1. Microbial Diseases of the Urinary and Reproductive Systems26
Microbial Diseases of the Urinary and Reproductive Systems

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 (in females) or urethra (in 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
Figure 26.5a

11. Gonorrhea Neisseria gonorrhoeae
Attaches to oral or urogenital mucosa by fimbriae.
Females may be asymptomatic; males have painful urination and pus discharge.
Treatment is with antibiotics.
If left untreated, may result in
Endocarditis
Meningitis
Arthritis
Ophthalmia neonatorum

12. Gonorrhea
Figure 26.7

13. Gonorrhea
UN 26.1

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

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

16. Syphilis
Figure 26.9a

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

18. 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

19. Syphilis
Figure 3.6b

20. 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 and secondary stages treated with penicillin

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

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

23. Bacterial Vaginosis Gardnerella vaginalis Diagnosis by clue cells
Treatment: Metronidazole
Figure 26.12

24. 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

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

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

27. Trichomoniasis Trichomonas vaginalis
Found in semen or urine of male carriers
Vaginal infection causes irritation and profuse discharge.
Diagnosis is by microscopic identification of protozoan.
Treatment: Metronidazole.
Figure 26.15

28. Vaginitis and Vaginosis
Table UN 26.1