1. Medical Technology Department, Faculty of Science, Islamic University-Gaza MB M ICRO B IOLOGY Dr. Abdelraouf A. Elmanama Ph. D Microbiology 2008 Chapter 26 Microbial Diseases of the Urinary and Reproductive Systems

2. 2008 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. 2008 Female Urinary Organs Figure 26.1

4. 2008 Female Reproductive Organs Figure 26.2a

5. 2008 Male Reproductive & Urinary Organs Figure 26.3

6. 2008 Urinary bladder and upper urinary tract sterile Lactobacilli predominant in the vagina >1,000 bacteria/ml or 100 coliforms/ml of urine indicates infection Normal Microbiota

7. 2008 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 Cystitis

8. 2008 Leptospirosis Figure 26.4 Leptospira interrogans Reservoir: Dogs and rats Transmitted by skin/mucosal contact from urine- contaminated water Diagnosis: Isolating bacteria or serological tests

9. 2008 Prevented by condoms Treated with antibiotics Sexually Transmitted Diseases (STDs )

10. 2008 Gonorrhea Figure 26.5a

11. 2008 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 Gonorrhea

12. 2008 Figure 26.7 Gonorrhea

13. 2008 Gonorrhea

14. 2008 Chlamydia trachomatis May be transmitted to newborn's eyes Painful urination and watery discharge Mycoplasma hominis Ureaplasma urealyticum Nongonococcal Urethritis

15. 2008 N. gonorrhoeae C. trachomatis Can block uterine tubes Chronic abdominal pain Pelvic Inflammatory Disease

16. 2008 Figure 26.9a Syphilis

17. 2008 Treponema pallidum Invades mucosa or through skin breaks Figure 26.10 Syphilis

18. 2008 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 Syphilis

19. 2008 Syphilis Figure 3.6b

20. 2008 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 Syphilis

21. 2008 Chlamydia trachomatis Initial lesion on genitals heals Bacteria spread through lymph causing enlargement of lymph nodes Treatment: doxycycline Lymphogranuloma Venereum (LGV)

22. 2008 Haemophilus ducreyi Ulcer on genitalia May break through surface Infection of lymph nodes Treatment: erythromycin and ceftriaxone Chancroid (Soft Chancre)

23. 2008 Gardnerella vaginalis Diagnosis by clue cells Treatment: metronidazole Figure 26.12 Bacterial Vaginosis

24. 2008 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 Genital Herpes

25. 2008 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 Genital Warts

26. 2008 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 Candidiasis

27. 2008 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 Trichomoniasis

28. 2008 Vaginitis and Vaginosis Table 26.1