BACTERIAeL INFECTION

BaedahMadjid
Depart. of Microbiology,
Medical Faculty, Hasanuddin University.
2007
LEARNING OBJECTIVES :
Student must able to explain about the patho-mechanisms of infection
LEARNING OUTCOMES
Student must know how to explain about:
o the role of the bacterial normal flora
o the stages of the bacterial pathogenesis
o the microbial factors involved in the onset and spread of the microbial infection.
o the strategy for the bacterial survival
o the factors affect the outcome of the infection
POINTS TO DISCUSS
o Definition : terms connected
o The Role of the Normal flora in Diseases
o Transmission of the Infection
o The Stages of bacterial pathogenesis
o Factors affect the outcomes of the infection
o Summary
DEFINITION
o Normal Flora: microorganisms that are frequently found in the various body sites in
normal, healthy individuals.
o Pathogens :
- in medicine: the pathogen is any microorganisms capable of causing diseases
- microbiology: being pathogen microbe must posses virulence factors
(microbial pathogenicity)
o Pathogen opportunistic
The non-pathogen bacteria pathogen on susceptible host
o Pathogenesis = pathogeny: the organization & development of the infection
o Pathogenicity: the quality or state or being pathogenic; degree of pathogenic capacity.
o Invasion: the penetration of the hosts body by microorganisms

106

NORMAL MICROBIAL FLORA

o Normal Flora: microorganisms that are frequently
found in various body sites in normal, healthy
individuals.
o Origin of human NF: environment : other human
skin & mucous, water, air
o One organism will always predominate in one
anatomical site. This balance between microbes
and the host tends to be stable.
o The constituents and the numbers of the flora
vary in different areas and sometime at different
ages &physiologic states
o Mostly bacteria, & some fungi
- Non pathogen
- Pathogen Carrier state
o Bacterial normal flora :
- Resident NF: strain that have an establish
niche at one of the body sites
- Transient NF:
acquired from the environment
establish themselves briefly
excluded by:competition and hosts innate
or immune defense mechanisms.
ECOLOGY OF NORMAL FLORA
o Ecology is a science concerned with the interrelationship of organisms and their environment.
o The environment of an organism is the product of the presence and activities of other
organisms that inhibit it is of nonliving chemical and physical forces.
o That product are from :
- other microorganisms
- the host
o The organisms tend to segregate and to becoe adapted to a particular habitat or
environment niche.

HOST - NF RELATIONSHIP
Host - NF relationship symbiotic :
living animals/human use as habitats by other organisms can be grouped as:
- Commensalisms : one species use the body of other larger species
- Mutualism: provide reciprocal benefits for the two organisms involved.
- Parasitism : benefits only the parasite.

107

ROLE OF NF IN DISEASES
o Flora that reach sterile sites may cause disease:
- E. coli urinary bladder UTI
- Perforation of the colon from rupture a diverticulum or a penetrating abdominal wound
feces into peritoniumperitonitis caused primarily by facultative members of the
flora.
o Mouth flora may reach heart valves by transient bacteremia colonized a previously
damaged heart valve.
o Mouth flora plays mayor role in dental carries.
o Compromised immune system opportunity for invasion opportunistic pathogen
o Non-specific toxic effects of colonic flora are Postulated
o Blind-loop overgrowth may cause fat malabsorption and B12 deficiency.
o Colonization of jejenum occur in sprue
o Ammonia production and bypass lead to hepatic encephalopathy.
NF'S BENEFICIAL TO HUMAN BEING
o Priming of Immune system: Sterile animal has little immunity to infection
o Exclusionary effect
- Lactobacilus vaginal flora protect host against transmitted N. gonorrhea
- Exclusionary effect makes entrance of pathogens more difficult
o Production of Essential Nutrients
- Help food digestion
- Produce some vitamins
STAGES OF BACTERIAL PATHOGENESIS
o Contamination port the entry: epithelium cell
o Attachment to host cells = adherence
o Invasion = Penetration
o Multiplication
o Dissemination
o Elimination = Resolution

108

109

110

Toxin produced by bacteria # 2

Mode of Action of Exotoxin
o As superantigen : Staph. aureus (enterotoxin & TSST), Clost. perfringens, Bacillus
cereus, Strept. pyogenes (erythrogenic toxin)
o Inactivates GTPases in enterocytes: Clost. difficile
o Stimulates adenylatecyclase : Vibrio cholerae, toxigenic E. coli, Bordetella pertussis
o Inactivates protein synthesis: E. coli O157, C. diphtheriae
o Inhibits glycine release: Clost. tetani
o Inhibits acetylcholine release: Clost. botulinum
o Inhibits chemokine receptor: Bordetella pertussis
o Protease cleaves desmosome in skin: Staph. aureus(scalded skin syndrome)
o Lecithinasecleaves cell membranes: Clost. perfringens
o An adenylatecylase: edema factor of Bacilusanthracis
o A protease: lethal factor of Bacilusanthracis
The Biologic Effects of Endotoxins
o Fever : release of endogenous pyrogen (interleukin-1) from macrophages
o Hypotension, shock and impaired perfusion of essential organ: bradykinin-induced
vasodilatator membrane permeability & peripheral resistance
o Disseminated intravascular coagulation: activation of the coagulation system
thrombosis, petechial or purpuric rash and tissue ischemia vital organ failure .
o Activation of the alternative pathway of the complement: inflammation and tissue
damage
o Activation of macrophages: phagocytic ability , Ab production (ctivation of many
clones of B lymphocytes)

111

6. ELIMINATION
Bacteria can be eliminated by:
1. Natural host defense:
- Lysozyme and other enzyemes
- Acid
- Complement
2. Acquired host defense:
- Antibodies
3. Antibiotics therapy

Catatan:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

112