Presentation on theme: "Microbial Diseases of the Urinary and Reproductive Systems"— Presentation transcript:
1Microbial Diseases of the Urinary and Reproductive Systems Chapter 26Microbial Diseases of the Urinary and Reproductive Systems
2Microbial Diseases of the Urinary and Reproductive Systems Identify the portals of entry for microbes into the reproductive system.Urinary system regulates chemical composition of blood and excretes nitrogenous wasteMicrobial diseases of these two systems from outside infection or opportunistic infection by normal microbesMicrobes usually enter the urinary system through the urethraFlushing action of urine and acidity of urine have some antimicrobial value (used to use urine for earaches!)Microbes usually enter the reproductive system through the:Vagina (females) or urethra (males)
6Normal MicrobiotaDescribe the normal microbiota of the upper urinary tract, the male urethra, and the female urethra and vagina.Urinary bladder and upper urinary tract sterile when normal as well as male urethraLactobacilli predominant in the vagina during reproductive years>1,000 bacteria/ml or 100 coliforms/ml of urine indicates infectionList the antimicrobial features of the urinary system.
7Diseases of Urinary System: Cystitis Urethritis, cystitis, and ureteritisare inflammations of lower urinary tractOpportunistic gram(-) from intestinesoften cause urinary infectionsNosocomial infections follow catheterization>1000 bacteria sp. per ml urine or>100 coliforms per ml urine = infectionCystitis usually caused by E. coli & S.saprophyticusMay also be caused by Proteus,Klebsiella, Enterococcus,PseudomonasE. coli usually causes pyelonephritis, inflammation of kidneysAntibiotic-sensitivity tests may be required before treatmentList the microorganisms that cause cystitis, pyelonephritis, and leptospirosis, and name the predisposing factors for these diseases.
8Leptospirosis Leptospira interrogans spirochete Reservoir: Dogs and ratsTransmitted by skin/mucosal contact from urine-contaminated waterChills, fever, headache, muscle achesDiagnosis: Isolating bacteria or serological testsFigure 26.4
9Bacterial Diseases of Reproductive System Most of these are STD’s (sexually transmitted diseases)Prevented by condomsTreated with antibioticsDescribe modes of transmission for urinary and reproductive system infections.
10Gonorrhea – most common reported STD in U.S. Figure 26.5a
11Gonorrhea Neisseria gonorrhoeae Attaches to oral or urogenital mucosa by fimbriaeFemales may be asymptomatic; males have painful urination and pus dischargeTreatment with antibioticsUntreated may result inEndocarditisMeningitisArthritisOphthalmia neonatorum – infant eye infectionsList the causative agents, symptoms, methods of diagnosis, and treatments for gonorrhea, NGU, PID, syphilis, LGV, chancroid, and bacterial vaginosis.
12Gonorrhea – gram-negative, pairs of cocci Figure 26.7
14Nongonococcal Urethritis (NGU) Any inflammation of urethra not cause by N. gonorrhoeaeChlamydia trachomatis (most common STD)May be transmitted to newborn's eyesPainful urination and watery dischargeSymptoms mild or lacking, but can cause sterility and uterine tube inflammationOther causes of NGU:Mycoplasma hominisUreaplasma urealyticum
15Pelvic Inflammatory Disease (PID) Extensive bacterial infection of female pelvic organsN. gonorrhoeaeChlamydia trachomatisSalpingitis is infection of uterine tubes (next slide)Can block uterine tubes and cause sterilityChronic abdominal pain
16(PID) Salpingitis – infection of uterine tubes List reproductive system diseases that can cause congenital and neonatal infections, and explain how these infections can be prevented.
17SyphilisTreponema pallidum – spirochete not yet cultured in vitro, must be grown in cell culturesTransmitted by direct contact, invades intact mucosa or through skin breaksFigure 26.10
18SyphilisPrimary stage: small, hard-based chancre at site of infection; bacteria then invade blood and lymph systemSecondary: Skin and mucosal rashes are widely disseminatedLatent period: No symptoms with healing of lesionsTertiary: at least 10 year later gummas (tertiary lesions) on many organsCongenital: T. pallidum crosses placenta causing neurological damagePrimary & secondary stages treated with penicillin
19Syphilis (Treponema pallidum) Direct diagnosis:Darkfield microscopic identification of bacteria from primary and secondary lesionsStaining with fluorescent-labeled, monoclonal antibodiesIndirect, serological diagnosis:VDRL, RPR, ELISA test for reagin-type antibodies using cardiolipid (Ag)FTA-ABS tests for anti-treponemal antibodies
22SyphilisIn the FTA-ABS (fluorescent treponemal antibody absorption) test T. pallidum show up as light cells against a darker backgroundFigure 3.6b
23Lymphogranuloma Venereum (LGV) Chlamydia trachomatisPrimarily a disease of tropical and subtropical regionsInitial lesion on genitals heals without scarringBacteria spread through lymph causing enlargement of lymph nodes, obstruction of lymph vessels, swelling of external genitalsTreatment: doxycycline
24Chancroid (Soft Chancre) Haemophilus ducreyiUlcer on genitalia or mouthMay break through surfaceInfection of lymph nodesTreatment: erythromycin and ceftriaxone
25Bacterial Vaginosis Gardnerella vaginalis Infection without inflammationDiagnosis by clue cells, higher vaginal pHTreatment: metronidazoleFigure 26.12
27Viral Diseases of Reprod. System: Genital Herpes Discuss the epidemiology of genital herpes and genital warts.Herpes simplex virus 2 (HSV-2)Symptoms are painful urination, genital irritation, fluid-filled vesiclesNeonatal herpes transmitted to fetus or newborns, resulting in neurological damage or fatalitiesRecurrences from viruses latent in nerves after trauma or hormonal changesSuppression: acyclovir or valacyclovir
28Genital Warts Human papillomaviruses Treatment: Imiquimod to stimulate interferonHPV 16 causes cervical cancer and cancer of the penisDNA test to detect cancer-causing strainsVaccination against HPV strains
29Fungal Disease of Reprod. System: Candidiasis Discuss the epidemiology of candidiasis.Candida albicansGrows on mucosa of mouth, intestinal tract, genitourinary tractNGU in malesVulvovaginal candidiasis has lesions that itch and irritatePredisposing factors: pregnancy, diabetes, tumors, broad-spectrum antibioticsDiagnosis by microscopic identification and culture of yeast from lesionsTreatment: clotrimazole or miconazole
30Protozoan Disease of Reprod.: Trichomoniasis Discuss the epidemiology of Trichomoniasis.Trichomonas vaginalisFound in semen or urine of males carriersVaginal infection (pH increase) causes irritation and profuse dischargeDiagnosis by microscopic identification of protozoanTreatment: metronidazoleFigure 26.15