Infection Biology

DEFINITION OF TERMS
• Pathogenicity
• Describes the ability and strength of a pathogenic substance to cause
pathologic changes
• Infectivity
• The capability of the pathogen or agent to enter, survive, and multiply in the
host.
• Virulence
• The capacity and strength of the disease to produce severe and fatal cases of
illness
• Antigenicity
• The ability of the agent to induce antibodies in the host.
Infection Biology
MECHANISMS OF BACTERIAL DISEASE
• production of toxins
• induction of inflammation

MODES OF TRANSMISSION
• Human to Human
o direct (sexual, transvaginal), fecal-oral, inhalation, transplacental, blood-
borne
• Nonhuman to Human
o soil, water, direct animal source, vector-borne, animal excreta, fomites
Infection Biology
BACTERIAL ADHERENCE
• pili mediate attachment of bacteria
• glycocalyx mediates strong adherence to surface of human cells → allows
adhesion to prosthetic devices
Infection Biology
ENZYMES IN BACTERIAL INVASION
• hyaluronidase (a.k.a. spreading factor)
o spread through subcutaneous
tissue

• coagulase
o accelerates formation of a fibrin
clot coating the organisms with a layer of
fibrin
Infection Biology
• Immunoglobulin A (IgA) protease
o cleaves IgA → allows adherence
to mucous membranes
o seen in SHiN organisms – S.
pneumoniae, H. influenzae
type b, Neisseriae spp.
(gonococci and meningococci)
Infection Biology
• Leucocidin
o destroys both neutrophilic
leukocytes and macrophages (e.g.
Panton-Valentine Leucocidin or PVL)
Infection Biology
Guide Question:

Which of the following may be considered primarily responsible for the

development of cellulitis from a small furuncle?
A. Lipases
B. Hyaluronidases
C. Panton-Valentine leucocidins
D. Hemolysins
Infection Biology
Which of the following may be considered primarily responsible for the development of cellulitis
from a small furuncle?
A. Lipases
B. Hyaluronidases
C. Panton-Valentine leucocidins
D. Hemolysins

ANS: B. Hyaluronidases

Since hyaluronate is a major constituent of the ground substance of most connective tissues (the skin in
particular), hyaluronidase may be crucial for the spreading of pathogens from an initial site of infection.
Hyaluronidase, therefore, is also known as the ‘spreading factor.’ e.g. A pimple today becomes cellulitis
tomorrow!
Infection Biology
VIRULENCE FACTORS
• Polysaccharide Capsule
o protect against phagocytosis
• Cell Wall Proteins
o M protein of S. pyogenes (group A Streptococcus) of antiphagocytic (via
molecular mimicry – it can cause the autoimmune response seen
in acute rheumatic fever)
TOXIN PRODUCTION
EXOTOXINS
Exotoxins
• polypeptides secreted by certain bacteria that
alter specific cell functions resulting in the
symptoms of disease
• have an A–B subunit structure:
o A subunit is the active (toxic) subunit
o B subunit is the binding subunit
EXOTOXIN
• Streptolysin O (Streptococcus pyogenes)
• Botulinum toxin (Clostridium botulinum)
• Enterotoxin (Staphylococcus aureus)
• TSST-1 (Staphylococcus aureus)
• Exfoliative toxins A, B (Staphylococcus aureus)
• Shiga toxin (Shigella dysenteriae)
• Tetanus toxin (Clostridium tetani)
• Cholera toxin (Vibrio cholerae)
ENDOTOXIN
Endotoxin
• Lipopolysaccharides (LPS) located in the outer membrane of gram-negative
bacteria
• Lipid A is the toxic component of LPS
ENDOTOXIN
Endotoxin is a component
of Gram (-) bacteria and
Endotoxin
plays an important role in
the pathogenesis of septic
shock when it is recognized
by the immune cells.

Activates Activates Activates tissue

macrophages complement factor

Hypotension, Disseminated
Fever, hypotension edema, neutrophil intravascular
chemotaxis coagulation
Bacteriology
Staphylococcus spp.
Staphylococcus aureus
• gram-positive cocci in grape-like clusters
• yellow or golden colonies on blood agar
• catalase-positive
• coagulase-positive
Staphylococcus aureus
HABITAT
• human nose (anterior nares) and skin

TRANSMISSION
• direct contact (hands)
• fomites - objects or materials which are likely to carry infection, such as clothes, utensils, and furniture.
• contaminated food
Staphylococcus aureus
Toxins
• Exofoliatin A and B: superantigen causing epidermal
separation in Staphylococcal Scalded Skin Syndrome
• Enterotoxins (heat-stable): superantigens causing food
poisoning
• Toxic shock syndrome toxin (TSST-1): superantigen
leading to toxic shock syndrome
Staphylococcus aureus
Clinical Syndromes

PYOGENIC:
• Skin and Soft Tissue Infections – bullous impetigo
• Acute Endocarditis - most common cause of acute
endocarditis
• Pneumonia – most common cause of bacterial
pneumonia post-viral infection
Staphylococcus aureus
TOXIGENIC:
• Gastroenteritis - due to ingestion of heat-stable enterotoxin
• Scalded Skin Syndrome (Ritter Disease)
o separation of skin at stratum granulosum
• Toxic Shock Syndrome
o fever, hypotension, sloughing of filiform papillae -
strawberry tongue, desquamating rash and
multi-organ involvement (>3)
o tampon-using menstruating women or in patients with
nasal packing for epistaxis
Staphylococcus epidermidis
• low-virulence organism
• glycocalyx adheres well to foreign bodies and form biofilms
o prosthetic heart valves
o prosthetic joints
o indwelling catheters
Staphylococcus saprophyticus
• gram-positive cocci in clusters
• catalase-positive
• coagulase-negative
• novobiocin-resistant (S. epidermidis is novobiocin-sensitive)
• whitish, non-hemolytic colonies on blood agar

EPIDEMIOLOGY
• 2nd most common cause of UTIs in sexually active women

CLINICAL FINDINGS
• dysuria, pyuria, and bacteriuria