IMMUNOLOGY

Infection and Diseases

Infection is the process by which the microorganism
enters into a relationship with the host.

Essential Steps
Entrance Multiplicaton Propagation
GIT Locally Portal of exit

Genitourinary tract Spread to target organ Mode of

transmission
Respiratory tract

Skin, mucous
membrane
 Outcome of Infections
 Abortive
 Subclinical or silent

 Clinical

Outcome depends on:

1- Microbial factors ( pathogenicity and
virulence)
2- Host resistance ( natural and acquired)
 Types of Microorganisms

Commensal or normal microbial flora

Opportunistic microorganisms

Pathogenic microorganisms
 Opportunistic Microorganisms
(potential pathogens)
They can cause disease under the following
conditions:

1- Host defence mechanisms are lowered.

2- The natural habitat of the organism is
changed.
3- Alteration in the host tissue occurs.
 Pathogenic Microorganisms
( true pathogens)
They are pathogens capable of infecting the
tissues of normal healthy subjects.

Properties of true pathogens

Infectivity Virulence Transmissibility

 Infectivity

Pathogen  portal of entry  initiates

infection.

The capacity to initiate infection depends on:

1- Dose of pathogen.
2- Growth phase ( more infective in log
phase)
3- Virulence.
 Virulence
It is the degree of pathogenicity of the organism.

Virulence Factors
a- Adherence factors e.g. pili.
b- Invasiveness ( ability to invade tissue, multiply and spread
rapidly).

c- Toxin production. ( endotoxins, exotoxins)

d- Extracellular enzymes. ( help to establish infection e.g.
hyaluronidase, coagulase, fibrinolysin, collagenase).
 Transmissibility
Organisms should have:

a) Portal of exit ( e.g. urine, stools, blood,

body secretions).
b) A mode of transmission to a new host ( e,g.
hands,objects, insects, droplets).
 Characteristics of Exotoxins and Endotoxins

Exotoxins Endotoxins

1- Excreted by living cells. 1-Released upon bacterial death,

part of Gram negative cell wall.

2- Produced by Gram +ve and 2- Only found in Gram –ve

some Cram –ve bacteria. bacteria.
3- Polypeptides. 3- LPS complex.
4- Relatively unstable. 4- Relatively stable.
5- Highly immunogenic. 5- Weakly immunogenic.
 Characteristics of Exotoxins and Endotoxins
Exotoxins
6 –Converted to toxoids.
7- Highly toxic.
8- Binds to specific receptors
on host cells, have selective
effect on tissues e.g.
leucocidins, haemolysins,
necrotoxins.
9- Do not produce fever in
host.
Endotoxins
6- Not converted to toxoids.
7- Less toxic.
8- No specific receptors on host
cells, produce nonspecific
effects as pyrexia, hypotention,
shock.
9- Usually produce fever by
release of IL-1 and other
mediators.
 Sources of Infection to Man
A) Exogenous: B) Endogenous:

1- Patients. 1- E. coli from gut UTI.

2- Healthy carriers. 2- Staph aureus from nose
3- Infected animals.  skin boils.
4- Soil. 3- Pneumococci from
nasopharynx 
bronchopneumonia.
 :C) Hospital acquired infections

: Infections may be acquired in the hospital

-Endogenously -1
.from patient’s own normal flora -
-Exogenously -2
from other people (cross infection). - -
- from inanimate objects in the hospital
. environment (environmental infection)
 Modes of Infection
1- Respiratory infections.
2- Skin, wound and burn infections.
3- Venereal infections.
4- Alimentary tract infections ( faecal-oral route):
a) Food-borne infection.
b) Water-borne infection.
5- Percutaneous transmission.
6- Laboratory infection.