Transcript Chapter 26
MICROBIOLOGY Chapter 26 Microbial Diseases of the Urinary and Reproductive Systems Dr. Abdelraouf A. Elmanama Ph. D Microbiology Medical Technology Department, Faculty of Science, Islamic University-Gaza 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) 2008 Female Urinary Organs 2008 Figure 26.1 Female Reproductive Organs 2008 Figure 26.2a Male Reproductive & Urinary Organs 2008 Figure 26.3 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 2008 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 2008 Leptospirosis • Leptospira interrogans • Reservoir: Dogs and rats • Transmitted by skin/mucosal contact from urinecontaminated water • Diagnosis: Isolating bacteria or serological tests 2008 Figure 26.4 Sexually Transmitted Diseases (STDs ) • Prevented by condoms • Treated with antibiotics 2008 Gonorrhea 2008 Figure 26.5a Gonorrhea • 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 2008 Gonorrhea 2008 Figure 26.7 Gonorrhea 2008 Nongonococcal Urethritis • Chlamydia trachomatis • May be transmitted to newborn's eyes • Painful urination and watery discharge • Mycoplasma hominis • Ureaplasma urealyticum 2008 Pelvic Inflammatory Disease • N. gonorrhoeae • C. trachomatis • Can block uterine tubes • Chronic abdominal pain 2008 Syphilis 2008 Figure 26.9a Syphilis • Treponema pallidum • Invades mucosa or through skin breaks 2008 Figure 26.10 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 2008 Syphilis 2008 Figure 3.6b 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 & secondary stages treated with penicillin 2008 Lymphogranuloma Venereum (LGV) • Chlamydia trachomatis • Initial lesion on genitals heals • Bacteria spread through lymph causing enlargement of lymph nodes • Treatment: doxycycline 2008 Chancroid (Soft Chancre) • Haemophilus ducreyi • Ulcer on genitalia • May break through surface • Infection of lymph nodes • Treatment: erythromycin and ceftriaxone 2008 Bacterial Vaginosis • Gardnerella vaginalis • Diagnosis by clue cells • Treatment: metronidazole 2008 Figure 26.12 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 2008 Genital Warts • 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 2008 Candidiasis • 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 2008 Trichomoniasis • 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 2008 Figure 26.15 Vaginitis and Vaginosis 2008 Table 26.1