Mechanisms of Bacterial Pathogenesis

NORMAL FLORA MECHANISM BACTERIAL INFECTION

Normal Flora and Pathogenesis

Outcomes of exposure to a microorganism: 1. Transient colonization 2. Permanent colonization 3. Disease Colonization vs infection
Colonization: establishment of a site of reproduction of microbes on a person without necessarily resulting in tissue invasion or damage.

Infection: growth and multiplication of a microbe in or on the body of the host with or without the production of disease.

Introduction of Normal Flora

1. A diverse microbial flora => Human body Area: the skin and mucous membranes Time: shortly after birth until death Number: 1014 bacteria =>1013 host cells Normal flora may: a. Aid the host b. Harm the host (in sometimes) c. Exist as commensals (no effect to the host) Viruses and parasites => NOT normal microbial flora

2.

3.

Significance of Normal Flora

The normal flora influences the susceptibility to pathogens, and morbidity of the host

Normal flora may aid the host in several ways: Aid in digestion of food and absorb nutrien Help the development of mucosa immunity Protect the host from colonization with pathogenic microbes. Sinthesis vit K

Normal Flora competing with Invading Pathogens

Adopted from Samuel Baron Medical Microbiology

Normal flora may act as opportunistic pathogens

Especially in hosts rendered susceptible by: 1. Immuno-suppression (AIDS) 2. Radiation therapy & Chemotherapy

3. Perforated mucous membranes

4. Rheumatic heart diseaseetc.

Sites of human body that the normal flora microbes colonize

Respiratory tract and head : outer ear, eye, mouth, nose,
oropharynx, nasopharynx e.C: Streptococcus viridans Sterile sites: sinuses, middle ear, brain, lower respiratory tract (trachea, bronchiole, lung)

Gastrointestinal tract: esophagus, stomach, small

intestine, large intestine

e.c :

Bacteroides,Bifidobacteria,Eubacteria,Lactobacillus,coliform, Streptococus,Clostridium

Genitourinary system : anterior urethra, vagina (e.c

Gardnerella vaginalis, Ureaplasma urealyticum,Bacteroides,

Factors Influencing Normal Flora

1. Local Environment (pH , IUD, vaginal douching,etc).
2. Diet

3. Age
4. Health condition (immune activity) 5. Antibiotics,..etc

Introduction of Bacterial Pathogenesis

1. Infection: growth and multiplication of a microbe in or on the body with or without the production of disease. 2. The capacity of a bacterium to cause disease reflects its relative Pathogenicity.

3. Virulence is the measure of the pathogenicity of a microorganism.

4. Pathogenesis refers both to (1) the mechanism of infection and to (2) the mechanism by which disease develops.

Host Susceptibility
1. Susceptibility to bacterial infections => Host Defenses vs Bacterial Virulence 2. Host Defenses: - Barriers (skin & mucus) the first line - Innate Immunity (complement, macrophages & cytokines) the early stage - Adaptive Immunity (Ag-specific B & Tcells)the later stage

Strict pathogens are more virulent and can cause diseases in a normal person.
Opportunistic pathogens

are typically members of normal flora and cause diseases when they are introduced into unprotected sites; usually occur in people with underlying conditions.

Entry into the human body

The most frequent portals of entry- Mucus - Skin Routes: Ingestion, Inhalation, Trauma, Needlestick, Catheters, Arthropod bite, Sexual transmission

: infection

: shedding

Portals of Entry
Entry of a Microbe Need to adhere, penetrate, and then cause damage Gain access via portal of entry and may a have preferred portal of entry - Streptococcus pneumoniae via GI tract? Portals of Entry: Mucous membranes

Respiratory GI Urogenital conjunctiva

Skin Parenteral route

Puncture or injection

Characteristics of Pathogenic Bacteria

1. Transmissibility 2. Adherence to host cells 3. Invasion of host cells and tissue 4. Evasion of the host immune system 5. Toxigenicity A bacterium may cause diseases by 1. Destroying tissue (invasiveness)

2. Producing toxins (toxigenicity)

3. Stimulating overwhelming () host immune responses

Toxins
Provide properties to spread and cause damage to the host. Compare endotoxins and exotoxins
Endotoxins from inside the cell. Released upon cell lysis. Exotoxins are secreted out of the cell during cell life. Toxin Toxigenicity Toxemia Toxoid Antitoxin

Substances that contribute to pathogenicity Ability to produce a toxin Presence of toxin the host's blood Inactivated toxin used in a vaccine Antibodies against a specific toxin

Exotoxins
Mostly seen in Gram (+) Bacteria Most gene that code for exotoxins are located on plasmids or phages

Figure 15.4a

Endotoxin

Figure 15.4b

Pathological Mechanisms of Bacterial Infections

1. Bacteria-mediated Pathogenesis 2. Host-mediated Pathogenesis 3. Bacterial virulence factors => bacterial factors causing diseases

Adopted from Samuel Baron Medical Microbiology

Bacterial Virulence Mechanisms

SUMMARY-I
1. Host Defenses: - Barriers (skin & mucus) first line - Innate Immune Responses (complement, macrophages & cytokines) the early stage - Adaptive Immune Responses (Ag-specific B & T cells) the later stage 2. Susceptibility to bacterial infections depends on the balance between host defenses and bacterial virulence.

3. Pathogenic mechanisms of bacterial infections include Bacteria-mediated Pathogenesis Host-mediated Pathogenesis

SUMMARY-II
4. Normal flora may aid the host in several ways: Aid in digestion of food Help the development of mucosa immunity Protect the host from colonization with pathogenic microbes.

Mechanisms of Pathogenicity

Figure 15.9