1. Microbiology: A Systems Approach
PowerPoint to accompany
Microbiology: A Systems Approach
Cowan/Talaro
Chapter 23
Infectious Diseases Affecting the Genitourinary System
Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

2. Chapter 23
Topics
- Defenses
- Diseases

3. Defenses
Genitourinary system
Normal flora
Protection

4. Genitourinary system
Urinary system
Reproductive system

5. Urinary system Removes substances from the blood
Regulates body processes
Forms urine to transport out of body

6. The urinary tract includes the kidneys, ureters, bladder and the urethra.
Fig The urinary system.

7. Reproductive system
Male system
Female system

8. The major parts of the male reproductive system.
Fig The male reproductive system.

9. The major parts of the female reproductive system.
Fig The female reproductive system.

10. Normal flora Both male and female Female Outer regions of the urethra
Non hemolytic streptococci, staphylococci, corynebacteria, some lactobacilli
Female
Vagina
Bacterial and some fungi

11. Protection Flushing action (desquamation)
Urine contains antibacterial proteins (IgA), lysozyme and lactoferin
Female vagina
Mucous membrane (secretory IgA)
Acidic pH (fermentation)

12. Diseases Urinary tract Reproductive tract Genital ulcer Warts
Group B streptococcus

13. Urinary tract Bacterial infection Cystitis Pyelonephritis Urethritis
Leptospirosis
Urinary schistosomiasis

14. Bacterial infection Escherichia coli Staphylococcus saprophyticus
Proteus mirabilis
Bacterial infection
Acquired from GI tract
More common in women
Most common nosocomial infection

15. Features of urinary tract infections.
Checkpoint 23.1 Urinary tract infections (cystitis, pyelonephritis)

16. Leptospirosis Bacterial infection
Approximately 200 different serotypes
Kidney infection
Zoonotic
Present in animal urine

17. Leptospira interrogans, the causative agent of leptospirosis, is a spirochete bacteria.
Fig Leptospira interogans, the agent of leptospirosis.

18. Features of leptospirosis.
Checkpoint 23.2 Leptospirosis

19. Urinary schistosomiasis
Helminth infection
Lodges in the blood vessels of the bladder
Obstruction of the bladder

20. Features of urinary schistosomiasis.
Checkpoint 23.3 Urinary schistomiasis.

21. Reproductive tract Vaginitis and vaginosis Discharge diseases
Genital ulcer diseases
Warts
Group B Streptococcus

22. Vaginitis and vaginosis
Fungi - vaginitis
Mixed bacteria – vaginosis (noninflammatory)
Bacterial - vaginitis

23. Gram stain of the fungi Candida albicans, the causative agent of vaginitis.
Fig Gram stain of Canidida albicans in a vaginal smear.

24. For mixed infections, Gardnerella is the major bacteria involved, and can be identified by the formation of clue cells.
Fig Clue cell in bacterial vaginosis.

25. Trichomonas vaginalis is a protozoan infection, and is considered a sexually transmitted disease (STD).
Fig Trichomonas vaginalis adhering to humans cells.

26. Features of vaginitis and vaginosis.
Checkpoint 23.4 Vaginitis/vaginosis

27. Discharge diseases
Increase in fluid discharge for both male and female
Gonorrhea
Chlamydia

28. Gonorrhea Bacterial infection Strictly a human disease - STD
Phase variation – fimbrial proteins
IgA protease
Male - urethritis
Female
Salpingitis
Pelvic inflammatory disease (PID)
Can affect other organs (skin, eye)
Infant eye infections

29. Neisseria gonorrhoeae, the causative agent of gonorrhea, can cause peritonitis and PID, which can result in ectopic pregnancies.
Fig Invasive gonorrhea in women.

30. N. gonorrhoeae can cause eye infections in new borns.
Fig Gonococcal ophthalmia neonatorum in a
Week-old infant.

31. N. gonorrhoeae, from a male patient with gonorrhea, are diplococcus inside neutrophils.
Fig Gram stain of urethral pus from a male patient
With gonorrhea.

32. Incidence rates of gonorrhea and syphilis from 1964 to 2003.
Fig Gonorrhea and syphilis-reported rates.

33. Chlamydia Bacterial infection Elementary body Reticulate body
Intracellular
Asymptomatic
Male - nongonococcal urethritis
Female - PID
Infant conjunctivitis
Rare - lymphogranuloma venereum

34. Chlamydia trachomatis, the causative agent of chlamydia, adheres to the mucosa of the fallopian tube.
Fig Chlamydia trachomatis adhering to mucosa
of fallopian tube.

35. Chlamydia is an intracellular pathogen, and the life cycle involves an infectious elementary body stage and a reticular body or multiplying stage.
Fig The life cycle of Chlamydia.

36. Features of discharge diseases.
Checkpoint 23.5 Genital “discharge” diseases

37. Genital ulcer diseases
Lesions on the genitals
Syphilis
Chancroid
Genital herpes

38. Syphilis Bacterial infection Stages Congenital Primary - chancre
Secondary
Tertiary
Congenital

39. After the chancre has healed, secondary syphilis develops, in which a skin rash forms on the trunk, arms, palms, and soles.
Fig Symptom of secondary syphylis.

40. After resolution of secondary syphilis, latency occurs which can last up to 20 years, and in time destruction of tissues (gummas) can result in cardiovasculer, hepatic, bone, cartilage, and nerve damage.
Fig The pathology of late, or tertiary syphilis.

41. Congenital syphilis begins as an early profuse nasal discharge and later develops into a condition called Hutchinson’s teeth.
Fig Congenital syphilis.

42. Treponema pallidum, the causative agent of syphilis, is a spirochete bacterium.
Fig Electron micrograph of the syphilis spirochete
Attached to cells.

43. T. pallidum can be identified by dark-field microscopy, in which the characteristic spiral morphology can be observed.
Fig Treponema pallidum from a syphilitic chancre,
Viewed with dark-field illumination.

44. Chancroid Bacterial infection Pleomorphic
Most prevalent in tropic and subtropic environments
STD

45. Genital herpes Virus infection Chronic – viral latency Asymptomatic
Recurrent symptoms
Serious in newborns

46. Herpes simplex virus -1 and –2 are responsible for genital herpes, and can be transmitted to the fetus, which then can infect the skin, mouth, eyes, and the CNS.
Fig Prenatal herpes simplex.

47. HSV-1 is believed to be responsible for oral herpes or cold sores.
Fig Oral herpes infection.

48. HSV-1 and –2 have an icosahedral capsid and envelope structure, as evident by the transmission electron micrograph.
Fig Transmission electron micrograph of herpes simplex
Virus.

49. Reactivation of HSV-2 causes the virus to travel down the neuron to the body’s surface, forming visible lesions.
Fig HSV-2 latent in lumbosacral ganglion.

50. Because herpes can be shed without visible lesions, preventative methods include condom use by women.
Fig The female condom.

51. Features of genital ulcer diseases.
Checkpoint 23.6 Genital ulcer diseases

52. Warts Human papillomavirus (HPV) Molluscum contagiosum Mild
Serious (cervical cancer- oncogenes)
Molluscum contagiosum
Virus infection
Less severe than HPV

53. Features of wart diseases.
Checkpoint 23.7 Wart diseases

54. Group B Streptococcus Bacterial infection
Infants contract it from the mother during birth
Pregnant women are routinely screened

55. Features of Group B streptococcus colonization.
Checkpoint 23.8 Group B Streptococcus colonization

56. Summary of diseases in the genitourinary tract.
Taxonomic organization of microorganisms causing
Disease in the genitourinary tract.

57. Infectious Diseases Affecting the Genitourinary System.
Fig. 23.p762