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Enteric pathogen bacteria • Enterobacteriaceae • Gram negative • Exotoxin enterotoxin • Endotoxin in cell walls(LPS) Antigens 3 major groups of antigens: 1. Somatic O Lipopolysacharides 2. Capsular K antigens / Vi antigen 3. Flagellar H proteins Virulence Factors • • • • • • Enterotoxin Capsule Antigenic phase variation Exotoxin production Adhesion factors Intracellular survival and multiplication protecting from antibiotic&immune reaction • Antimicrobial resistance exposure to antibiotic • Resistance to serum killing capsule Endotoxin. - Lipid A component of LPS - Release upon cell death & lysis Endotoxin Mediated Toxicity: - Fever - Leukopenia - Activation of complement - Thrombocytopenia - Disseminated Intravascular coagulation - Decreased peripheral circulation - Shock - Death Exotoxin production - Enterotoxin - Shiga&shiga like toxin cytotoxic,enterotoxic - Hemolysins Desease due to Enterobacteriaceae 1. Intestinal Infections Pathogenic processesinvasive 2. Extra intestinal Infections Enteric commensals opportunistic pathogens • • • • • Enteritis : non bloody diarrhea Septicemia Enteric fever Asymptomatic carriage/chronic carriage Shigellosis: pus&bloody in the stoolmucosal ulceration. Pathogenesis 1. Bacteremia- Septicemia Ingestion of bacteriasmall intestine mesenteric lymph node bacteremia RES system(multiplication)septicemia and BileGall bladder:. Cholecystitis . Carriage stage Inflamation&ulceration of Peyer’s patches 2. Infection is limited to the mucosa and sub mucosa of the intestine Clinically Significant Nonfermentative Gram Negative Bacilli • Pseudomonas • Acinetobacter Virulence Factors Assosiated with Pseudomonas: . Pili . Exotoxin . Capsule . Enzymes . Endotoxin Infections Opportunistic pathogen 1. Bacteremia 2. Endocarditis 3. Pulmonary Infections 4. Ear Infection 5. Burn wound Infection 6. UTI 7. Eye Infections ,ect