BACTERIAL
PATHOGENESIS
By Dr. Maliha Atif
Associate Professor
Pathology
LEARNING OBJECTIVES
01 02 03
Identify the types of Enlist stages of Discuss
bacterial infection bacterial determinants of
pathogenesis bacterial
pathogenesis
Pathogen
A microorganism is a pathogen if it is capable of causing disease
Opportunistic pathogen
IMPORTANT
DEFINITIONS
The term opportunistic refers to the ability of the organism to take the
opportunity offered by reduced host defences to cause disease.
Virulence
Virulence is a quantitative measure of pathogenicity and is measured by the
number of organisms required to cause disease.
Virulence Factors
Enzymes
Toxins
Motility
Presence of pili or capsular protection
Space occupation
Multiplication
Types of Infection
Acute, Subacute, Chronic
Pathogenesis: Process of development of disease
Stages of Pathogenesis
(1) Transmission from an (2) Evasion of primary (3) Adherence to mucous
external source into the host defences such as membranes, usually by
portal of entry. skin or stomach acid. bacterial pili.
(5) Disease symptoms (6) Host responses, both
(4) Colonization by caused by toxin nonspecific and specific
growth of the bacteria at production or invasion immunity
the site of adherence. accompanied by (7) Progression or
inflammation. resolution of the disease.
TYPICAL STAGES OF AN INFECTIOUS
DISEASE
(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).
(2) The prodrome period, during which nonspecific symptoms such as fever, malaise, and loss of
appetite occur.
(3) The specific-disease period, during which the overt characteristic signs and symptoms of the
disease occur.
(4) The recovery period, also known as the convalescence period, during which the patient starts
returning to the healthy state.
IgG and IgA antibodies protect the recovered patient from reinfection by the same organism.
Determinants of Bacterial Pathogenesis
• Transmission of Bacteria
• Adherence to Cell Surfaces
• Invasion, Inflammation & Intracellular Survival
• Toxin Production
• Immunopathogenesis
Determinants of Bacterial Pathogenesis
TRANSMISSION OF BACTERIA
• Human to- human
• Direct contact
• Indirect Contact : via a vector such as an insect, notably ticks or mosquitoes.
• Non-human-to-human sources: e.g animals, soil, water, and food
• Zoonoses:
Human diseases for which animals are the reservoir are called zoonoses.
• Vertical Transmission: Transmission from mother to offspring
• Horizontal Transmission : Person-to-person transmission that is not from mother to offspring.
Determinants of Bacterial Pathogenesis
Transmission:
Bacterial diseases transmitted by food
Pili are the main mechanism by which bacteria adhere to human
cells. They are fibers that extend from the surface of bacteria that
Determinants of mediate attachment to specific receptors on cells. e.g. Neisseria
gonorrhoeae and E. coli
Bacterial
Pathogenesis (contd)
Biofilm production: 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
Adherence of Examples: 1) Staphylococcus epidermidis
bacteria 2) Persistence of Pseudomonas in the lungs of cystic fibrosis patients.
3) The formation of dental plaque, the precursor of dental caries.
Virulent Factors Involved In
Tissue Invasion
ENZYMES:
• Collagenase &Hyaluronidase produced by
Streptococcus pyogenes degrades collagen
and hyaluronic acid in the subcutaneous
tissue, allowing the organism to spread
rapidly.
• IgA protease degrades secretory IgA,
allowing bacteria to attach to mucous
membranes.
Coagulase, which is produced by Staphylococcus
aureus and accelerates the formation of a fibrin
clot from fibrinogen (this clot may protect the
bacteria from phagocytosis by coating the
Virulent Factors organisms with a layer of fibrin).
(contd....)
Leukocidins: Destroy both neutrophilic
leukocytes and macrophages.
Virulent Factors (contd....)
ANTIPHAGOCYTIC FACTORS:
The capsule surrounding bacteria is antiphagocytic (i.e., it retards
the phagocyte from ingesting the organism) e.g. Str. pneumoniae and Neisseria
meningitidis.
Cell wall proteins of the gram-positive cocci, such as the M protein of
Streptococcus pyogenes and protein A of Staphylococcus aureus.
Toxin Production
• The second major mechanism by
which bacteria cause disease is
the production of toxins
Virulent • Exotoxins
Factors • Endotoxins
Determinants of Bacterial Pathogenesis (contd)
• INFLAMMATION
• is an important host defense induced by the presence of bacteria in the body.
• There are two types of inflammation,
• Pyogenic inflammation: Host defense against pyogenic (pus-producing) bacteria such as
S. pyogenes, consists of neutrophils (and antibody and complement).
• Granulomatous inflammation: Host defense against intracellular, granuloma-producing
bacteria, such as M. tuberculosis, consists of macrophages and CD4-positive T cells.
INTRACELLULAR SURVIVAL
• • Bacteria can evade our host defenses by a process called intracellular survival (i.e.,
bacteria that can live within cells are protected from attack by macrophages and
neutrophils).
It is not the organism itself that causes
the symptoms of disease but the
immune response to the presence of
the organism.
For example, in rheumatic fever,
Immunopathogenesis antibodies are formed against the M
protein of S. pyogenes, which cross-
react with joint, heart, and brain tissue.
Inflammation occurs, resulting in the
arthritis, carditis, and chorea that are
the characteristic findings in this
disease.
Entry: The agent
Encounter: The agent
Breach of Defense enter into parts of
meets the host
the host
How Spread: The agent Multiplication: The
Damage: The host
the Infection spread from the site agent multiply in the
response or agent &
host cause tissue
of entry host
occurs damage
Outcome: The agent
or host wins out or
learn to coexist
Summary
01 02 03 04
Pathogenesis Microorganisms Contact of agent Breach of
depend upon have different with the host is defence is
type of causative weapons to the starting point necessary to
agent produce damage initiate effect by
the agent
