Bacterial Pathogenesis

Lec3 (2021-2022)
Done by: Dr. Zainab Jumaa Qasim

‫ﻣﺑﺎدئ ﻋﻠم اﻷﻣراض‬:

PRINCIPLES OF PATHOGENESIS:
‫ﻗﺎدرا‬
ً
• A microorganism is a pathogen if it is capable of causing disease;
however, some organisms are highly pathogenic (i.e., they often cause
disease).
‫اﻟ ُﻣ ْﻣ ِرﺿﺎت اﻻﻧﺗﮭﺎزﯾﺔ‬ ‫ﻧﺎدرا‬
ً
• Opportunistic pathogens are those that rarely, if ever, cause
disease in immunocompetent people but can cause serious
infection in immunocompromised patients. These opportunists are
frequent members of the body’s normal flora.
‫ﻣﺎ ﺗﺳﺑب اﻟﻣرض ﻟﻸﺷﺧﺎص ذوي اﻟﻛﻔﺎءة اﻟﻣﻧﺎﻋﯾﺔ وﻟﻛن ﯾﻣﻛن أن ﺗﺳﺑب ﻋدوى ﺧطﯾرة ﻓﻲ اﻟﻣرﺿﻰ اﻟذﯾن ﯾﻌﺎﻧون ﻣن ﻧﻘص اﻟﻣﻧﺎﻋﺔ‬.
 ‫ ﺗﺑدي ﺗﺷرح ھل ﺳﻼﯾد‬13:10 ‫ھذا اﻟﺳﻼﯾد ﻧﻔﮭﻣﺔ ﻣﺎ ﻣطﻠوب اﻟﺷرﺣﺔ ﻣﺎﻟﺗﺔ ﺑس ھﻲ ﺗﺳﺋل ﻋﻧﺔ دﻗﯾﻘﺔ‬

• Virulence is a measure of a microbe’s ability to cause disease (i.e., a highly

virulent microbe requires fewer organisms to cause disease than a less
virulent one). The ID50 (infectious dose) is the number of organisms
required to cause disease in 50% of the population. A low ID50 indicates a
highly virulent organism.
• The infectious dose of an organism required to cause disease varies greatly
among the pathogenic bacteria. For example, Shigella and Salmonella both
cause diarrhea by infecting the gastrointestinal tract, but the infectious dose
of Shigella is less than 100 organisms, whereas the infectious dose of
Salmonella is on the order of 100,000 organisms.
• The infectious dose of bacteria depends primarily on their virulence factors
(e.g., whether their pili allow them to adhere well to mucous membranes,
whether they produce exotoxins or endotoxins, whether they possess a
capsule to protect them from phagocytosis, and whether they can survive
various nonspecific host defenses such as acid in the stomach).
24:43‫دﻗﯾﻘﺔ‬
‫ اذا ﻋدھﺎ‬capsule
‫ ﻓﮫ راح ﺗﺧﻠص ﻣن ھﺟوم‬Macrophages and neutrophils
‫واذا ﻣﺎ ﻋدھﺎ ﻓﺔ ال‬Macrophages and neutrophils ‫ﺗﮭﺎﺟﻣﮭﺎ‬

‫ﺳؤال ﺟدا ﻣﮭم‬

WHY DO PEOPLE GET INFECTIOUS DISEASES?

• People get infectious diseases when microorganisms overpower our

host defenses (i.e., when the balance between the organism and the
‫ﻟﺻﺎﻟﺢ‬ host shifts in favor of the organism). From the organism’ perspective, ‫ﻣﻧظور‬
the two critical determinants in overpowering the host are: ‫اﻟﺗﻐﻠب‬
1. The number of organisms to which the host, or person, is exposed ‫ﯾﺗﻌرض‬
‫ ﺿراوة‬2. The virulence of these organisms. however, that a small number of

highly virulent organisms can cause disease just as a large number of

less virulent organisms can. ‫اﻧو‬، ‫اﺧذﻧﺎ ﺑﺎﻟﺳﻼﯾد اﻟﺳﺎﺑﻖ ﻣﺛﺎل ﻋن ھل ﺷﻲ‬
the infectious dose
of Shigella is less than 100 organisms, whereas the infectious
dose of Salmonella is on the order of 100 000 organisms
 ‫اﻟﻔﻛرة ﯾﻌﻧﻲ اﻧو اﻟﺷﺧص ﻋﻧدة اﻟﺑﻛﺗرﯾﺎ ﺑس ﻣﺎ ﻋﻧدة اﻋراض‬ Asymptomatic (subclinical(
‫ ﻣﺻﻠﺢ ﻣﮭم ﻛل ﺳﻧﺔ ﺗﺟﯾﺑﺔ‬Subclinical
• Many infections are asymptomatic or inapparent because our host
defenses have eliminated the microorganism before it could multiply
to sufficient numbers to cause the symptoms of disease. ‫اﻟﻌدﯾد ﻣن اﻹﺻﺎﺑﺎت ﻏﯾر ﻣﺗﻧﺎظرة أو ﻏﯾر‬
‫ظﺎھرة ﻷن دﻓﺎﻋﺎت ﻣﺿﯾﻔﻧﺎ ﻗد ﻗﺿت ﻋﻠﻰ‬
• The term infection has two meanings: ‫وﺟود ﻣﯾﻛروﺑﺎت ﻓﻲ اﻟﺟﺳم‬ ‫اﻟﻛﺎﺋﻧﺎت اﻟﺣﯾﺔ اﻟدﻗﯾﻘﺔ ﻗﺑل أن ﺗﺗﻛﺎﺛر إﻟﻰ‬
• (1) the presence of microbes in the body ‫أﻋداد ﻛﺎﻓﯾﺔ ﻹﺣداث أﻋراض اﻟﻣرض‬

• (2) the symptoms of disease. The presence of microbes in the body

does not always result in symptoms of disease ‫أﻋراض اﻟﻣرض وﺟود ﻣﯾﻛروﺑﺎت ﻓﻲ اﻟﺟﺳم‬
‫ال ﯾؤدي داﺋ ًﻣﺎ إﻟﻰ ظﮭور أﻋراض اﻟﻣرض‬

TYPES OF BACTERIAL INFECTIONS

Exotoxins and Endotoxins ‫ ﺗﺷرح ال‬59:13 ‫ اﻟﻰ دﻗﯾﻘﺔ‬38:14 ‫ﻣن دﻗﯾﻘﺔ‬
• Bacteria cause disease by two major mechanisms: ‫ﯾﻠﻲ ﯾرﯾد ﯾﻔﮭم ﻓﺔ ﯾﺷوف اﻟﻔدﯾو‬
‫ ﯾﻌﻧﻲ اذا ﻣﺎ ﯾﻧﻔرز ﻓﺔ ﺷﻠون ﺗﺻﯾر ﻋﻧدي‬,not actively released from the cell ‫ﺿﻣن اﻟﺷرح ﯾﻛول‬
• (1) toxin production ‫ اﻻﻧﺗﯾﺑﺎﯾﺗك ﻣن ﯾدﻣر اﻟﺑﻛﺗرﯾﺎ(اﻟﺑﻛﺗرﯾﺎ راح ﺗﺻﯾر ﻋﺑﺎره ﻋن ﻗطﻊ)ﻓﺔ ھﺎي ﻗطﻊ ﺟدار اﻟﺧﻠﯾﺔ راح‬،!‫اﻋراض؟‬
• (2) invasion and inflammation. ‫اﻟﻐزو واﻻﻟﺗﮭﺎب‬ ‫ وﺗﺳﺑب اﻟﻲ اﻋراض اذا ﻛﺎﻧت ﺑﻛﻣﯾﺔ ﻛﺑﯾرة‬Endotoxins ‫ﯾﻧﻔرز ﻣﻧﮭﺎ ال‬

• Toxins fall into two general categories: exotoxins and endotoxins.

• Exotoxins are polypeptides released by the cell, whereas endotoxins are lipopolysaccharides
(LPS), which form an integral part of the cell wall. ‫اﻟﺗﻲ ﺗﺷﻛل ﺟز ًءا ال ﯾﺗﺟزأ ﻣن ﺟدار اﻟﺧﻠﯾﺔ‬
• Endotoxins occur only in gram-negative rods and cocci, are not actively released from the cell, and
cause fever, shock (hypotension + disseminated intravascular coagulation), and other
‫ أﻋراض ﻣﻌﻣﻣﺔ‬generalized symptoms. ‫اﻧﺧﻔﺎض ﺿﻐط اﻟدم‬ ‫اﻟﺗﺧﺛر اﻟﻣﻧﺗﺛر داﺧل اﻷوﻋﯾﺔ‬
‫ﺣد ذاﺗﮭﺎ‬
• Both exotoxins and endotoxins by themselves can cause symptoms; the presence of the
bacteria in the host is not required. ‫وﻻ ﯾﻠزم وﺟود اﻟﺑﻛﺗﯾرﯾﺎ ﻓﻲ اﻟﻣﺿﯾف‬
‫اﻟﺑﻛﺗﯾرﯾﺎ اﻟﻐﺎزﯾﺔ‬ ‫ﻣﺣﻠﯾًﺎ‬ ‫وﺗﺣدث‬
• Invasive bacteria, on the other hand, grow to large numbers locally and induce an inflammatory
response consisting of erythema, edema, warmth, and pain. ‫ووذﻣﺔ ودفء وأﻟم‬
‫ﻣﻣﻛن ﺗﺟﯾب ﺳؤال اﻧو ھل وﺟود‬
‫ﺣﻣرار ﻓﻲ اﻟﺟﻠد‬
‫اﻟﺑﻛﺗرﯾﺎ ﺿروري ﻋﻠﻣود ﺗﺳﺑب‬
‫اﻋراض ﻓﺔ اﻟﺟواب ال‬
 ‫ﻣﻌدﯾﺔ‬ ‫ﺗﻧﺗﺷر‬
• infections are communicable or contagious (i.e., they are spread from
‫اﻟﺳل‬
host to host). For example, tuberculosis is communicable (i.e., it
‫اﻟﻘطرات‬
spread from person to person via airborne droplets produced by ‫اﻟﻣﺣﻣوﻟﺔ‬
‫ اﻟﺗﺳﻣم اﻟﻐذاﺋﻲ‬coughing), but botulism is not, because the exotoxin produced by the ‫ﺟوا‬
organism in the contaminated food affects only those eating that food.
‫اﻟطﻌﺎم اﻟﻣﻠوث‬

‫ﻣﺻطﻠﺣﺎت ﻣﮭﻣﺔ‬
‫ﻣﺻطﻠﺣﺎت وﺑﺎﺋﯾﺔ‬ ‫ﻟوﺻف‬
• Three epidemiologic terms are often used to describe infections:
‫• اﻟﻣﺗوطﻧﺔ‬ endemic infections are those that occur at a persistent, usually low level in a
certain geographic area, ‫ﻣﺳﺗوى ﻣﺳﺗﻣر‬
‫ﺗﺣدث ﺑﻣﻌدل أﻋﻠﻰ ﺑﻛﺛﯾر ﻣن اﻟﻣﻌﺗﺎد‬
‫ • اﻷوﺑﺋﺔ‬epidemics are those infections that occur at a much higher rate than usual, and
‫ • اﻷوﺑﺋﺔ‬pandemics are those infections that spread rapidly over large areas of the globe. ‫اﻟﻌﺎﻟم‬
• many infections are inapparent or subclinical and can be detected only by
‫ إظﮭﺎر‬demonstrating a rise in antibody titer or by isolating the organism.‫ﻋزل‬
‫ﻛﺎﻣﻧﺔ‬
• Some infections result in a latent state, after which reactivation of the growth of
the organism and recurrence of symptoms may occur. ‫إﻋﺎدة ﺗﻧﺷﯾط ﻟﻧﻣو اﻟﻛﺎﺋن اﻟﺣﻲ وﺗﻛرار اﻷﻋراض‬
‫ﺣﺎﻣﻠﺔ ﻣزﻣﻧﺔ‬
• Certain other infections lead to a chronic carrier state, in which the organisms
continue to grow with or without producing symptoms in the host.‫أﻋراض‬ ‫ﺗﺳﺗﻣر اﻟﻛﺎﺋﻧﺎت اﻟﺣﯾﺔ ﻓﻲ اﻟﻧﻣو ﻣﻊ أو ﺑدون إﻧﺗﺎج‬
‫اﻟﻧﺎﻗﻼت اﻟﻣزﻣﻧﺔ‬ ‫ﻓﻲ اﻟﻣﺿﯾف‬
• Chronic carriers are an important source of infection of others and hence are a
public health hazard. ‫ﻓﮭﻲ ﺗﺷﻛل ﺧطرا ﻋﻠﻰ اﻟﺻﺣﺔ اﻟﻌﺎﻣﺔ‬
‫ اﻟﺷﺧص ﯾﻠﻲ ﻣﻧﺎﻋﺗﺔ ﻗوﯾﺔ ﺗﺣﯾط ھل ﺑﻛﺗرﯾﺎ ﺑﺟدار الن ﻣﺎ ﺗﻛدر ﺗﻘﺿﻲ ﻋﻠﯾﮭﺎ( اﺑدال اﻧو‬، ‫ﺑﻣرض اﻟﺳل ﻣن ﺗدﺧل اﻟﺑﻛﺗرﯾﺎ ﻓﺔ راح ﺗﺳﺑب اﻋراض وو‬
‫ اﻟﺑﻛﺗرﯾﺎ‬، ‫ﺗﻛون ﻣﻧﺗﺷرة ﺑﺎﻟرﺋﺔ ﻓﺔ ﺗﺣﺻرھﺎ ﻋﻠﻣود ال ﺗﻧﺗﺷر وال ﺗﺗﻛﺎﺛر) وھذا اﻟﺟدار ﻛل ﻓﺗرة ﯾﻣوت ﻓﺔ اﻟﻣﻧﺎﻋﺔ ﺗﺟدد ھذا اﻟﺟدار ﻣﺎ دام اﻟﻣﻧﺎﻋﺔ ﻗوﯾﺔ‬
‫ ﯾﻠﻲ ﻣﺣﺻورة ﺑﺎﻟﺟدار ﻧﺳﻣﯾﮭﺎ‬latent infections
‫اﻟﺑﻛﺗرﯾﺎ ﺧﻼﻟﮭﺎ ال ﺗﺗﻛﺎﺛر واﻟﻣرﯾض ﻣﺎ ﯾﻛون ﻣﻌدي وﻣﺎ ﻋﻧدة اي اﻋراض‬
‫ ﻛل ﺳﻧﺔ ﻣوﺟودة ﺑس ھﺎي‬epidemics , ‫ﻟﻠﻔﮭم‬
‫ﻣﺎ دام ﻣﻧﺎﻋﺗﺔ ﻗوﯾﺔ ﺗﺑﻘﻰ اﻟﺑﻛﺗرﯾﺎ ﻣﺣﺎﺻرة‬
‫ ﻓﺔ اﻟﺑﻛﺗرﯾﺎ ﺗرﺟﻊ ﺗﻧﺗﺷر‬، ‫اذا ﻣﻧﺎﻋﺗﺔ ﺿﻌﻔت الي ﺳﺑب ﻛﺎن ﻓﺔ اﻟﺟدار ﺑﻌد ﻣراح ﯾﺗﺟدد‬ )‫اﻟﺳﻧﺔ اﻧﺗﺷرت ھواي (ﻣﺛﻼ اﻟﻛوﻟﯾرا‬
)Pandemic ( Covid-19’s
 ‫ﺣﻔظ ﺑﺎﻟﺗﺳﻠﺳل ﻛل ﺳﻧﺔ ﺗﺟﯾﺑﮭم ﻣد‬

STAGES OF BACTERIAL PATHOGENESIS

•A generalized sequence of the stages of infection is as follows:

‫ﻣﺻدر‬
•(1) Transmission from an external source into the portal of entry. ‫ﺑواﺑﺔ اﻟدﺧول‬
‫ﺗﺟﻧب‬
•(2) Evasion of primary host defenses such as skin or stomach acid.
‫اﻻﻟﺗﺻﺎق‬
•(3) Adherence to mucous membranes, usually by bacterial pili.
‫• اﻻﺳﺗﻌﻣﺎر‬(4) Colonization by growth of the bacteria at the site of adherence. ‫ﻣوﻗﻊ اﻻﻟﺗﺻﺎق‬
•(5) Disease symptoms caused by toxin production or invasion accompanied
by inflammation. ‫أﻋراض اﻟﻣرض اﻟﻧﺎﺗﺟﺔ ﻋن إﻧﺗﺎج اﻟﺳﻣوم أو اﻟﻐزو اﻟﻣﺻﺣوب ﺑﺎﻟﺗﮭﺎب‬
• (6) Host responses, both nonspecific and specific (immunity), during steps
3, 4, and 5.
• (7) Progression or resolution of the disease. ‫ﺗﻘدم أو ﺣل اﻟﻣرض‬

‫راح ﺗﺟﻲ ﺑﺎﻟﻣد‬

DETERMINANTS OF BACTERIAL PATHOGENESIS

• 1. Transmission
• An understanding of the mode of transmission of bacteria and other infectious agents is extremely
important from a public health perspective, because interrupting the chain of transmission is an
excellent way to prevent infectious diseases Transmission
• The modes of transmission of microbes include both human-to human transmission to the new
host usually occurs via airborne respiratory droplets or fecal contamination of food and water.
Organisms can also be transmitted by sexual contact, urine, skin contact, blood transfusions,
contaminated needles, or biting insects. The transfer of blood, either by transfusion or by
sharing needles during intravenous drug use, can transmit various bacterial and viral pathogens.
• Nonhuman-to-human processes. Nonhuman sources include animals, soil, water, and food.
• The main “portals of entry” into the body are the respiratory tract, gastrointestinal tract, skin,
and genital tract.
• Human diseases for which animals are the reservoir are called zoonoses.
 ‫ﺷﻠون ﺗﻧﺗﻘل اﻟﻌدوى ﻣن اﻻم اﻟﻰ اﻟطﻔل‬

• 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 ‫ﻋﺑر اﻟﻣﺷﯾﻣﺔ‬
placenta, within the birth canal during birth, and via breast milk. ‫ﻟﺑن اﻷم‬
• (Horizontal transmission, by contrast, is person-to-person
transmission that is not from mother to offspring.)
‫ ﻛل طرق اﻻﻧﺗﻘﺎل اﻟﺳﺎﺑﻘﺔ ﻧﺳﻣﯾﮭﺎ‬horizontal

2. Adherence to Cell Surfaces:

‫ وﻏﺎﻟﺑًﺎ ﻣﺎ ﺗﻛون ﻏﯾر ُﻣ ْﻣ ِرﺿﺔ‬، ‫ﺗﻌﺗﺑر آﻟﯾﺎت اﻻﻟﺗزام ھذه ﺿرورﯾﺔ ﻟﻠﻛﺎﺋﻧﺎت اﻟﺣﯾﺔ اﻟﺗﻲ ﺗرﺗﺑط ﺑطﻔرات اﻷﻏﺷﯾﺔ اﻟﻣﺧﺎطﯾﺔ اﻟﺗﻲ ﺗﻔﺗﻘر إﻟﻰ ھذه اﻵﻟﯾﺎت‬
• These adherence mechanisms are essential for organisms that attach to mucous
membranes; mutants that lack these mechanisms are often nonpathogenic.
• Pili are the main mechanism by which bacteria adhere to human cells.
They are fibers that extend from the surface of bacteria that mediate
attachment to specific receptors on cells.
• Glycocalyx is a polysaccharide “slime layer” secreted by some strains
of bacteria that mediates strong adherence to certain structures such
as heart valves, prosthetic implants, and catheters
Pili ‫ وھﻲ أﻟﯾﺎف ﺗﻣﺗد ﻣن ﺳطﺢ اﻟﺑﻛﺗﯾرﯾﺎ اﻟﺗﻲ ﺗﺗوﺳط اﻻرﺗﺑﺎط ﺑﻣﺳﺗﻘﺑﻼت ﻣﺣددة ﻋﻠﻰ اﻟﺧﻼﯾﺎ‬، ‫ھﻲ اﻵﻟﯾﺔ اﻟرﺋﯾﺳﯾﺔ اﻟﺗﻲ ﺗﻠﺗﺻﻖ ﺑﮭﺎ اﻟﺑﻛﺗﯾرﯾﺎ ﺑﺎﻟﺧﻼﯾﺎ اﻟﺑﺷرﯾﺔ‬

Glycocalyx ‫ واﻟﻐرﺳﺎت‬، ‫ﻋﺑﺎرة ﻋن طﺑﻘﺔ ﻋدﯾد اﻟﺳﻛﺎرﯾد اﻟﻠزﺟﺔ ﺗﻔرزھﺎ ﺑﻌض ﺳﻼﻻت اﻟﺑﻛﺗﯾرﯾﺎ اﻟﺗﻲ ﺗﺗوﺳط ﻓﻲ اﻟﺗﺻﺎق ﻗوي ﺑﮭﯾﺎﻛل ﻣﻌﯾﻧﺔ ﻣﺛل ﺻﻣﺎﻣﺎت اﻟﻘﻠب‬
‫ واﻟﻘﺳطرة‬، ‫اﻻﺻطﻧﺎﻋﯾﺔ‬
 ‫اﻟﻐزو واﻻﻟﺗﮭﺎﺑﺎت واﻟﺑﻘﺎء داﺧل اﻟﺧﻼﯾﺎ‬

3. Invasion, Inflammation, & Intracellular

Survival
‫إﺣدى اﻵﻟﯾﺗﯾن اﻟرﺋﯾﺳﯾﺗﯾن اﻟﻠﺗﯾن ﺗﺳﺑب ﺑﮭﻣﺎ اﻟﺑﻛﺗﯾرﯾﺎ اﻟﻣرض ھﻲ ﻏزو اﻷﻧﺳﺟﺔ ﻣﺗﺑوﻋًﺎ ﺑﺎﻟﺗﮭﺎب‬
• One of the two main mechanisms by which bacteria cause disease is
invasion of tissue followed by inflammation.
‫ أﻣراض اﻟﻣﻧﺎﻋﺔ ھﻲ ﻋﻣﻠﯾﺔ ﺗطور اﻟﻣرض اﻟﺗﻲ ﺗﻧطوي ﻋﻠﻰ اﺳﺗﺟﺎﺑﺔ ﻣﻧﺎﻋﯾﺔ‬، ‫ واﻵﻟﯾﺔ اﻟﺛﺎﻟﺛﺔ‬، ‫ إﻧﺗﺎج اﻟﺳﻣوم‬، ‫اﻵﻟﯾﺔ اﻟرﺋﯾﺳﯾﺔ اﻷﺧرى‬
• The other main mechanism, toxin production, and a third mechanism,
Immunopathogenesis (is the process of disease development
involving an immune response .
• Several enzymes secreted by invasive bacteria play a role in
pathogenesis: ‫دورا ﻓﻲ اﻟﺗﺳﺑب ﻓﻲ اﻟﻣرض‬ً ‫ﺗﻠﻌب اﻟﻌدﯾد ﻣن اﻹﻧزﯾﻣﺎت اﻟﺗﻲ ﺗﻔرزھﺎ اﻟﺑﻛﺗﯾرﯾﺎ اﻟﻐﺎزﯾﺔ‬

• For example, hyaluronidase produced by Streptococcus pyogenes

‫ ﯾﺣﻠل‬degrades hyaluronic acid in the subcutaneous tissue, allowing the
‫ﺑﺎﻻﻧﺗﺷﺎر ﺑﺳرﻋﺔ‬ ‫ﻷﻧﺳﺟﺔ ﺗﺣت اﻟﺟﻠد‬
organism to spread rapidly.
• IgA protease degrades IgA, allowing bacteria to attach to mucous
membranes.‫(اﻟدﻣوع‬IgA is the main antibody found in mucous secretions, ‫ﺗﺳﺋل ﻋﻧﮭﺎ‬
‫واﻟﻠﻌﺎب‬ ‫اﻟﻌرق‬
including tears, saliva, sweat, colostrum and secretions from the
‫اﻟﺑوﻟﻲ اﻟﺗﻧﺎﺳﻠﻲ‬ genitourinary tract, gastrointestinal tract, prostate and respiratory
epithelium. It is also found in small amounts in blood) Colostrum
‫ﻣﺎدة ﺻﻣﻐﯾﺔ ﻣوﺟودة ﻓﻲ ﺣﻠﯾب اﻻم ﻓﻲ اول ﺛﻼث اﯾﺎم‬

• The capsule surrounding bacteria is antiphagocytic (i.e., it retards the

phagocyte from ingesting the organism). Mutant strains of many
pathogens that do not produce capsules are nonpathogenic.
‫اﻟﻛﺑﺳوﻟﺔ اﻟﻣﺣﯾطﺔ ﺑﺎﻟﺑﻛﺗﯾرﯾﺎ ﻣﺿﺎدة ﻟﻠﺑﻠﻌﻣﺔ (إﻧﮭﺎ ﺗؤﺧر اﻟﺑﻠﻌﻣﺔ ﻋن اﺑﺗﻼع اﻟﻛﺎﺋن اﻟﺣﻲ) اﻟﺳﻼالت اﻟﻣﺗﺣوﻟﺔ ﻟﻠﻌدﯾد ﻣن ﻣﺳﺑﺑﺎت‬
‫ ﯾﺟﯾﻧﺎ‬mcq ‫اﻷﻣراض اﻟﺗﻲ ال ﺗﻧﺗﺞ اﻟﻛﺑﺳوالت ﻏﯾر ﻣﺳﺑﺑﺔ ﻟﻸﻣراض‬
Mutant (noncapsule)
‫ ﺷﻧو ﻓرﻗﮭﺎ ﻋن ﯾﻠﻲ ﻋدھﺎ‬capsule
‫ ﯾﻠﻲ ﻋدھﺎ ﺗﻛون ﻣﺣﻣﯾﺔ ﻣن ال‬phagocytic
 Exotoxins ‫ﺗﻔرزھﺎ‬ ‫ﺑﻛﺗﯾرﯾﺎ ﻣﻌﯾﻧﺔ‬ ‫ﺗﻐﯾر‬
• Exotoxins are polypeptides secreted by certain bacteria that alter specific cell
‫ﯾؤدي إﻟﻰ ظﮭور‬
‫ أﻋراض اﻟﻣرض‬functions 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. ‫وﺗﺣﻔز‬
• Exotoxins are antigenic and induce antibodies called antitoxins.
‫ﺗﻌدﯾل‬ ‫ﻣﻌﺎﻟﺟﺔ‬
• Exotoxins can be modified to form toxoids (treated with formaldehyde), which
are antigenic but not toxic. Toxoids, such as tetanus toxoid, are used to immunize ‫ﻟﻠﺗﺣﺻﯾن‬
against disease. ‫ﻟﻘﺎح اﻟﻛزاز‬
‫وأھداف‬
• Exotoxins have different mechanisms of action and different targets within the cell
and therefore cause a variety of diseases with characteristic symptoms. ‫اﻷﻋراض اﻟﻣﻣﯾزة‬
‫اﻧﻘﺳﺎم‬
• Some exotoxins act by proteolytic cleavage of a cell component, whereas others
‫ ﻛﻣﺳﺗﺿدات ﻓﺎﺋﻘﺔ‬act as superantigens, causing the overproduction of cytokines.

• Some are neurotoxin causes paralysis, ‫اﻟﺷﻠل‬ ‫ﺗﺣﻠل‬

• Enterotoxin cause diarrhea, hemolysin (RBC lysis)
‫اﻟﺳﯾﺗوﻛﯾن (ﺑﺎﻹﻧﺟﻠﯾزﯾﺔ‬: cytokine(‫‏ ھو‬
‫ﺑروﺗﯾن أو ﻋدﯾد ﺑﺑﺗﯾد أو ﺑروﺗﯾن ﺳﻛري‬
‫ﯾﺳﺗﺧدم ﻓﻲ ﻋﻣﻠﯾﺎت ﻧﻘل اﻹﺷﺎرة واﻟﺗواﺻل‬
‫ﻣﺎ ﺑﯾن اﻟﺧﻼﯾﺎ‬.

Many exotoxins have an A–B subunit structure in

which the A subunit is the active (toxic) one and the B
subunit is the one that binds to the cell membrane and
mediates the entry of the A subunit into the cell.
 ‫اﻟﺟﺳم ال ﯾﻛون ﺿده اﺟﺳﺎم ﻣﺿﺎدة‬ ‫ﺗﺟﻠطﺎت ﺑﻛل اﻟﺟﺳم‬
‫اﻻﻋراض ﺗﺳﺋل ھواي ﻋﻠﯾﮭﺎ‬
Endotoxins ‫ھﺑوط ﺑﺎﻟﺿﻐط‬
‫ارﺗﻔﺎع اﻟﺣرارة‬ ‫ﺑﺎﻻﻣﺗﺣﺎن‬

• Endotoxins are lipopolysaccharides (LPS) located in the outer membrane

only of gram-negative bacteria. They are not secreted
‫ﯾؤدي‬
by bacteria.
‫ﻓﻲ إﺷﺎرات‬
• Lipid A is the toxic component of LPS. It induces the overproduction of ‫وﻗد ﺛﺑت أن‬
‫ اﻷوﺗوﻛرﯾن‬cytokines (Cytokines are are important in cell signaling. Cytokines have ‫اﻟﺳﯾﺗوﻛﯾﻧﺎت‬
‫ واﻟﺑﺎراﻛرﯾن واﻟﻐدد‬been shown to be involved in autocrine, paracrine and endocrine ‫ﺗﺷﺎرك‬
‫اﻟﺻﻣﺎء ﻛﻌواﻣل‬
‫ﻣﻌدﻟﺔ ﻟﻠﻣﻧﺎﻋﺔ‬
signaling as immunomodulating agents, such as tumor necrosis factor, ، ‫اﻟورم‬ ‫ﻧﺧر‬ ‫ﻋﺎﻣل‬
interleukin-1, and nitric oxide, from macrophages, which causes the ، 1 ‫واﻹﻧﺗرﻟوﻛﯾن‬
‫ ﻣﻣﺎ ﯾﺳﺑب أﻋراض‬، ‫ ﻣن اﻟﺿﺎﻣﺔ‬، ‫وأﻛﺳﯾد اﻟﻧﯾﺗرﯾك‬
symptoms of septic shock, such as fever and hypotension. ‫اﻟﺻدﻣﺔ اﻹﻧﺗﺎﻧﯾﺔ‬
• In addition, LPS activates the complement cascade resulting in increased
‫ ﻧﻔﺎذﯾﺔ اﻷوﻋﯾﺔ اﻟدﻣوﯾﺔ‬vascular permeability, and the coagulation cascade, resulting in increased
‫اﻟﺗﺧﺛر اﻟﻣﻧﺗﺷر داﺧل‬
vascular permeability and disseminated intravascular coagulation DIC ‫اﻷوﻋﯾﺔ‬
• Endotoxins are poorly antigenic, do not induce antitoxins, and do not form
toxoids. ‫ﺿﻌﯾﻔﺔ‬ ‫ﺗﺣﻔز‬

coagulation cascade‫ﺷﻼل اﻟﺗﺧﺛر‬

‫ﻣﺎ ﯾﺳوي اﺟﺳﺎم ﻣﺿﺎدة‬-١
‫اﻟﺗوﻛﺳت ﺑﺎرت ھوة‬-٢ lipid
‫ ﻣوﺟود ﻓﻘط ﺑﺎﻟﻛرام ﻧﻛﺗف ھوة ﺟزء ﻣن ﺟدار اﻟﺧﻠﯾﺔ‬-٣
‫ ﯾﻌﻧﻲ( ﻋﻧدة ھﺑوط ﺑﺎﻟﺿﻐط الن اﻟﺿﻐط اﻟطﺑﯾﻌﻲ‬٤٠ ‫ ﻋﻠﻰ‬٦٠ ‫ﻛﺎﻟت اﻧو ﺗﺟﯾب ﻛﯾس اﻧو ﺷﺧص ﻋﻧدة ارﺗﻔﺎع ﺑﺎﻟﺣرارة وﺿﻐطﺔ‬
‫ھوة ﯾﺛﯾر اﻟﻣﻧﺎﻋﺔ ﺑس ﻣﺎ ﯾﺳوي اﺟﺳﺎم ﻣﺿﺎدة‬
‫ ﯾﻠﻲ ﺳﺑﺑﮭﺎ ھوة‬، )‫)وﺗﻛﻠﻲ اﻧو ﻋﻧده ﻋدوى ﻣﻧو ﺳﺑﺑت ھﺎي االﻋراض ﻣﺛﻼ ال ﺑوﻟﻲ ﺑﺑﺗﯾدو ( ال‬۸٠‫ﻋﻠﻰ‬۱۲٠
‫ﻻزم ﺗﻛون اﻻﺻﺎﺑﺔ ﻗوﯾﺔ ﻋﻠﻣود ﯾﺳوي ھﺎي اﻻﻋراض‬ lipopolysaccharides
 Generalized infection
‫ﺗﺟرﺛم اﻟدم‬

• Bacteremia : a transitory disease in which bacteria (not

multiplied) present in the blood are usually cleared from
the vascular system with no harmful effects. ‫ﺿﺎرة‬

• Septicemia : a disease in which the blood serves as a site of

‫ﺗﺳﻣم اﻟدم‬ ‫ﯾﻌﻣل‬

‫وﺳﯾﻠﺔ‬
‫اﻟﺗﻛﺎﺛر اﻟﺑﻛﺗﯾري‬ bacterial multiplication as well as a means of transfer of the
infectious agent from one site to another.

‫ﻣﺻطﻠﺣﺎت ﻣﮭﻣﺔ‬

‫ﺗﺟرﺛم اﻟدم‬

‫ﺗﺳﻣم اﻟدم‬
‫ﺟﮭﺎزي‬

‫ﻣﺷﺗﺑﮫ ﺑﮫ‬

‫ﺗﻌﻔن اﻟدم اﻟﺷدﯾد‬

‫ﺗﻌﻔن اﻟدم ﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ ﺿﻌف اﻟﺟﮭﺎز‬

‫ﺳﺗﺟﺎﺑﺔ ﺟﮭﺎزﯾﺔ ﻟﻠﻌدوى أو اﻟﺻدﻣﺔ‬

‫اﻟﺻدﻣﺔ اﻹﻧﺗﺎﻧﯾﺔ‬

‫ﺗﻌﻔن اﻟدم واﻧﺧﻔﺎض ﺿﻐط اﻟدم‬

 ‫ﺗﺟﻲ ﺑﺎﻻﻣﺗﺣﺎن‬
‫اﻟﺗﯾﺑل اﻟوﺣﯾد ﯾﻠﻲ ﯾﺟﻲ ﺑﺎﻻﻣﺗﺣﺎن‬

‫اﻟﺗﺄﺛﯾرات اﻟﺳرﯾرﯾﺔ‬ ‫ﺗﺄﺛﯾرات ﻣﺧﺗﻠﻔﺔ‬ ‫ﺣﻣﻰ ‪ ،‬ﺻدﻣﺔ‬

‫طرﯾﻘﺔ اﻟﻌﻣل‬ ‫أوﺿﺎع ﻣﺧﺗﻠﻔﺔ‬

‫ﯾﺳﺗﺣث اﻷﺟﺳﺎم اﻟﻣﺿﺎدة ﻋﺎﻟﯾﺔ اﻟﻌﯾﺎر ﺗﺳﻣﻰ ﻣﺿﺎدات اﻟﺳﻣوم‬
‫اﺳﺗﺿداد‬ ‫ﻣﺳﺗﺿد ﺿﻌﯾف‬

‫ﻟم ﯾﺗم ﺗﻛوﯾن ذﯾﻔﺎﻧﺎت وﻻ ﯾﺗوﻓر ﻟﻘﺎح‬

‫اﻟﻠﻘﺎﺣﺎت‬
‫ﯾﺗﻠف ﺑﺳرﻋﺔ ﻋﻧد ‪ 60‬درﺟﺔ ﻣﺋوﯾﺔ (ﺑﺎﺳﺗﺛﻧﺎء اﻟذﯾﻔﺎن اﻟﻣﻌوي ﻟﻠﻣﻛورات اﻟﻌﻧﻘودﯾﺔ)‬
‫اﺳﺗﻘرار اﻟﺣرارة‬ ‫ﻣﺳﺗﻘر ﻋﻧد ‪ 100‬درﺟﺔ ﻣﺋوﯾﺔ ﻟﻣدة ﺳﺎﻋﺔ واﺣدة‬

‫اﻷﻣراض اﻟﻧﻣوذﺟﯾﺔ‬

‫اﻟﺗﯾﺗﺎﻧوس ‪ ،‬اﻟﺗﺳﻣم اﻟﻐذاﺋﻲ ‪ ،‬اﻟدﻓﺗﯾرﯾﺎ ‪،‬‬ ‫اﻟﻣﻛورات اﻟﺳﺣﺎﺋﯾﺔ ‪ ،‬اﻹﻧﺗﺎن ﺑواﺳطﺔ ﻗﺿﺑﺎن ﺳﺎﻟﺑﺔ اﻟﺟرام‬
 ‫اﻟﻣراﺣل اﻟﻧﻣوذﺟﯾﺔ ﻟﻣرض ﻣﻌدي‬

TYPICAL STAGES OF AN INFECTIOUS

DISEASE ‫اﻟﻣرض اﻟﻣﻌدي اﻟﺣﺎد اﻟﻧﻣوذﺟﻲ ﻟﮫ أرﺑﻊ ﻣراﺣل‬

• A typical acute infectious disease has four stages: ‫اﻛﺗﺳﺎب‬

‫ﻓﺗرة اﻟﺣﺿﺎﻧﺔ‬ • (1) The incubation period, which is the time between the acquisition of the
organism (or toxin) and the beginning of symptoms (this time varies from hours to
days to weeks, depending on the organism). ‫اﻷﻋراض‬ ‫ﺗﺧﺗﻠف‬

‫( • ﻓﺗرة اﻟﺑﺎدرة‬2) The prodrome period, during which nonspecific symptoms such as fever,

‫ﻓﺗرة اﻟﻣرض اﻟﻣﺣددة‬

malaise, and loss of appetite occur. ‫اﻟﺗوﻋك وﻓﻘدان اﻟﺷﮭﯾﺔ‬ ‫اﻟﻌﻼﻣﺎت‬
• (3) The specific-illness period, during which the overt characteristic signs and
symptoms of the disease occur. ‫ﻓﺗرة اﻟﻧﻘﺎھﺔ‬
‫ﻓﺗرة اﻟﺷﻔﺎء‬ • (4) The recovery period, also known as the convalescence period, during
‫ ﯾﮭدأ ﺧﻼﻟﮭﺎ اﻟﻣرض‬whichthe illness abates and the patient returns to the healthy state. ‫ﯾﻌود اﻟﻣرﯾض إﻟﻰ ﺣﺎﻟﺗﮫ اﻟﺻﺣﯾﺔ‬.
‫ﺣﺎﻣﻠﯾن ﻣزﻣﻧﯾن‬
• After the recovery period, some individuals become chronic carriers or latent ‫ﻋدوى ﻛﺎﻣﻧﺔ‬
‫ﺳرﯾرﯾﯾن‬ infection or subclinical . In subclinical infections and after the recovery period is
over, the presence of antibodies is often used to determine that an infection has
occurred. ‫ ﻏﺎﻟﺑًﺎ ﻣﺎ ﯾﺳﺗﺧدم وﺟود اﻷﺟﺳﺎم اﻟﻣﺿﺎدة ﻟﺗﺣدﯾد ﺣدوث اﻟﻌدوى‬، ‫ﻓﻲ ﺣﺎﻻت اﻟﻌدوى ﺗﺣت اﻹﻛﻠﯾﻧﯾﻛﯾﺔ وﺑﻌد اﻧﺗﮭﺎء ﻓﺗرة اﻟﺷﻔﺎء‬

The END
toko