12. pathogenesis II Flashcards
the quantitative ability of an agent to cause disease. these agents cause disease when introduced into the host in small numbers. involves adherence, persistence, invasion and toxigenicity
virulence
the process by which bacteria stick to the surfaces of host cells. after bacteria have entered the body, this is a major initial step in the infection process
adherence
the process by which bacteria, parasites and fungi and viruses enter host cells or tissues and spread in the body
invasion
the ability of a microorganism to produce a toxin that contributes to the development of disease
toxigenicity
these are the objective changes in the body, such as fever, rash, that can be directly observed
signs
these are subjective changes, such as pain and loss of appetite, that are experienced by the patient
symptoms
what are the four stages of the infectious process?
- the incubation period
- the prodromal stage
- the illness period
- the convalescence (recovery) period
this period of the infectious process is the time between pathogen entry and development of signs and symptoms. the pathogen is reproducing but has not reached a sufficient level to cause clinical manifestation. this periods length varies with the pathogen
the incubation period
this period of the infectious process occurs with an onset of signs and symptoms that are not yet specific enough to make a clear diagnosis. however, the patient is often contagious
the prodromal period
this period of the infectious process occurs when the disease is the most severe and displays characteristic signs and symptoms. the host immune response is typically triggered at this stage
the illness period
this period of the infectious process is the period of decline, the signs and symptoms begin to disappear
the convalescence (recovery) period
pathogens adhere with a ______ degree of specificity to particular tissues
high
the cell surfaces of both bacteria and host cells are ________
hydrophobic
in general, the more hydrophobic the bacterial cell surface the ________ the adherence to the host cell
greater
is gram positive or gram negative bacteria more hydrophobic?
gram neg
examples of this are pili and fimbrae, membrane and capsular materials (glycocalyx, capsule or S layer), and specialized adhesion molecules on the surface of the invading microbe
adherence factors/adhesions
these are the main adherence virulence factors that mediate ligand-receptor mechanisms to adhere to host cell surfaces
pili (or fimbrae)
______ strains have type 1 pili, which adhere to epithelial cell receptors
E.coli
E.coli organisms that cause urinary tract infections commonly have _____
P-pili
these have fimbrae that consist partly of protein F, and M protein and are covered by lipoteichoic acids (LTA)
group A streptococci e.g. Streptococcus pyogenes
_____ and ________ cause adherence of the Streptococci to buccal epithelial cells (e.g. cause sore throat)
LTA and protein F
during this step of a pathogen infecting a host, the bacterial pathogens actively penetrate the hosts mucous membranes and epithelium. this is accomplished by secreting lytic substances or enzymes such as coagulase, collagenase, hemolysins
invasion
how do hyaluronidase and collagenase work?
1, attacking the extracellular matrix and basement membranes of body surfaces (integuments) and intestinal linings
2. degrading carbohydrate-protein complexes between cells or on the cell surface
- some pathogens may penetrate to deeper tissue and continues disseminating through the body of the host
in this type of pathogen, after adherence occurs, conformational changes in the cytoskeleton of the host cell allow the uptake of the bacteria
intracellular pathogen
these three bacteria induce the polymerization of the host cell actin which induces the formation of pseudopods by the host cells and engulfing of the pathogen (invasion); they also activate the assembly of an actin tail and other cytoskeleton proteins, which propel the bacteria within the host cell and from one cell to another
- Listeria monocytogenes
- Shigella spp.
- Rickettsia spp.
invasiveness varies greatly among pathogens. for some pathogens, a ______ infection is sufficient to cause disease. however, many pathogens invade other tissues
localized
_______, the cause of tetanus, is considered noninvasive because it does not spread from one tissue to another, but its toxin becomes blood-borne, thereby causing disease
Clostridium tetani
______ the cause of anthrax and ______ the cause of plague also produce toxins and they are highly invasive
Bacillus anthraces and Yersinia pestis
how do pathogens get access to all organs and systems of the host?
some pathogens may enter the small terminal lymphatic capillaries that surround epithelial cells. these capillaries merge into large lymphatic vessels that eventually drain into the circulatory system.
the presence of viable bacteria in the bloodstream is called
bacteremia
this is a substance that disrupts the normal metabolism of host cells with deleterious effects on the host
toxin
these are disease that result from the entrance of a specific preformed toxin into the body of a host
intoxications
true or false: intoxications require the presence of the actively growing pathogen
false - just its toxin
toxins are classified into two main groups which are:
- exotoxins
- endotoxins
these are toxins that are secreted outside the cell
exotoxins
these are toxins that are part of the outer membrane of gram negative bacteria
endotoxins
endotoxin or exotoxin? is excreted by a living cell
exotoxin
endotoxin or exotoxin? is an integral part of the cell wall of gram negative bacteria; released on bacterial death and in part during cell division
endotoxin
endotoxin or exotoxin? found only in gram negative bacteria
endotoxin
endotoxin or exotoxin? produced by both gram negative and gram positive bacteria
exotoxin
endotoxin or exotoxin? a polypeptide
exotoxin
endotoxin or exotoxin? lipopolysaccharide complexes; lipid A portion probably responsible for toxicity
endotoxin
endotoxin or exotoxin? relatively unstable; toxicity often destroyed rapidly by heating at temperature above 60 degrees cels
exotoxin
endotoxin or exotoxin? relatively stable. withstand heating at temps above 60 degrees cels for hours without loss of toxicity
endotoxin
endotoxin or exotoxin? weakly immunogenic `
endotoxin
endotoxin or exotoxin? highly antigenic; stimulate formation of high titer antitoxin
exotoxin
endotoxin or exotoxin? highly toxic; fatal to animals in microgram quantities or less
exotoxin
endotoxin or exotoxin? moderately toxic; fatal to animals in tens to hundred of micrograms
endotoxin
endotoxin or exotoxin? usually do not produce fever in the host
exotoxin
endotoxin or exotoxin? usually produce fever in the host
endotoxin
endotoxin or exotoxin? frequently controlled by extrachromosomal genes (e.g. plasmids)
exotoxin
endotoxin or exotoxin? synthesis directed by chromosomal genes
endotoxin
exotoxins can be divided into three groups which are
- AB exotoxins
- specific host site exotoxins
- membrane-disrupting exotoxins
this group of exotoxins consists of A and B subunits (often referred to as binary toxins or type III toxins).
AB exotoxins
this subunit of the AB exotoxins provides the toxic activity
A
this subunit of the AB exotoxins is used for the adherence and entry of the toxin complex to a host cell
B
an example of an AB exotoxin is ______________ produced by Corynebacterium diphtheriae and causes diphtheria disease (swollen neck or throat)
diphtheria toxin
an example of a specific host site exotoxin is ________
neurotoxins - specifically affects nervous tissue
an example of a specific host tissue exotoxin is ______ produced by Clostridium bootulinum and causes botulism; it is one of the most lethal toxins known
botulinum toxin
what is the toxin that is produced by C. tetani that causes tetanus
Tetanospasmin toxin
this is an example of a specific host tissue exotoxin that is an enterotoxin, thus it affects the intestinal mucosa and causes toxic shock syndrome
staphylococcal enterotoxin
this is a type of specific host tissue exotoxin that has a specific toxic action upon cells/tissues of a special organ
cytotoxins e.g. nephrotoxin, hepatotoxin
this is a type of exotoxin that disrupts th integrity of the plasma membrane. e.g. leukocidins toxins that kill phagocytic leukocytes
membrane disrupting exotoxins
vaccines have been developed for some of the exotoxin-mediated disease and continue to be important in the prevention of disease. these vaccines are called _____ and are made from modified exotoxins that are no longer toxic
toxoids
regarding endotoxins, if _________ gets in the bloodstream, it interacts with receptors on macrophages and neutrophils which causes the release of pro inflammatory cytokines. the following can be observed: fever, diarrhea, hypoglycaemia, hypotension, shock resulting in impaired perfusion of essential organs (e.g brain, heart, kidney) and death from massive organ dysfunction
lipopolysaccharide (LPS)
this is a tissue degrading enzyme which degrades collagen in connective tissue, and is produced by Clostridium perfringens and promotes the spread of infection in the tissue
collagenase
this is a tissue degrading enzyme that hydrolyze hyaluronic acid, a substance of connective tissue. they are produced by many bacteria and aid in their spread through tissues
hyaluronidases
this is a tissue degrading enzyme produced by Staphylococcus aureus and works with blood factors to coagulate plasma. it contributes to the formation of fibrin walls around staphylococcal lesions which help them persist in tissues
coagulase
some pathogens evaded phagocytosis by absorbing normal host components to their surfaces. an example of this is ______________ (bacteria) has surface protein A which binds to the Fc portion of IgG
S. aureus
what are some pathogens that impede phagocytosis?
- polysaccharide capsules
- S. pyrogens: has M protein
- N. gonorrhoeae has pili
_____ of pathogenic bacteria encode for pathogenic agents or virulence factors that could be found in chromosomes (as PAIs), plasmids, or as transposons or phage encoded
genes
these are large groups of evens that are associated with pathogenicity and are located on the bacterial chromosome, they have one or more virulence genes. they have a different G+C content than the rest of the bacterial genome and they are commonly associated with tRNA genes
pathogenicity islands
what is the PAI name and virulence characteristics of E.coli?
PAI I536, II536
alpha hemolysin, fimbriae, adhesions, in UTI
what is the PAI name and virulence characteristics of Salmonella serotype Typhimurium?
SPI-1
invasion and damage of host cells, diarrhea
what is the PAI name and virulence characteristics of Staphylococcus aureus?
SCC mec/SaPl1
methicillin and other antibiotic resistance/toxic shock syndrome toxin-1, enterotoxin