Staff members of microbiology and

immunology,
faculty of medicine,
Helwan university
 continued

Objectives:
— Understand the meaning and types of pathogen.

— Identify the meaning, types, sites and effect of

bacterial carrier.

— Understand the meaning of infection and disease.

— Explain factors that govern disease production.

— Recognize the meaning of bacterial
pathogenicity.

— Identify virulence factors of bacteria.

— Differentiate between exotoxin and endotoxin.

 Microorganism is pathogen
when it is able to cause
disease

Saprophytic: live Parasitic: live in/on

freely on nature living host

Pathogenic: Commensal: live in/on living host

cause disease without causing disease

Opportunistic: under certain

conditions commensals cause
disease.
How can commensals
become
opportunistic ?
Lowered host defense

Alteration of the host

tissue

Change in natural
habitat of the
organism
Bacterial carrier
Carrier
— Healthy or diseased?

— Possess microorganism or no?

— Transmit microorganism or no?

Carrier:
—Healthy.

—Possess microorganism.

—Transmit microorganism.
 Carrier

Transient
Permanent
(incubation
(chronic)
period)
Are carriers serious?
Why carriers are serious?
Not confined
No manifestations.
to bed.

Communicate
normally with Carry organism in the
entire epidemic period.
public.
 Infection and disease
— Infection: relation between microorganism and
host.

— Disease: destruction of host tissue by the

organisms due to:
1- Invasion of tissue.
2-Toxin production.
3-Other virulence factors.
 source

The Portal
infection
of
to occur needs:
exit
reservoir

Mode of
multiplication
transmission

Portal of
entry
Factors that govern disease production

Microbial Host resistance

factors factors

Virulence pathogenicity
Natural Acquired
immunity immunity
Microbial factors
— Pathogenicity: the ability to cause
disease.

— Virulence: Degree of pathogenicity.

 Bacteria
Virulent Moderately Avirulent
virulent

Cause disease Cause no

Mild disease disease
 Virulence factors
of bacteria

Invasive
Adherence Survive
factors intracellularly
factors
Antigenic Toxin
variation production
I- Adherence factors:

Pili Fimbriae Glycocalyx

N.Gonorrhea
Streptococci Staph.epidermidis
E.coli

attachment to Adherence to
Adherence to
urinary tract endothelium
buccal mucosa.
epithelium. of heart valves.
I- Invasive factors:
Antiphagocytic Extracellular enzymes
Collagenase
Capsule hyalouronidase
Lecithenase
Phospholipase.
Streptokinase
Streptodornase

IgA protease
III- Ability to survive intracellularly
— M. tuberculosis and Legionella:

Inhibit phagosome-lysosome fusion.

— Lesteria:

Escape phagosome to cytoplasm before phagosome-lysosome

fusion.
IV- Antigenic variation
—Pathogens change their
surface antigen and evade
the immune system.
V- Toxin production
— Bacterial products which have direct
harmful action on tissue cells.

Exotoxin Endotoxin
 continued

Exotoxin:
— Nature: Protein.

— Toxicity: quite toxic.

— Bacteria: living.
— Site of action: diffuse extracellularly to
surrounding medium.

— Control of production: genes on

plasmids and bacteriophage.

— Action: specific, neurotoxin, enterotoxin

………...
Endotoxin:
— Nature: Lipopolysaccharide.

— Toxicity: lipid A of lipopolysaccharide,

highly toxic.

— Bacteria: dead.
— Site of action: general effect.

— Controlof production: genes on

chromosomes.

— Action (generalized) (endotoxic or

septic shock):
ü Fever.
ü Hypotention.
ü DIC.
ü Shock and death due to massive organ failure.
Property Exotoxin Endotoxin
Location of
genes
Composition
Action
Heat stability
Diffusibility
Immunogenicity
Toxicity
Convertibility to
toxoid
Produced by
Property Exotoxin Endotoxin
Location of Plasmid, Bacterial chromosome
bacteriophage, PAIs.
genes
Composition Proteins Lipopolysaccharide

Action Specific Non0specific

Heat stability Labile, destroyed at Stable at 100 °C for 1

60°C. hour.
Diffusibility Diffusible Not diffusible
Excreted by living cell Integral part of cell wall
Immunogenicity Strong induce high titer Weak immunogenicity
of antitoxin
Toxicity Strong Weak

Convertibility to Yes No

toxoid
Produced by Gram positive mainly. Gram negative.
—Define!
übacterial carrier.
üPathogen.
üParasitic.
üCommensal.
—Illustrate chain of
infection!
—Innumerate bacterial
virulence factors!
—Differentiate between exotoxin
and endotoxin!