Ch. 14 Genitourinary tract infections

1. Medical Microbiology Ch. 14 Genitourinary tract infections

2. Microbial Diseases of the Urinary and Reproductive Systems • Microbes usually enter the urinary system through the urethra • Microbes usually enter the reproductive system through the: • Vagina (females) or urethra (males)

3. Female Urinary Organs Figure 26.1

4. Female Reproductive Organs Figure 26.2a

5. Male Reproductive & Urinary Organs Figure 26.3

6. Normal Microbiota • Urinary bladder and upper urinary tract sterile • Lactobacilli predominant in the vagina • >1,000 bacteria/ml or 100 coliforms/ml of urine indicates infection

7. Cystitis • Usually caused by • E. coli • S. saprophyticus • May also be caused by • Proteus • Klebsiella • Enterococcus • Pseudomonas • E. coli usually causes pyelonephritis • Antibiotic-sensitivity tests may be required before treatment

8. Leptospirosis • Leptospira interrogans • Reservoir: Dogs and rats • Transmitted by skin/mucosal contact from urine-contaminated water • Diagnosis: Isolating bacteria or serological tests Figure 26.4

9. Sexually Transmitted Diseases (STDs ) • Prevented by condoms • Treated with antibiotics

10. Gonorrhea • Neisseria gonorrhoeae • Attaches to oral or urogenital mucosa by fimbriae • Females may be asymptomatic; males have painful urination and pus discharge • Treatment with antibiotics • Untreated may result in • Endocarditis • Meningitis • Arthritis • Ophthalmia neonatorum

11. Gonorrhea Figure 26.7

12. Nongonococcal Urethritis • Chlamydia trachomatis • May be transmitted to newborn's eyes • Painful urination and watery discharge • Mycoplasma hominis • Ureaplasma urealyticum

13. Pelvic Inflammatory Disease • N. gonorrhoeae • C. trachomatis • Can block uterine tubes • Chronic abdominal pain

14. Syphilis • Treponema pallidum • Invades mucosa or through skin breaks Figure 26.10

15. Syphilis • Direct diagnosis: • Darkfield microscopic identification of bacteria • Staining with fluorescent-labeled, monoclonal antibodies • Indirect, serological diagnosis: • VDRL, RPR, ELISA test for reagin-type antibodies using cardiolipid (Ag) • FTA-ABS tests for anti-treponemal antibodies

16. Syphilis Figure 3.6b

17. Syphilis • Primary stage: chancre at site of infection • Secondary: Skin and mucosal rashes • Latent period: No symptoms • Tertiary: Gummas on many organs • Congenital: Neurological damage • Primary & secondary stages treated with penicillin

18. Lymphogranuloma Venereum (LGV) • Chlamydia trachomatis • Initial lesion on genitals heals • Bacteria spread through lymph causing enlargement of lymph nodes • Treatment: doxycycline

19. Chancroid (Soft Chancre) • Haemophilus ducreyi • Ulcer on genitalia • May break through surface • Infection of lymph nodes • Treatment: erythromycin and ceftriaxone

20. Bacterial Vaginosis • Gardnerella vaginalis • Diagnosis by clue cells • Treatment: metronidazole Figure 26.12

21. Genital Herpes • Herpes simplex virus 2 (Human herpesvirus 2) or HHV 2 • Neonatal herpes transmitted to fetus or newborns • Recurrences from viruses latent in nerves • Suppression: acyclovir or valacyclovir

22. Genital Warts • Human papillomaviruses • Treatment: Imiquimod to stimulate interferon • HPV 16 causes cervical cancer and cancer of the penis • DNA test to detect cancer-causing strains • Vaccination against HPV strains

23. Candidiasis • Candida albicans • Grows on mucosa of mouth, intestinal tract, genitourinary tract • NGU in males • Vulvovaginal candidiasis • Diagnosis by microscopic identification and culture of yeast • Treatment: clotrimazole or miconazole

24. Trichomoniasis • Trichomonas vaginalis • Found in semen or urine of males carriers • Vaginal infection causes irritation and profuse discharge • Diagnosis by microscopic identification of protozoan • Treatment: metronidazole Figure 26.15