Chapter 21 Micro

Causative Agent of Gonorrhea

Neisseria gonorrhoeae -a gram-negative diplococcus -appears as kidney- bean-shaped bacteria with their flat sides touching, they have frimbriae

urethritis (UTI)

inflammation of the urethra

Microbiota of Female Genital Tract (childbearing years)

-Lactobacillus -Prevotella -Streptococcus -low levels of Candida albicans

Microbiota in Urethra (male and female)

-Nonhemolytic streptococci -Staphylococci -Corynebacteria -Lactobacilli

Catheter-associated UTIs (CA-UTIs)

UTIs that are acquired in health care facilities

Chlamydia in Children

-Babies born to mothers with Chlamydia infections can develop eye infections and pneumonia if they become infected during passage through the birth canal -Antibiotic drops or ointment applied to newborn's eyes

Syphilis Pathogenesis and Virulence Factors

-Binds to the epithelium of mucus membranes by its hooked tip -Moves into circulation and the body is transformed into a large receptacle for incubating the pathogen

Secondary syphilis presentation

-3 weeks-6 months after chancre heals -fever -headache -rash -lesions containing viable spirochetes

Defenses in the urine

-Acidic pH -Lysozyme: enzyme that breaks down peptidoglycan -Lactoferrin: iron-binding protein that inhibits bacterial growth -Secretory IgA: specific for previously encountered microorganisms

Chlamydia prevention

-Avoiding contact with infected tissues and secretions through abstinence or barrier protection (condoms) is the only means of prevention.

Neurosyphilis

-Can involve any part of the nervous system -Argyll-Robertson pupil: a condition caused by adhesions along the inner edge of the iris that affix the pupil's position into a small irregular circle -Diverse results include severe headaches, atrophy of the optic nerve, blindness, and dementia

Pathogenesis and Virulence Factors of Bacterial Vaginosis

-Can lead to PID, infertility, and ectopic pregnancies -Babies born to mothers with vaginosis have low birth weights.

Vaginitis/Vaginosis causative agent

-Candida albicans: Most common cause of vaginitis. Known as a yeast infection. -Other bacteria and protozoa

General signs/symptoms of chlamydia

-Certain strains of C. trachomatis can invade lymphatic tissues, resulting in lymphogranuloma venereum -Lymph nodes near the lesion begin to fill with granuloma cells and become inflamed and tender. -"Nodes" cause long-term lymphatic obstruction that lead to chronic, deforming edema of genitalia or anus.

gonorrhea in children

-Children born to gonococcus carriers are in danger of being infected. Physicians screen preganant women for its presence. -Gonococcal eye infections are very serious and result in keratitis, ophthalmia neonatorum, and blindness. Antibiotic eye drops or ointments are applied at birth as a universal precaution -Finding gonorrhea in children other than neonates is strong evidence for sexual abuse by adults.

Pathogenesis and Virulence Factors of Chlamydia

-Chlamydia is able to grow intracellularly and avoid the host's immune response -Unique cell wall prevents the phagosome from fusing with the lysosome inside phagocytes -Presence of bacteria inside cells causes the release of cytokines that provoke intense inflammation

Vaginosis from Gardnerella species "bacterial vaginosis"

-Common condition in women in their childbearing years -Doesn't appear to induce inflammation in the vagina -vaginal discharge with a very fishy odor is the result of metabolic by-products of anaerobic metabolism by the bacteria causing the infectio

cytisis signs and symptoms

-Cystitis is a disease of sudden onset: •Pain •Frequent urges to urinate, even when the bladder is empty •Dysuria: burning pain accompanying urination •Urine can be cloudy due the presence of bacteria and white blood cells •Hematuria: presence of blood in the urine causes it to have an orange color •Low-grade fever and nausea

Candida albicans

-Dimorphic fungus -Live in low numbers on mucosal surfaces of the mouth, gastrointestinal tract, vagina, etc. -normal biota

Defenses of the male reproductive system

-Flushing action of the urine, which helps move microorganisms out of the system

Defenses of the urinary tract

-Flushing action of urine flowing out of the system -Urine flow also encourages desquamation of epithelial cells lining the urinary tract, shedding microbes with the cells.

Pathogenesis and Virulence Factors of Gonorrhea

-Gonococci use specific chemical groups on the tips of fimbriae to anchor themselves to mucosal epithelial cells. -Fimbrial genes can rearrange themselves to put out fimbriae of different configurations: Antibodies that previously recognized fimbrial proteins may not recognize them once they are rearranged -IgA protease cleaves IgA molecules stationed on mucosal surfaces

two diseases causing warts in the reproductive tract

-Human Papillomavirus Infection (HPV) -Molluscum Contagiosum

Syphilis transmission and Epidemiology

-Humans are the sole natural hosts and source of T. pallidum -Risk of infection from an infected sexual partner is 12 - 30% per encounter. -cannot survive for long outside the host

Gonorrhea general signs/symptoms

-In a small number of cases, the gonococcus enters the bloodstream and is disseminated to the joints and skin. -can lead to chronic arthritis and painful, sporadic, papular rash on the limbs. -Rare complications of gonococcal bacteremia are meningitis and endocarditis.

Discharge diseases

-Infectious agent causes an increase in fluid discharge in the male and female reproductive tract. -Causative agents are transferred to new hosts when the fluids in which they live contact the mucosal surfaces of the receiving partner.

Composition of urinary tract

-Kidneys: remove metabolic wastes from the blood, acting as a sophisticated filtering system -Ureters: tubular organs extending from each kidney to the bladder -Bladder: collapsible organ that stores urine and empties it into the urethra -Urethra: conduit of urine to the exterior of the body

Identify the most important risk group for group B Streptococcus infection and explain why that group is important.

-Pregnant women -Colonization of pregnant women can result in preterm delivery. Amniotic infection or stillbirth. -infants may experience life-threatening bloodstream infections, meningitis, or pneumonia -Infants may have permanent disabilities such as developmental disabilities, hearing loss, or impaired vision

Cardiovascular syphilis

-Results from damage to the small arteries in the aortic cell wall -aorta is subject to distention and fatal rupture. -Aortic valves can also be damaged, resulting in insufficiency and heart failure.

Treatment of UTIs

-Sulfa drugs such as trimethoprim-sulfamethoxazole -Non-antibiotic drug phenazopyridine (Pyridium) is administered simultaneously

3 diseases hat result in genital ulcers

-Syphilis -Chancroid -Herpes

Male reproductive anatomy

-Testes: produce sperm cells and hormones -Epididymides: coiled tubes leading out of the testes -Vas deferens: combines with the seminal vesicle and terminates in the ejaculatory duct -Contents of the ejaculatory duct empty into the urethra during ejaculation -Prostate gland: walnut-shaped structure at the base of the urethra that contributes to the released semen -Scrotum: contains the testes -Penis: cylindrical organ that houses the urethra

Transmission and Epidemiology of Chlamydia

-The reservoir of pathogenic strains of C. trachomatis is the human body -Vertical transmission and sexual contact -Adolescent women are more likely than older women to harbor the bacterium because it prefers to infect cells prevalent in the adolescent cervix

Structures in genitourinary tract?

-Urinary tract: removes substances from the blood, regulating certain body processes, and forming urine and transporting it out of the body -Genital system: also known as the reproductive system, functions mainly in reproduction

Female reproductive anatomy

-Uterus -Fallopian tubes (uterine tubes) -Ovaries -Vagina -Cervix: lower one-third of the uterus that connects to the vagina, serves as the opening to the uterus, and a common site of infection

Defenses of female reproductive tract

-Vagina is lined with mucus membranes and the protective covering of secreted mucus -Mucus is a major nonspecific defense during childhood and menopause. -Secretory IgA antibodies specific for any previously encountered infections -Changes in pH of the vagina

Transmission and Epidemiology of Bacterial Vaginosis

-Very common in sexually active women - may be associated with sex, but not transmitted by it -Could occur if the act of penetration in the absence of semen (or saliva) causes changes in the vaginal epithelium or biota

Micorbiota of the penis

-aerobic Pseudomonas and Staphylococcus species -in an uncircumcised penis, the area under the foreskin is colonized by anaerobic gram-negatives

Chlamydia treatment

-annual screening of young women for the presence of the bacterium -Doxycycline or azithromycin

pyelonephritis signs and symptoms

-back pain -fever -serious infection that can result in permanent damage to the kidneys if improperly or inadequately treated

Leptospirosis

-bacterial disease transmitted through contact with contaminated animal urine -can affect kidneys, live, brain, eyes

Latency and Tertiary Syphilis

-can last 20 years or longer -pathological complications in susceptible tissues and organs

Transmission and Epidemiology of Catheter-associated UTIs

-commonly caused by E. coli, S. saprophyticus, Enterococcus, and Klebsiella -The use of urinary catheters increase risk of these infections

Where is normal microbiota in the GI tract

-in the outer region of the urethra -Kidneys, ureters, bladder, and upper urethra are presumably kept sterile by urine flow and regular bladder emptying

Chlamydia

-most common reportable infectious disease in the US -Chlamydiae exist as two stages: (1) infectious particles called elementary bodies and (2) intracytoplasmic, reproductive forms called reticulate bodies

Prevention and Treatment of Candida albicans

-no vaccine -Topical and oral azole drugs are used to treat vaginal candidiasis

Transmission and Epidemiology of Candida albicans

-opportunistic -sexual contact w/ infected person -more frequently reoccurs in those with primary infections for example someone with HIV

primary syphilis presentation

-painless chancre at the site of entry of the pathogen -chanchre heals in 3-6 weeks

Congenital syphilis

-pass from a pregnant woman's circulation into the placenta and be carried throughout the fetal tissues -Inhibits fetal growth and disrupts critical periods of development -Can result in mild defects to spontaneous miscarriage or stillbirth

Treatment for Group B Streptococcus

-penicillin or ampicillin -treat resistant strains with erythromycin

Gummas

-tertiary syphilis -Painful, swollen, syphilitic tumors-Develop in tissues in the liver, skin, bone, and cartilage

Transmission and Epidemiology of Leptospirosis

-transmits through contact of skin abrasions or mucous membranes with animal urine or some environmental source containing urine

Transmission and Epidemiology of community-acquired UTIs

-transmitted from the GI tract to the urinary system -more common in women because of nearness of the urethral opening to the anus -Some E. coli can invade the deeper tissue of the urinary tract and avoid being killed by antibiotics. They reemerge to cause symptoms again later.

Transmission and Epidemiology of Gonorrhea

-vertical transmission -through sexual contact -strictly a human infection

life cycle of chlamydia

1. Infectious stage, elementary body (EB) is taken into a phagocyte and ends up in its phagosome 2. In the phagosome, ea. EB develops into a recticulate body (RB) 3. RBs multiply by binary fission 4. Mature RBs are reorganized into EBs 5. Completed EBs are released from host cell

Causative agents of UTI's

95% of UTIs are caused by normal microbiota of the gastrointestinal tract

Discuss prostatitis.

Causative agent: GI tract biota Transmission: Endogenous transfer from GI tract Virulence factor: various Prevention: none Treatment: Antibiotics, muscle relazers, alpha blockers Distinctive features: pain in genital area and/or back, difficulty urinating

Chancroid

Causative agent: Haemophilus ducreyi Transmission: direct contact Virulence factor: hemolysin (exotoxin) Prevention: avoiding contact Treatment: ceftriaxone or azithromycin Distinctive features: no systematic effect

Herpes

Causative agent: Herpes simplex 1 and 2 Transmission: direct contact, vertical Virulence factor: latency Prevention: avoiding contact, antiviral can reduce recurrences Treatment: Acyclovir and derivatives Distinctive features: can be asymptomatic or have frequent recurrences

Syphilis

Cause: treponema pallidum (spirochete w/ gram-negative cell wall) Stages: Primary syphilis, secondary syphilis, tertiary syphilis Transmission: direct contact or vertical virulence factor: lipoproteins prevention: antibiotic treatment of contacts, avoiding contact Treatment: Penicillin G

Gonorrhea treatment

Ceftriaxone + azithromycin or doxycycline

Treatment of Leptospirosis

Early treatment with amoxicillin or doxycycline

Provide some detail about the first "cancer vaccine" and how it works

Gardasil vaccine approved in 2006 •Prevents infection by four types of HPV because a virulence factor of HPV is their ability to activate oncogenes, which code for proteins that interfere with normal cell function, resulting in uncontrolled growth.

Vaginitis signs and symptoms

Inflammation of the vagina, characterized by some degree of vaginal itching, burning, and discharge

Causative Agent of Leptospirosis

Leptospira interrogans (spirochete)

Microbiota of Male Genital Tract

Same as urethra: -Nonhemolytic streptococci -Staphylococci -Corynebacteria -Lactobacilli

Vaginosis signs and symptoms

Similar to vaginitis, but does not include significant inflammation

Gonorrhea prevention

condoms

pyelonephritis (UTI)

infection of the kidneys

Cytitis (UTI)

infection of the urinary bladder that occurs when urine flow is reduced or bacteria are accidentally introduced into the bladder

Treatment of bacterial vaginosis

oral or topical metronidazole or clindamycin

Signs and symptoms of leptospirosis (Immune phase)

•Blood infection is cleared by natural defenses •Milder fever; headache due to leptospiral meningitis •Weil's syndrome: kidney invasion, hepatic disease, jaundice, anemia, neurological disturbances •Long-term disability and death can result from damage to kidneys and liver, but they occur primarily with the most virulent strains and in elderly persons.

Chlamydia sings/symptoms in males

•Causes inflammation of the urethra •Symptoms mimic gonorrhea: discharge and painful urination •Untreated infections may lead to epididymitis.

Chlamydia sings/symptoms in females

•Cervicitis •Discharge •Salpingitis •PID is a frequent sequela of female chlamydial infection. PID itself may be acute and painful, or asymptomatic, allowing damage to the upper reproductive tract to continue unchecked

Gonorrhea signs and symptoms in females

•Likely that both the urinary and genital tracts will be infected during sexual intercourse •Mucopurulent (containing mucus and pus) or bloody vaginal discharge occurs in about half the cases. •Painful urination if the urethra is affected. •Salpingitis: inflammation of the fallopian tubes •Pelvic inflammatory disease (PID): salpingitis that includes inflammation of other parts of the upper reproductive tract •Buildup of scar tissue from PID can block fallopian tubes, causing sterility or ectopic pregnancies.

Signs and symptoms of leptospirosis (Leptospiremic phase)

•Pathogen appears in the blood and cerebrospinal fluid •Sudden high fever •Chills •Headache •Muscle aches •Conjunctivitis •Vomiting

Discharge Diseases with Major Manifestation in the Genitourinary Tract

•Trichomoniasis •Gonorrhea •Chlamydia

Gonorrhea signs and symptoms in men

•Urethritis •Painful urination •Yellowish discharge •Relatively large number of cases are asymptomatic •In most cases, infection is limited to the distal urogenital tract. •Can occasionally spread from the urethra to the prostate gland and the epididymis •Scar tissue formed in the spermatic ducts during the healing of an invasive infection can render a man infertile.