Bacterial Pathogenesis

by Salyers, Abigail A.; Whitt, Dixie D.

• ISBN13: 9781555811716
• ISBN10: 155581171X
• Edition: 2nd
• Format: Paperback
• Copyright: 2001-12-01
• Publisher: Amer Society for Microbiology

Summary

Univ. of Illinois, Urbana. Text provides a comprehensive introduction to bacterial pathogenesis for students and researchers. Integrates material from pathogenic microbiology, molecular biology, immunology, and human physiology. More than 175 illustrations are included. Previous edition: c1994. Softcover. DNLM: Bacterial--pathogenicity.

Table of Contents

Preface	xv
Foreword	xix
PART I Basic Principles	1	(184)
The Uneasy Truce: Never Underestimate the Power of Bacteria	3	(16)
Why Bacteria Are Once Again in the Public Health Spotlight	3	(1)
Ancient History Takes a Toll on Today's Human Health	4	(1)
Pressing Current Issues	5	(9)
Emerging and Reemerging Infectious Diseases	6	(4)
Food-Borne and Water-Borne Infections	10	(1)
Modern Medicine as a Source of New Diseases	11	(1)
Microbiota Shift Diseases	11	(1)
Genomics	12	(1)
Bioterrorism	13	(1)
New Solutions, New Hope	14	(1)
New Respect for Prevention	14	(1)
Surveillance--an Early Warning System	14	(1)
Making Hospitals Safe for Patients	15	(1)
And Now for the Really Good News--You've Got a Bacterial Infection	15	(1)
Selected Readings	16	(1)
Summary Outline	17	(1)
Questions	18	(1)
Approaching and Studying Bacterial Diseases	19	(15)
Microbes and Disease	19	(5)
Establishing a Connection--Koch's Postulates	19	(3)
Concepts of Disease	22	(2)
Measuring Infectivity and Virulence	24	(1)
Animal Models	24	(7)
Tissue Culture and Organ Culture Models	28	(3)
Good Information about the Pathology of a Disease	31	(1)
Selected Readings	31	(1)
Summary Outline	31	(2)
Questions	33	(1)
Molecular Approaches to the Diagnosis and Characterization of Bacterial Infections	34	(19)
Seeking Insights into Virulence	34	(2)
Molecular Koch's Postulates	34	(1)
Virulence as a Complex Phenomenon	34	(1)
The Importance of Bacterial Physiology	35	(1)
Molecular Microbe Hunting	36	(4)
Role of Molecular Methods in Diagnosis	36	(2)
PCR	38	(1)
Checkerboard Hybridization	38	(2)
RAPID-PCR	40	(2)
Ligase Chain Reaction	40	(1)
Ribotyping or Insertion Sequence Typing Using Restriction Fragment Length Polymorphisms (RFLP)	41	(1)
PFGE	42	(1)
Identifying Virulence Factors Experimentally	42	(8)
Cloning, Transposon Mutagenesis, and Transcriptional Fusions	42	(4)
Finding Genes That Are Expressed In Vivo	46	(2)
Signature-Tagged Mutagenesis	48	(1)
Molecular Mania--a Boon or a Boondoggle?	48	(2)
Selected Readings	50	(1)
Summary Outline	50	(2)
Questions	52	(1)
The First Line of Defense Against Infection: Prevention and the Phagocytic Cell Response	53	(16)
An Ounce of Prevention	53	(1)
The Human Brain--the First Line of Defense against Infection	53	(1)
Nonspecific and Specific Defenses	54	(3)
Definitions	54	(1)
Connections between Nonspecific and Specific Defense Systems	54	(2)
Fashion Statement	56	(1)
Epithelia	57	(1)
Defenses of Skin	57	(3)
Chemical and Physical Barriers to Bacterial Colonization	57	(1)
Normal Microbiota	58	(1)
Defenses of the Dermis	59	(1)
When Skin Is Breached	59	(1)
Common Themes	59	(1)
Defenses of Mucosal Surfaces	60	(1)
Phagocytes and Nonspecific Cytotoxic Cells: Defende of Blood and Tissue	60	(5)
A Versatile Defense Force	60	(2)
Distribution of Phagocytic and Cytotoxic Cells	62	(2)
How Phagocytes Kill Bacteria	64	(1)
Just Say NO	65	(1)
Collateral Damage	65	(1)
Killing by Nonspecific Cytotoxic Cells	65	(1)
Selected Readings	65	(1)
Summary Outline	66	(2)
Questions	68	(1)
The First Line of Defense, Continued: Complement, Chemokines, and Cytokines	69	(15)
Characteristics and Roles of Complement	69	(2)
Steps in Complement Activation	71	(1)
Role of Cytokines and Chemokines in Directing the Phagocyte Response	72	(4)
Other Activities of Cytokines	76	(1)
Stress and Resistance to Disease: Connections between the Nervous System and the Immune System	77	(1)
The Dark Side of the Nonspecific Defenses: Septic Shock	77	(4)
Selected Readings	81	(1)
Summary Outline	81	(2)
Questions	83	(1)
The Second Line of Defense: Antibodies and Cytotoxic T Cells	84	(17)
Antibodies	84	(4)
Characteristics of Antibodies and Their Diverse Roles in Preventing Infection	84	(1)
Serum Antibodies	85	(2)
Secretory Antibodies--Antibodies That Protect Mucosal Surfaces	87	(1)
Affinity and Avidity	87	(1)
Cytotoxic T Cells	88	(1)
Production of Activated Cytotoxic T Cells and Antibodies	88	(5)
Processing of Protein Antigens by APCs	88	(2)
Interaction between APCs and T Cells: The T-Cell-Dependent Response	90	(1)
The Th1/Th2 View of Immunity Development	91	(1)
Production of Antibodies by B Cells	91	(1)
Links to Nonspecific Defenses	92	(1)
T-Independent Antigens	92	(1)
Mucosal Immunity	93	(2)
Development of the Specific Response System from Infancy to Adulthood	95	(1)
The Dark Side of the Specific Defenses--Autoimmune Disease	95	(1)
Selected Readings	96	(1)
Summary Outline	96	(4)
Questions	100	(1)
Vaccination--an Underappreciated Component of the Modern Medical Armamentarium	101	(14)
Vaccines--a Major Health Care Bargain	101	(2)
The Current Vaccine Situation	101	(2)
A New Form of Child Abuse (as if We Needed One)	103	(2)
The Success Stories	105	(3)
The Less-than-Success Stories	108	(3)
New Directions	111	(1)
Passive Immunization	112	(1)
Selected Readings	112	(1)
Summary Outline	113	(1)
Questions	114	(1)
Bacterial Strategies for Evading or Surviving the Defense Systems of the Human Body	115	(16)
Overview of Bacterial Defense Strategies	115	(1)
Colonization and Invasion of Host Surfaces	116	(7)
Penetrating Intact Skin	116	(1)
Penetrating the Mucin Layer	116	(1)
Resisting Antibacterial Peptides	117	(1)
Adherence	117	(4)
sIgA Proteases	121	(1)
Iron Acquisition Mechanisms	121	(1)
Invasion and Intracellular Residence	122	(1)
Evading Complement, Phagocytes, and the Antibody Response	123	(1)
Capsules	123	(4)
Resistance to Nitric Oxide	124	(1)
Other Strategies for Circumventing Complement and Phagocytes	124	(1)
Surviving Phagocytosis	124	(1)
Evading the Host's Antibody Response	124	(2)
The Opportunists	126	(1)
Selected Readings	127	(1)
Summary Outline	128	(2)
Questions	130	(1)
Bacterial Exotoxins: Important but Still a Mystery	131	(19)
Exotoxins, Toxic Proteins Produced by Bacteria	131	(7)
Transparent Mechanisms, Mysterious Purposes	131	(1)
Characteristics and Nomenclature	132	(1)
Exotoxin Structure and Function	133	(2)
Secretion and Excretion of Exotoxins	135	(3)
Examples of Diseases Caused by Toxins	138	(9)
Diphtheria	138	(4)
Botulism and Tetanus	142	(3)
Wound Infections	145	(1)
Toxins and Shock	146	(1)
Pasteurellosis	147	(1)
Selected Readings	147	(1)
Summary Outline	148	(1)
Questions	149	(1)
Antimicrobial Compounds	150	(18)
Antimicrobial Compounds: the Safety Net of Modern Medicine	150	(1)
Importance of Antimicrobial Compounds	150	(1)
Killing versus Inhibiting Growth	151	(1)
Antiseptics and Disinfectants	151	(1)
Mechanisms of Action	151	(1)
Resistance to Antiseptics and Disinfectants	152	(1)
Antibiotics	152	(4)
Characteristics of Antibiotics	152	(3)
The Process of Antibiotic Discovery	155	(1)
The Economics of Antibiotic Discovery	156	(1)
Mechanisms of Antibiotic Action	156	(7)
Targets of Antibiotic Action	156	(1)
Cell Wall Synthesis Inhibitors	157	(1)
Protein Synthesis Inhibitors	158	(3)
Quinolones--a Class of Antibiotics That Targets DNA Replication	161	(1)
Rifampin--an Inhibitor of RNA Synthesis	162	(1)
Trimethoprim and Sulfonamides	162	(1)
Metronidazole	162	(1)
The Newest Antibiotics	162	(1)
The Continuing Challenge	163	(1)
Selected Readings	164	(1)
Summary Outline	165	(2)
Questions	167	(1)
How Bacteria Become Resistant to Antibiotics	168	(17)
The Dawning of Awareness	168	(2)
Mechanisms of Antibiotic Resistance	170	(7)
Overview of Resistance Mechanisms	170	(1)
Limiting Access of the Antibiotic	170	(1)
Enzymatic Inactivation of the Antibiotic	171	(1)
Active Efflux of the Antibiotic	172	(1)
Modification or Protection of the Antibiotic Target	173	(2)
Failure to Activate an Antibiotic	175	(1)
Regulation of Resistance Genes	175	(1)
Cross-Resistance and Linkage	176	(1)
Antibiotic Tolerance	177	(1)
Transfer of Resistance Genes	177	(3)
Why Mutation Is Often Not the Preferred Solution	177	(1)
Plasmids	178	(1)
Transposons and Integrons	178	(1)
Conjugative Transposons	179	(1)
Will We Return to the Preantibiotic Era?	180	(1)
Selected Readings	181	(1)
Summary Outline	182	(2)
Questions	184	(1)
PART II Specific Bacterial Pathogens	185	(276)
The Spirochetes: Borrelia burgdorferi and Treponema pallidum	187	(15)
Lyme Disease	188	(1)
Features of B. burgdorferi	188	(2)
Morphology and Physiology	188	(2)
Borrelia Plasmids	190	(1)
The Borrelia Genome Sequence--Some Clues but Still Many Mysteries	190	(2)
The Tick-Mammal Cycle	192	(1)
Response of B. burgdorferi to Its Arthropod and Mammalian Hosts	192	(3)
Osps	192	(1)
Leaving the Bloodstream	193	(1)
The Lyme Disease Vaccine	193	(1)
Chronic Lyme Disease	194	(1)
Variation in the Severity of the Disease--Coinfection Confounds the Problem	194	(1)
Studying Virulence Factors of B. burgdorferi	195	(1)
Special Difficulties	195	(1)
Animal Models	195	(1)
Diagnosis and Prevention of Lyme Disease	195	(2)
Diagnosis	195	(1)
Prevention and Treatment	196	(1)
Syphilis and Lyme Disease: Two Spirochetal Diseases with a Similar Pathology but a Different Ecology	197	(1)
Progression of Syphilis	197	(1)
Diagnosis and Treatment of Syphilis	198	(1)
Taking Stock	198	(1)
Selected Readings	199	(1)
Summary Outline	200	(1)
Questions	201	(1)
Yersinia pestis, the Cause of Plague, and Its Relatives	202	(14)
The Rich and Terrible History of Yersinia pestis	202	(6)
Biological Warfare in the 14th Century	203	(1)
Modern Interest in Y. pestis	204	(1)
Characteristics of Y. pestis and Plague	204	(3)
Yersinia enterocolitica and Yersinia pseudotuberculosis, Food-Borne Relatives of Y. pestis	207	(1)
Yersinia Plasmids	207	(1)
Virulence Factors of Y. pestis, Y. enterocolitica, and Y. pseudotuberculosis	208	(5)
Virulence Factors Unique to Y. pestis	211	(1)
Survival in the Mammalian Body	212	(1)
Future Directions	213	(1)
Selected Readings	213	(1)
Summary Outline	214	(1)
Questions	215	(1)
Staphylococcus Species	216	(16)
The Many Types of Staphylococcal Infections	216	(3)
S. aureus	217	(1)
Coagulase-Negative Staphylococci: S. epidermidis and S. saprophyticus	217	(1)
Emerging Antibiotic Resistance, a Developing Horror Story	218	(1)
Characteristics of Staphylococci	219	(1)
Colonization of the Human Body	219	(1)
Key Features of the Staphylococci	219	(1)
Virulence Factors of S. aureus	220	(7)
Virulence Factors	220	(7)
Virulence Factors of the Coagulase-Negative Staphylococci	227	(1)
S. epidermidis	227	(1)
S. saprophyticus	228	(1)
Future Directions	228	(1)
Selected Readings	229	(1)
Summary Outline	229	(1)
Questions	230	(2)
Group A and Group B Streptococci and Enterococci	232	(15)
A Closer Look at Diseases Caused by Streptococci	233	(3)
The Changing Spectrum of Group A Streptococcal Disease	233	(1)
Understanding Disease Diversity	234	(2)
Group B Streptococci and Enterococci--Emerging Human Pathogens	236	(1)
Group B Streptococci	236	(1)
Enterococcal Infections	237	(1)
Virulence Factors	237	(8)
Group A Streptococci	237	(4)
Regulation of Virulence Factors	241	(1)
Virulence Factors of Group B Streptococci	241	(1)
Enterococcus Virulence Factors	242	(3)
Selected Readings	245	(1)
Summary Outline	245	(1)
Questions	246	(1)
Pseudomonas aeruginosa and Related Species, a Lesson in Versatility	247	(16)
A Consummate Opportunist	247	(1)
Characteristics of P. aeruginosa	248	(1)
Types of Infections	249	(2)
Virulence Factors	251	(9)
Measuring Virulence--Model Systems Raise Exciting New Possibilities	251	(1)
Overview of the Disease Process	252	(1)
Adhesins	253	(1)
The Type III Secretion System	254	(1)
ExoS and ExoU	254	(1)
Exotoxin A	255	(1)
Elastolytic Activity	255	(2)
Other Extracellular Factors	257	(1)
Alginate Production	257	(2)
LPS Variation	259	(1)
Antibiotic Resistance	259	(1)
Future Directions	260	(1)
Selected Readings	260	(1)
Summary Outline	261	(1)
Questions	262	(1)
Bordetella pertussis	263	(13)
Whooping Cough	263	(1)
Characteristics of the Disease	263	(1)
The Vaccine Dilemma	264	(1)
Overview of the Infection Process	264	(1)
Virulence Factors	264	(6)
Model Systems	264	(3)
Adherence	267	(1)
Toxins	268	(1)
B. pertussis and Phagocytic Cells	269	(1)
Is There a Type III Secretion System?	270	(1)
Type IV Secretion System	270	(1)
Regulation of Virulence Genes	270	(2)
Phenotypic Modulation (Transcriptional Regulation)	270	(2)
Phase Variation	272	(1)
Prevention and Treatment	272	(1)
Selected Readings	272	(1)
Summary Outline	273	(2)
Questions	275	(1)
Streptococcus pneumoniae	276	(15)
Pneumococcal Disease	276	(3)
Characteristics of S. pneumoniae	277	(1)
Progression of Pneumococcal Disease	278	(1)
Virulence Factors of S. pneumoniae	279	(6)
Animal and Cell Culture Models	279	(1)
Colonization of the Nose and Throat and Entry into the Lung	279	(1)
Survival in the Lung	280	(2)
Ability To Evoke an Inflammatory Response	282	(1)
Interaction with the Blood-Brain Barrier	283	(1)
Signature-Tagged Mutagenesis	283	(1)
Antibiotic Resistance	283	(1)
Natural Transformation	284	(1)
Prevention and Treatment	285	(2)
Antibiotic Therapy	285	(1)
Vaccines	286	(1)
Selected Readings	287	(1)
Summary Outline	288	(1)
Questions	289	(2)
Tuberculosis	291	(20)
A Disease of the Past Returns To Haunt the Future	291	(2)
Nothing Fails Like Success	292	(1)
Drug Resistance--a Worrisome New Development	292	(1)
So Soon We Forget	292	(1)
Spread and Progression of Tuberculosis	293	(5)
Symptoms and Mode of Spread	293	(1)
Progression of the Disease	293	(4)
Latency and Persistence--Another TB Mystery	297	(1)
Mycobacterium tuberculosis and Its Unusual Cell Wall--a Case of Fat Making for Lean and Mean	298	(1)
Treatment of TB and the Challenge Posed by Drug-Resistant Strains	298	(4)
Standard Treatment Options	298	(2)
The Emergence of Resistance	300	(1)
The W Strain--a Taste of Things To Come?	301	(1)
The Search for New Drugs	301	(1)
Diagnosis of TB	302	(1)
Virulence Factors	303	(3)
Studying Virulence Factors	303	(1)
Entry into and Survival in Phagocytes	303	(1)
Avoidance of the Activated Macrophage Response	304	(1)
Ability To Elicit a Destructive Inflammatory Response	305	(1)
Factors That Affect Host Susceptibility	305	(1)
Immunity to TB	306	(1)
BCG: a Widely Used but Controversial Vaccine	306	(1)
BCG as a Carrier for Other Vaccine Antigens	306	(1)
Selected Readings	307	(1)
Summary Outline	307	(2)
Questions	309	(2)
Legionella pneumophila and Legionnaires' Disease	311	(11)
The Dark Side of Modern Comforts: Air-Conditioning Turns Ugly	311	(1)
Legionnaires' Disease	312	(1)
The Natural Host?--a Free-Living Macrophage Equivalent	312	(1)
Virulence Factors	313	(5)
Problems with Determining Legionella Virulence Factors	313	(1)
Survival in Amoebae	314	(1)
Regulation of Virulence Genes	315	(1)
Interaction with Mammalian Macrophages	316	(1)
Damage to the Lung	317	(1)
Prevention and Treatment	318	(1)
Legionella as a Paradigm for Intracellular Pathogens	318	(1)
Selected Readings	319	(1)
Summary Outline	319	(2)
Questions	321	(1)
Mycoplasma pneumoniae and Chlamydia pneumoniae	322	(10)
Lifestyles of Mycoplasma pneumoniae and Chlamydia pneumoniae	322	(3)
Characteristics of Mycoplasma and Chlamydia Species	325	(2)
Virulence Factors	327	(2)
M. pneumoniae	327	(1)
C. pneumoniae	328	(1)
Selected Readings	329	(1)
Summary Outline	329	(2)
Questions	331	(1)
Bacillus anthracis, the Cause of Anthrax	332	(7)
Features of the Disease	332	(1)
Virulence Factors	333	(2)
Ability To Germinate and Survive in Macrophages	333	(1)
Toxins	334	(1)
Antiphagocytic Capsule	335	(1)
Prevention of Anthrax	335	(1)
Selected Readings	336	(1)
Summary Outline	337	(1)
Questions	338	(1)
Helicobacter pylori, a Resourceful Gastric Pathogen	339	(13)
A Revolution in Gastroenterology	339	(3)
Good News--You're Infected!	339	(1)
The Long Road to Acceptance	340	(1)
The H. pylori-Inspired ``Gold Rush''	340	(2)
Characteristics of H. pylori	342	(1)
Morphology and Metabolism	342	(1)
Genomics	343	(1)
Virulence Factors	343	(3)
Animal Models	343	(1)
Colonization of the Stomach Mucosa	344	(1)
Eliciting an Inflammatory Response	345	(1)
LPS--Immune Mimicry	346	(1)
Type IV Secretion System	346	(1)
Prevention and Treatment	346	(3)
H. pylori Mysteries	349	(1)
Selected Readings	349	(1)
Summary Outline	350	(1)
Questions	351	(1)
Clostridium difficile and Pseudomembranous Colitis	352	(11)
Pseudomembranous Colitis--a Disease Caused by Antibiotics	352	(1)
Emergence of Pseudomembranous Colitis	352	(1)
Characteristics of C. difficile	353	(1)
Development and Ecology of the Disease	353	(2)
Virulence Factors	355	(4)
Toxins	355	(3)
Other Virulence Factors	358	(1)
Prevention and Treatment	359	(1)
Selected Readings	360	(1)
Summary Outline	361	(1)
Questions	362	(1)
Vibrio cholerae, the Cause of Cholera	363	(18)
Pathogenesis and Epidemiology of Cholera	363	(3)
Progression of the Disease	363	(1)
History and Distribution of Cholera Outbreaks	364	(2)
Solving the Cholera Problem	366	(1)
Virulence Factors	366	(9)
Overview	366	(1)
Colonization of the Small Intestinal Mucosa	367	(1)
Cholera Toxin	368	(5)
Other Toxins Produced by V. cholerae	373	(1)
Gene Capture--a Role for Integrons	374	(1)
The Capsule of V. cholerae O139--a Difference, but Probably Not an Important One	374	(1)
Antibiotic Resistance	374	(1)
Transcriptional Regulation of Virulence Genes	375	(1)
The ToxR/ToxS/ToxT Regulatory System	375	(1)
Regulation in Response to Iron Levels	376	(1)
Prevention and Treatment	376	(1)
Oral Rehydration Therapy	376	(1)
The Frustrating Search for a Safe and Effective Cholera Vaccine	377	(1)
Future Directions	377	(1)
Selected Readings	378	(1)
Summary Outline	379	(1)
Questions	380	(1)
Salmonella Species	381	(17)
Salmonella Species and Serogroups	381	(1)
Diseases Caused by Salmonella Species	382	(2)
S. typhimurium	382	(1)
S. typhi	383	(1)
Virulence Factors	384	(8)
Animal Models	384	(1)
Overview of the Disease Process	384	(2)
Adherence and Invasion	386	(5)
Host Factors That Affect Susceptibility to Salmonella Infections	391	(1)
Why Is S. typhi So Invasive?	391	(1)
Acid Tolerance Response	392	(1)
Prevention and Treatment	392	(2)
Antibiotic Therapy	392	(1)
Vaccines	393	(1)
Salmonella as a Basis for Other Vaccines	393	(1)
Future Directions	394	(1)
Selected Readings	394	(1)
Summary Outline	395	(2)
Questions	397	(1)
Listeria monocytogenes, a Doubly Motile Pathogen	398	(9)
Listeriosis	398	(2)
Characteristics of Disease Caused by Listeria monocytogenes	398	(2)
Listeria as a Model for Studies of the Cell-Mediated Immune Response and Cytoskeleton Formation	400	(1)
Virulence Factors	400	(4)
Animal and Cell Culture Model Systems	400	(1)
Genetic System	400	(1)
Motility	400	(1)
Invasion and Cell-to-Cell Spread	400	(1)
LLO (hly)	401	(1)
PI-PLC (plcA) and PC-PLC (plcB)	402	(1)
Metalloprotease	402	(1)
Actin-Based Motility	402	(1)
Systemic Spread of L. monocytogenes	403	(1)
Organization and Regulation of Virulence Genes	404	(1)
Prevention and Treatment	404	(1)
Selected Readings	405	(1)
Summary Outline	405	(1)
Questions	406	(1)
Diarrheagenic Escherichia coli Strains	407	(15)
Different Types of Diarrheagenic Escherichia coli Strains	407	(1)
Classification of Pathogenic E. coli Strains	408	(3)
Serogroup and Serotype	408	(1)
Virotype	408	(3)
Virulence Factors	411	(7)
ETEC Strains	411	(1)
EAggEC Strains	412	(2)
EPEC Strains	414	(2)
EHEC Strains	416	(1)
Prevention and Treatment	416	(2)
Selected Readings	418	(1)
Summary Outline	418	(2)
Questions	420	(2)
Escherichia coli Extraintestinal Infections	422	(15)
Epidemiology of Urinary Tract Infections	422	(2)
Community-Acquired Urinary Tract Infections	422	(1)
Hospital-Acquired (Nosocomial) Urinary Tract Infections	423	(1)
Virulence Factors of E. coli Strains That Cause Urinary Tract Infections	424	(8)
Colonization of the Colon and Vagina	424	(1)
Adhesins	425	(1)
Invasion of Uroepithelial Cells	426	(1)
Toxins	427	(1)
Other Virulence Factors	427	(1)
UPEC Strains--a Paradigm for Adhesion Biogenesis	428	(1)
Organization and Regulation of Virulence Genes	429	(3)
Meningitis and Other Disseminated Infections	432	(1)
Virulence Factors Associated with Strains That Cause Meningitis, Pneumonia, and Septicemia	433	(1)
Prevention and Treatment	433	(1)
Selected Readings	434	(1)
Summary Outline	434	(2)
Questions	436	(1)
Neisseria Species	437	(15)
The Two Pathogenic Neisseria Species	437	(1)
Types of Disease	438	(1)
Commonalities	438	(1)
Gonorrhea	438	(2)
Gonorrhea--Still a Major Public Health Problem	438	(1)
Just When We Thought We Were Seeing the Light at the End of the Tunnel, It Turned Out To Be the Headlight of an Oncoming Train	439	(1)
What You Don't Know Can Hurt You: Complications of Gonorrhea	439	(1)
Meningococcal Meningitis	440	(1)
Virulence Factors	441	(6)
N. gonorrhoeae	441	(1)
How N. gonorrhoeae Evades the Host Defense Responses	442	(5)
N. meningitidis	447	(1)
Prevention and Treatment	447	(2)
Gonorrhea	447	(1)
Meningococcal Meningitis	448	(1)
Selected Readings	449	(1)
Summary Outline	449	(2)
Questions	451	(1)
Chlamydia trachomatis	452	(9)
The Hidden Epidemic	452	(2)
C. trachomatis--a Lot of Pathogenic Potential in a Very Small Package	454	(2)
Virulence Factors	456	(2)
Special Problems Faced by Scientists Working on Chlamydiae	456	(1)
Adherence and Invasion by EBs	456	(2)
Prevention and Treatment	458	(1)
Closing Observations	459	(1)
Selected Readings	459	(1)
Summary Outline	459	(1)
Questions	460	(1)
APPENDIX 1 Overview of Bacterial Secretion Systems, Bacterial Adhesins and Their Mechanisms of Assembly, and Major Bacterial Toxins	461	(6)
A. Secretion Systems of Bacteria	461	(1)
B. Adhesins and Mechanisms of Assembly	462	(2)
C. Major Bacterial Toxins	464	(3)
APPENDIX 2 Answers to End-of-Chapter Questions	467	(28)
Glossary	495	(30)
Index	525