Bacterial Virulence Factors

The objective of this essay is to identify, analyse and evaluate bacterial virulence factors, their effects on the host tissues and the way bacterial organisms use opportunities to transfer and activate virulence factors. Virulence refers to a bacterial organisms ability to induce infection and disease. Virulence of bacteria depends on several factors and conditions of the bacterial environment, including; host susceptibility, bacterial infectivity, host resistance, and virulence factorsi. (Baron, 1996)

The human relationship with bacterial organisms is symbiotic: meaning cause and effect could be either commensal or mutual; with non-commensal flora and pathogens as commensal. (Williams, 2011) Pathogenic or opportunistic bacteria invade the human body by transmission from a reservoir and bypass the physical barriers of the body to suppress the immune system and its response. The goal is to compete with commensal flora and attach to nutrient rich site; producing toxins for detrimental infection to the host and to develop resistance. (Williams, 2011)

Bacterial bodies which are normally harmless i.e. commensal flora can become pathogenic when transferred from their normal environment into the host (opportunistic bacteria). E.coli, Pseudomonas, Acinetobacter, Serratia, and Proteus are examples of opportunistic pathogens. Circumstances whereby the host is compromised or exposed, i.e. whose resistance is impaired by disease, therapy, burns or by injections give rise to opportunistic invasion. An example is when direct injection into the blood via a wound causes septicaemia. Infections such as urinary tract infection (UTI) arise from Escherichia coli entering the body via the urethra. (Williams, 2011). Hospitals are primary sources of such infections with a large amount of compromised patients and many potential sources (reservoirs) for bacterial growth i.e. catheters, drips, dressings etc. (Williams, 2011)

Strains of bacteria have managed to develop and maintain resistance to antibiotics due to the widespread of their use, especially in hospitals where various abundant forms of medication are administered for treatments. This combined with the increased susceptibility of patients and the additional routes of entry has caused major problems in all hospitals. (Williams, 2011) The infamous example is MRSA (methicillinresistant Staphylococcus aureus) which is resistant to all antibiotics except Vancomycin. This bacterium is easily transferable especially between the patients and staff via commensal flora. This is difficult to control and it compromises the health of hospital patients, exposing them to a majority of additional health problems such as fatal infections and diseases. Due to the nature of resistance genes of bacteria, it is possible that resistance can be transferred from relatively harmless strains into more potent pathogens, creating highly resistant strains of bacteria known as super-bugs. (Williams, 2011)

The factors are types of virulence and their effect on the host tissue and holistic health:

Yasmin Acquah

Bacterial Virulence Factors

Table 7-1: Types of Bacterial Infections (edited from Baron, 1996ii) Virulence Factor Action Adherence Factors Many pathogenic virulent bacteria use pili (fimbriae) to colonise mucosal sites i.e. Escherichia coli produces fimbriae that can attach to the epithelium lining of the urogenital tract and cause bladder infection. Once attached, the bacterium cannot be removediii. Invasion Factors Virulent bacteria can translate host cells surface components on plasmids and chromosomes creating the ability to blend in with commensal flora Capsules Capsules surround many virulent bacteria which serve as protection against phagocytosis Endotoxins Gram-negative virulence bacteria are surrounded by fever inducing endotoxin (lipopolysaccharide) which also contribute to blood clotting, inflammation, lethal shock etc. Exotoxins Protein toxins and enzymes (i.e. proteases, collagenase and coagulases) are either secreted from virulent pathogenic virulent bacteria or released post-lytic cycle. Examples of exotoxins include enterotoxins, haemolysis, neurotoxins, and cytotoxins Siderophores Bacterial virulent factors which compete with commensal flora for iron rich attachment sites i.e. to bind to haemoglobin Immune Response Inhibitors This factor involves the immune systems response against bacteria in the form of indicator cytokine. A low dose of exotoxin is released to target and inhibit immune response indicators. E.g. Escherichia coli is a heat predisposed toxin which reduces the expression of interleukin 12 (IL-12) iv. (Wassenaar, 2011) Factors such as flagella aid the bacterium with Flagella swimming to favourable environments for survival purposes; therefore flagella play an important role in pathogenicityv. Bacteria have evolved numerous structural and metabolic virulence factors that enhance their survival rate in the host. (Baron, 1996) Non-encapsulated strains of bacteria are prone to phagocytosis and intracellular death than encapsulated strains of such as pneumococci; which are more virulent thus more resistant to immune defences. Bacterias i.e. pseudomonas, insensitivity to cell death are known to be serum resistant; as the bacterium feeds from human serum containing complement components. This arises from the relationship between surface structure of the capsule, lipopolysaccharide and virulence; whereby the amount and composition of capsular antigens present enhance virulence thus rendering the bacterium serum resistant. (Baron, 1996) Yasmin Acquah 2

Bacterial Virulence Factors

Some bacteria and parasites rely on their structure and composition of cell surface in order to enhance their ability to survive and multiply inside phagocytic cells e.g. Mycobacterium tuberculosis. The bacterium is able to alter surface antigens through mutation, creating unrecognizable progeny, thus eluding the immune response. Protozoan parasitic bodies such as Toxoplasma gondii, have the ability to inhibit their cell destruction by blocking hydrolytic enzyme containing lysosomes from fusing with the phagocytic vacuole in white blood cells. (Baron, 1996) Furthermore, bacterial virulence can also induce many illnesses that compromise the immune systems defence. Table 1: A list of diseases caused by exotoxins released from various bacteria cell lyses (from Williams, 2011). Disease Bacteria Scarlet fever Streptococcus pyogenes Cholera Vibrio cholerae Diphtheria Corynebacterium diphtheriae Gas Gangrene Clostridium perfringens Tetanus Clostridium tetani Botulism Clostridium botulinum

Figure 28.10 shows the process of muscle contractile dysfunction (botulism and tetanus) in skeletal muscles. The toxin released from C. botulinum blocks the release of acetylcholine contraction signals in one muscle (M). The other half of the antagonistic skeletal muscle (O) does not receive the glycine signal to relax, as it is blocked by C. tetani toxin. (Perry, 2011)

Figure 28.10: Diagram demonstrating the effect of the botulism toxin on the muscles contractile activity (from Perry et al, 2002) Word count: 997

Yasmin Acquah

Bacterial Virulence Factors

References:
i

Baron, S. (1996). Medical Microbiology. 4th ed. Galveston, Texas: University of Texas Medical Branch at Galveston. 239 ii Baron, S. (1996). Medical Microbiology. 4th ed. Galveston, Texas: University of Texas Medical Branch at Galveston. 239 Perry, J.J., Staley, J.T., and Lory, S. (2002). Microbial Life. Sinauer Associates Inc.,U.S. 431 iii The Virtual Museum of Bacteria (07 November 2011) Bacterial Pathogenicity. Accessed on 8/11/11 http://www.bacteriamuseum.org/cms/Pathogenic-Bacteria/bacterial-pathogenicity.html iv Wassenaar, T.M. (2011). Bacteria: The Benign, the Bad, and the Beautiful. John Wiley & Sons Inc. 81 v The Virtual Museum of Bacteria (07 November 2011) Bacterial Pathogenicity. Accessed on 8/11/11 http://www.bacteriamuseum.org/cms/Pathogenic-Bacteria/bacterial-pathogenicity.html

Yasmin Acquah