PATHOGENESIS OF

BACTERIAL INFECTION
JANUARY 31, 2008
 PATHOGENESIS IS DUE TO:
 HOST IMMUNE STATUS

 BACTERIA’S CHARACTERISTICS

 INOCULUM SIZE
 KOCH’S POSTULATES
1. THE ORGANISM MUST BE FOUND IN
HUMANS WITH THE INFECTIOUS
DISEASE BUT NOT IN HEALTHY ONES.

2. THE ORGANISMS MUST BE FOUND IN

HUMANS WITH THE INFECTIOUS
DISEASE AND GRWON IN PURE
CULTURE.
 KOCH’S POSTULATES
 3. THE ORGANISM ISOLATED IN PURE
CULTURE MUST INITIATE DISEASE
WHEN RE-INOCULATED INTO
SUSCEPTIBLE ANIMALS.
 4. THE ORGANISM SHOULD BE RE-
ISOLATED FROM THE
EXPERIMENTALLY INFECTED
ANIMALS.
 PATHOGENESIS
 A. TRANSMISSION
 HORIZONTAL TYPE
FROM ONE INDIVIDUAL TO
ANOTHER IN THE SAME SPECIES
INDIRECT(VECTORS) OR DIRECT
 VERTICAL TYPE
FROM PARENT TO OFFSPRING
 PATHOGENESIS
 droplet contact – coughing, sneezing
 direct physical contact - touch, sexual contact
 indirect contact - soil contamination, contaminated
surface
 airborne transmission - microorganism remains in the
air for long periods
 fecal-oral transmission - contaminated food,water
sources
 vector borne transmission - carried by insects or other
animals
 PATHOGENESIS
 B. ADHERENCE
 AVOIDS PERISTALSIS, CILIARY
ACTION, URINE FLOW
 ADHESIN-RECEPTOR INTERACTION
E. coli: TYPE 1 FIMBRIAE BINDS TO
MANNOSE-CONTAINING RECEPTORS
E.COLI FIMBRIAE
 PATHOGENESIS
 3. PENETRATION AND SPREAD
LOCAL INFECTION
SYSTEMIC INFECTION

Shigella ENTERS INTESTINAL

CELLS,DO NOT ENTER THE
BLOODSTREAM
 PATHOGENESIS
 4. SURVIVAL IN THE HOST
 AVOIDANCE OF PHAGOCYTOSIS
CAPSULES
protein A of S.aureus binds to the Fc
portion of IG
S. pyogenes peptidoglycan binds
complement
intracellular pathogens lyse the lysosomes
 PATHOGENESIS
 4. TISSUE INJURY
EXOTOXINS
ENDOTOXINS
NON-SPECIFIC IMMUNITY
SPECIFIC HUMORAL AND CELL-
MEDIATED IMMUNITY
 EXOTOXINS
 CLASSES OF EXOTOXINS
1. ACT ON THE EXTRACELLULAR
MATRIX OF CONNECTIVE TISSUE

2. A-B TYPE TOXINS

 EXOTOXINS ACTING ON THE
EXTRACELLULAR MATRIX
 PROTEASES
 COLLAGENASES
 HYALURONIDASES
 “LOOSEN UP” TISSUE FIBERS
 S. aureus HAS EXFOLIATIN
SCALDED SKIN SYNDROME
SCALDED SKIN SYNDROME
SSS
 A-B TOXINS
 A PART : ACTIVE,ENZYMATIC PART
 B PART: CELL BINDING PART
DIPTHERIA TOXIN
B binds to the cells in the respiratory tract
A is endocytosed, prevents Elongation
Factor –inhibits protein synthesis
Diptheriae toxin
 A-B toxin
 CHOLERA TOXIN
B part: binds to the cell surface
A part: enters cell
acts on adenylate cyclase in the cell
membrane; increases ion and water secretion
with decreased sodium uptake from the GIT
lumen ----diarrhea
 Toxins that inhibit protein
biosynthesis
 SHIGA TOXIN
A part binds to rRNA ---inhibition of
protein synthesis---death of GIT cells
----poor water absorption---diarrhea
 NEUROTOXINS
 TETANUS TOXIN
Clostridium tetani
BLOCKS GLYCINE RELEASE FROM
NEURONS---BLOCKS INHIBITORY
NEURONS---MUSCLE
OVERACTIVITY, RIGIDITY
(RIGID PARALYSIS)
 NEUROTOXIN
 BOTULINUM TOXIN
C.botulinum
MOST POISONOUS, NATURALLY
OCCURING TOXIN
BLOCKS ACH RELEASE---DECREASE
MUSCLE CONTRACTION---FLACCID
PARALYSIS
 DIPLOPIA
 BLURRED VISION
 BULBAR PARALYSIS
 RESPIRATORY DISTRESS
 DEATH
 LETHAL DOSE: 1ng/kg
 SPORES FOUND IN SOIL
 NEEDS ANAEROBIC ENVIRONMENT
 SPORES KILLED AT 100C
 TOXIN IS UNSTABLE
KILLED BY COOKING
AIR EXPOSURE
 MEDICAL USES
STRABISMUS
BLEPHAROSPASM
MIGRAINE HEADACHES
TORTICOLLIS
HYPERHYDROSIS
ACHALASIA (LES)
BOTOX
 2002-FDA APPROVED
 2006- MOST COMMON COSMETIC
OPERATIONIN THE US
 TREATMENT
TRIVALENT BOTULINUM
ANTITOXIN (CDC)
HEPTAVALENT ANTITOXIN (US
ARMY)
 MEMBRANE DAMAGING
TOXINS
 ACT AS DETERGENTS---DIGEST PATS
OF HUMAN CELL MEMBRANES
 ALPHA-TOXIN OF C. PERFRINGENS
GAS GANGRENE
GAS GANGRENE
 ENDOTOXINS
 LIPOPOLYSACCHARIDE IN THE CELL
ENVELOPE
 STIMULATE RELEASE OF CYTOKINES,
ALTERNATIVE PATHWAY
 ENDOTOXINS
 CAUSE SEPTIC SHOCK, GRAM (-) SEPSIS
HYPOTENSION
DIC
FEVER
MASSIVE ORGAN FAILURE
 HARD TO REVERSE
 BACTERIAL ANTIGENS CAN ELICIT
HUMORAL AND CELL-MEDIATED
IMMUNE RESPONSE IN THE ABSENCE
OF THE LIVE ORGANISM
PNEUMOCOCCAL
POLYSACCHARIDE
BIOTERRORISM
 ANTHRAX
 BOTULISM
 BRUCELLOSIS
 SMALLPOX (VARIOLA)
 TULARENSIS( FRANCISELLA
TULARENSIS)
 PLAGUE (YERSINIA PESTIS)
 Bacillus anthracis
direct contact
inhalation of spores
consumption of infected meat
ANTHRAX
 Brucellosis
occupational hazard
respiratory/ skin lesions
SMALLPOX