak that is consistently present but limited to a
particular region.

• Pandemic Disease
An epidemic affecting a large geographical area; often on a global scale.
• Reservoir of Infection
The source of an infectious agent
• Carrier
An individual who carries an infectious agent without manifesting
symptoms, yet who can transmit the agent to another individual.
• Fomites
Any inanimate object capable of being an intermediate in the
indirect transmission of an infectious agent.
• Vectors
A vector is a living organism that transmits an infectious agent from an infected
animal to a human or another animal
1. Mechanical vectors
The infectious agent is physically transmitted by the animal vector, but the
agent does not incubate or grow in the animal;
the transmission of bacteria sticking to the feet of flies.
2. Biological vectors
The infectious agent must incubate in the animal host as part of the agent’s
developmental cycle.
• The transmission of malaria by infected mosquitoes
Processes related to bacterial pathogenesis
1. Transmission
2. Adherence to cell surfaces
3. Invasion , inflammation and intracellular survival
4. Toxin production
1. TRANSMISSION
▪ The modes of transmission of microbes include both human to-
human and non human-to-human processes.
▪ Non human sources include animals, soil, water, and food.
▪ Human-to-human transmission can occur either by direct contact or
indirectly through a vector such as an insect.
▪ Animal-to-human transmission can also occur either by direct contact
with the animal or indirectly through a vector
▪ Diseases for which animals are the reservoirs are called zoonoses
▪ Bacteria, viruses, and other microbes can also be transmitted from
mother to offspring, a process called VERTICAL TRANSMISSION.
▪ The three modes by which organisms are transmitted vertically are
across the placenta, within the birth canal during birth, and through
breast milk.
▪ HORIZONTAL TRANSMISSION, is person-to-person transmission that
is not from mother to offspring
Portal of entry
There are four important portals of entry:
1. Respiratory tract
2. Gastrointestinal tract
3. Genital tract
4. Skin
2. ADHERENCE TO CELL SURFACES
• Pili are the structure through which bacteria adhere to human cells.
For example, the pili of Neisseria gonorrhoeae and E. coli mediate the
attachment of the organisms to the urinary tract epithelium
• Glycocalyx is a polysaccharide “slime layer” secreted by some
bacteria that mediates strong adherence to certain structures such as
heart valves, prosthetic implants, and catheters
▪ The various molecules that mediate adherence to cell surfaces are
called adhesins
3. Invasion, inflammation and intracellular
survival
Mechanisms by which bacteria cause disease:
1. Invasion of tissue followed by inflammation
2. Toxin production
3. Immunopathogenesis
1. INVASION:
Several enzymes secreted by invasive bacteria play a role in pathogenesis.
Following are:
• Collagenase and hyaluronidase, which degrade collagen and hyaluronic
acid, respectively, thereby allowing the bacteria to spread through
subcutaneous tissue.
• Coagulase, which is produced by Staphylococcus aureus and
accelerates the formation of a fibrin clot (this clot may protect the
bacteria from phagocytosis.
• Immunoglobulin A (IgA) protease, which degrades IgA, allowing the
organism to adhere to mucous membranes, and is produced chiefly
by N. gonorrhoeae, Haemophilus influenzae, and Streptococcus
pneumoniae
• Leukocidins, which can destroy both neutrophilic leukocytes and
macrophages
• In addition to these enzymes, several virulence factors contribute to
invasiveness.
1. The most important of these antiphagocytic factors is the CAPSULE
external to the cell wall of several important pathogens. The
polysaccharide capsule prevents the phagocyte from adhering to
the bacteria.
2. A second group of antiphagocytic factors are the cell wall PROTEINS
of the gram-positive cocci, such as the M protein of the group A
streptococci (S. pyogenes) and protein A of S. aureus.
➢The M protein is antiphagocytic, and protein A binds to
immunoglobulin G (IgG) and prevents the activation of complement
INFLAMMATION
2. INFLAMMATION
Bacteria can cause two types of inflammation:
1. Pyogenic Inflammation
2. Granulomatous Inflammation.
▪ In pyogenic (pus-producing) inflammation, neutrophils are the
predominant cells.
▪ In granulomatous inflammation, macrophages and helper T cells
predominate. The most important organism in this category is
Mycobacterium tuberculosis
3. INTRACELLULAR SURVIVAL
• Bacteria can evade our host defences by a process called intracellular
survival (i.e., bacteria that can live within cells are protected from
attack by macrophages and neutrophils)
• These bacteria are called “intracellular” pathogens and commonly
cause granulomatous inflammation.
• The best-known of these bacterias are Mycobacterium, Legionella,
Brucella, and Listeria.
• The best-known fungus is Histoplasma.
TOXIN PRODUCTION
1. EXOTOXINS
• Exotoxins are polypeptides secreted by certain bacteria that alter
specific cell functions resulting in the symptoms of disease.
• They are produced by both gram-positive and gram negative bacteria,
whereas endotoxin is found only in gram-negative bacteria.
• Exotoxins are antigenic and induce antibodies called antitoxins. .
• Exotoxins have different mechanisms of action and different targets
within the cell and therefore cause a variety of diseases with
characteristic symptoms
2. ENDOTOXINS
• Endotoxins are lipopolysaccharides (LPS) located in the outer
membrane only of gram-negative bacteria.
• They are not secreted by bacteria.
• Endotoxins are poorly antigenic, do not induce antitoxins.