PATHOGENESIS

OF
BACTERIAL
INFECTION
• Pathogenesis: the origin and development of
the disease
• The pathogenesis of bacterial infection
includes the
• initiation of the infectious process
• the mechanisms leading to the development of
signs and symptoms of bacterial disease.
Basic terms frequently used in describing aspects of
pathogenesis :
•Pathogen :
• A microorganism which is capable to causing disease.
•Non-pathogen :
• A microorganism that does not cause disease . It may be part of the
normal flora.
•Opportunistic pathogen:
• An agent capable of causing disease only when the host´s
resistance is impaired.
• An agent capable of causing disease only when spread from the
site with normal bacterial microflora to the sterile tissue or organ.
Basic terms frequently used in describing aspects of
pathogenesis :
• Pathogenicity:
• The ability of an infectious agent to cause disease .
• Toxigenicity:
• The ability of a microorganism to produce a toxin that
contributes to the development of disease.
• Invasion:
• The process where by the organism enter the host cells or
tissues and spread in the body.
• Infection:
• Multiplication of an infectious agent within the body.
• mechanisms of bacterial infection:
• Toxin production.
• Invasion and inflammation(pyogenic and granulomatous )
Types of infection
• Communicable: can spread from person to person
• Contagious: highly communicable disease
• Epidemic: affecting many people in an area
• Endemic: infection is constantly present at low level in specific
population
• Pandemic: has world wide distribution.
• In apparent or subclinical: It is one where clinical affects are not
apparent , can be detected only by demonstrating arise in antibody
titer or by isolating organism.
 Types of Infection
Primary infection: Initial infection with organism in host.
Reinfection: Subsequent infection by same organism in a host .
Focal infection: infection at localized sites like appendix and tonsil,
general effects are produced.
Cross infection: When a patient suffering from a disease and new
infection is set up from another host or external source.
Nosocomial infection: Cross infection occurring in hospital is called
nosocomial infection.
Sources of Infection in human
• 1.human : a common source of infection from a patient or carrier.
• 2. Animals: Infectious diseases transmitted from animals to human are
called zoonosis.
• 3. Insects: The disease caused by insects are called arthropod borne disease.
Insects like mosquitoes, fleas, lice that transmit infection are called vector.
• Some vectors may act as reservoir host.
• 5. Soil: Soil may serve as source of bacterial infection
• Spores of tetanus bacilli remain viable in soil for a long time,
• 6. Water: Vibrio cholerae
• 7. Food: Contaminated food may be source of infection. Presence of
pathogens in food may be due to external contamination .
Methods of Transmission of Infection

• 1. Contact: Syphilis, gonorrhea, trachoma.

• 2. Inhalation: tuberculosis.
• 3. Ingestion: Cholera (water), food poisoning (food) and dysentery
(hand borne).
• 4. Inoculation: Tetanus .
• 5. Insects: They act as mechanical vector (dysentery and typhoid by
housefly) .
• 6. Laboratory infection: Infection may be transmitted during
procedures like, injection. if proper care is not taken.
 The infectious process
•Infection indicates multiplication of microorganisms.
•Prior to multiplication, bacteria must enter and establish
themselves within the host.

•The most frequent portals of entry are the respiratory (mouth and
nose), gastrointestinal, and urogenital tracts. Abnormal areas of
mucous membranes and skin (e.g. cuts, burns) are also frequent
sites of entry.
 The infectious process
•Bacteria must attach or adhere to host cells, usually epithelial cells.

•After established a primary site of infection , they multiply and

spread.

•Infection can spread directly through tissues or via the lymphatic

system to bloodstream.
•Bloodstream infection (bacteremia) can be transient or persistent.
Bacteremia allows bacteria to spread widely in the body.
Virulence
• Virulence:
• The quantitative ability of an agent to cause disease.

• Virulent agents cause disease when introduced into the

host in small numbers.

• Virulence involves invasiveness and toxigenicity.

Bacterial virulence factors

• Many factors determine the virulence of

bacteria, or their ability to cause infection
and disease.:--------
 1. Adherence factors
• Once bacteria enter the body of the host, they must
adhere to cells of a tissue surface. If they do not adhere,
they would be swept away by mucus and other fluids
that bathe the tissue surface.

• Adherence to cell surfaces by pili and glycocalyx

 2. Enzymes
•Many species of bacteria produce enzymes that are play
important role in the infectious process.

•Collagenase:
• degrades collagen, the major protein of fibrous connective
tissue, and promotes spread of infection in tissue.

•Coagulase:
• Staphylococcus aureus produce coagulase
• Coagulase contributes to the formation of fibrin walls around
staphylococcal lesions, which prevents phagocytosis
 Enzymes
• Hyaluronidases:
• enzymes that hydrolyze hyaluronic acid, a constituent of the
ground substance of connective tissue. They are produced by
many bacteria (e.g. staphylococci, streptococci and anaerobes)
and aid in their spread through tissues.

• Streptokinase:
• many hemolytic streptococci produce streptokinase
(fibrinolysin). This enzyme, is aids in the spread of streptococci
through tissues.
 Enzymes
• Hemolysins and leukocidins:
• Many bacteria produce substances that are cytolysins - they
dissolve red blood cells (hemolysins) or kill tissue cells or
leukocytes (leukocidins).
• Streptolysin O, for example, is produced by group A streptococci
is hemolytic for red blood cells from many animals.
• Ig A protease:
• Degrade IgA and inactivate its antibody activity allowing
organism to adhere to mucus membrane
• Gonococci, meningococci, Hemophilus influenzae pneumococci,
 3. Antiphagocytic factors
• Many bacterial pathogens are rapidly killed once
they are ingested by polymorphonuclear cells or
macrophages.

• Many bacteria have polysaccharide capsules

protect it from phagocytosis .
4.Toxins
• Toxins produced by bacteria are
generally classified into two groups:

• exotoxins

• endotoxins
Endotoxins of gram-negative bacteria
• The endotoxins of gram-negative bacteria are derived from
bacterial cell walls and are often liberated when the bacteria
lyse.
• Lipopolysaccaride
• Low toxicity
• The substances are heat-stable .
• Poorly antigenic
• No vaccine available
• Clinical effects are fever and shock
• Meningococcemia ,
 Exotoxins
• Many gram-positive and gram-negative bacteria produce exotoxins
of considerable medical importance.
• Secreted by bacteria
• Polypeptide
• Heat labile
• High toxicity
• Induce high titer of antibodies
• There is a vaccine
• Some of these toxins have had major role in world history (e.g. toxin
of Clostridium tetani).
• Botulism , diphtheria ,cholera