Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings PowerPoint ® Lecture Slide Presentation prepared by Christine L. Case Microbiology B.E Pruitt & Jane J. Stein AN INTRODUCTION EIGHTH EDITION TORTORA FUNKE CASE Ch. 14 Genitourinary tract infections Medical Microbiology

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings 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)

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Female Urinary Organs Figure 26.1

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Female Reproductive Organs Figure 26.2a

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Male Reproductive & Urinary Organs Figure 26.3

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings 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

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings 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

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings 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

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Prevented by condoms Treated with antibiotics Sexually Transmitted Diseases (STDs )

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings 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

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Figure 26.7 Gonorrhea

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Chlamydia trachomatis May be transmitted to newborn's eyes Painful urination and watery discharge Mycoplasma hominis Ureaplasma urealyticum Nongonococcal Urethritis

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings N. gonorrhoeae C. trachomatis Can block uterine tubes Chronic abdominal pain Pelvic Inflammatory Disease

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Treponema pallidum Invades mucosa or through skin breaks Figure Syphilis

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings 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

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Syphilis Figure 3.6b

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings 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

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Chlamydia trachomatis Initial lesion on genitals heals Bacteria spread through lymph causing enlargement of lymph nodes Treatment: doxycycline Lymphogranuloma Venereum (LGV)

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Haemophilus ducreyi Ulcer on genitalia May break through surface Infection of lymph nodes Treatment: erythromycin and ceftriaxone Chancroid (Soft Chancre)

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Gardnerella vaginalis Diagnosis by clue cells Treatment: metronidazole Figure Bacterial Vaginosis

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings 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

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings 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

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings 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

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings 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 Trichomoniasis