Chapter 24 - Microbial Diseases of the Urinary and Reproductive Systems

The US leads the industrialized nations in the reported incidence of STD.

I. Anatomical Lines of Defense

A. Acidity

B. Everything goes out

C. Mucosal lining

D. Normal flora -

1. Urinary bladder - sterile

2. Vagina and urethra - lactobacilli, Staph. epid, diphtheroids, Strep. sp

E. A matter of distance -> urethra- rectum

F. Most common STDs - herpes, Papilloma virus, Chlamydia, gonorrhea

G. Other Portals of entry

1. mother to fetus

2. syringes

3. transfusion

H. Factors associated with increased #'s

1. oral contraceptives

2. increased practice of multiple partners

3. decrease in use of spermicides

4. inability to trace contacts

5. emergence of resistant strains

II. UTI Infections (Symptoms indicating a Urinary Tract Infection UTI - itching or burning on urination, pain on urination, lower back pain, blood or pus in the urine. Kidney infections are associated with fever, lower back pain, casts in the urine and fever.)

A. Cystitis - bladder infections -common in healthy adults and a common nosocomial infection

B. Variety of etiologies

        1. E.coli causing 70%
        2. Other Enterobacteriaceae = 10%
        3. Staph. saprophyticus = 10%
        4. Nosocomial infections are caused by Enterobacteriaceae and Enterococci (500,000/year from catheterization)
        5. Leptospirosis
        6. Yeast

C. Complications - Commonly results in reoccurring infections, can result in kidney infections

III. Genital Infections (Symptoms indicating a potential STD - abnormal discharge, itching or burning from GU opening, abnormal bleeding, pain during intercourse)

Disease	Etiologic Agent	Pathogenesis	Symptoms	Transmission	Prevention and treatment
Bacterial Infections of the GU
Vaginosis	Gardnerella vaginalis - pleomorphic Gram variable or GNCB* book is incorrect and anerobes	normal flora disrupted; vagina becomes more basic	fishy-smelling discharge Clue cells	Not considered an STD but not found in people without sexual activity	Renewal of Normal vaginal flora-yogurt Metronidazole = Flagyl
TSS - Toxic Shock Syndrome	Staph. aureus GPC in cl	super antigens produced by strains in vagina or wounds	sudden onset, high fever, vomiting, diarrhea, rash, confusion	exposure to toxin producing strain of S. aureus	tampon problem resolved no immunity treat shock & Nafcillin or Oxacillin
GBS	Group B Strep Strep agalactiae	infections in babies neonate are life threatening, subclinical in men and women	meningitis, pneumonia	during pregnancy or delivery	Penicillin
Gonorrhea	Neisseria gonorrhoeae	pili allow attachment, antigenic changes, intracellular, anti-IgA	males =painful urethritis; female = mild painful urination	STD concerns about PID - Pelvic Inflammatory Disease Orchitis newborns	Ceftriaxone behavioral changes & education vaccine
Chlamydia	Chlamydia trachomatis smallest bacteria	can not cultivate attachment, endocytosis for intracellular status	males =thin white discharge sometimes painful testes; female = vag. discharge, bleeding, abdominal pain	STD concerns about PID - Pelvic Inflammatory Disease	Doxycycline, Azithro, Erythro
Syphilis	Treponema pallidum spirochete	can not cultivate or stain, penetrates mucus membranes, hypersensitivity	Primary(chancre) secondary (rash) and tertiary (neurological, stroke,heart, gummas, etc)	STD congenital syphilis and Hutchinson's syndrome	Penicillin, Doxycycline Tetracycline
Disease	Etiologic Agent	Pathogenesis	Symptoms	Transmission	Prevention and treatment
Viral Infections of the GU
Genital Herpes	Herpes simplex type 2	lesions in epithelial tissue, vesicles contain virions	painful lesions on penis or in vagina	STD	serious risk to newborns antiviral- acyclovir
Genital Warts	Papilloma virus dsDNA 30 types - 15 assoc. w/cervical cancer	infect deep epithelium causing benign tumors	no pain latent infection cervical cancer 2nd only to breast	contact/STD	cryo or lazer surgery screening using Pap smear
AIDS/HIV	HIV virus	invade T-cells	flu-like initially, latent infection, immune suppression& 2nd disease with opportunists	STD Blood & body fluids	HIV cocktail can not deal with incorporated genome
Disease	Etiologic Agent	Pathogenesis	Symptoms	Transmission	Prevention and treatment
Fungal Infections of the GU
Candidiasis	Candida albicans	normal flora disrupted	itching, burning, thick white discharge	predisposed with pregnancy,birth control pills uncontrolled diabetes	OTC topical clotrimazole or Diflucan
Protozoal Infections of the GU
Trichmoniasis	Trichomonas vaginalis	inflammation, swelling	women = itching, frothy green, odiferous discharge men= asymptomatic	STD	Flagyl

Total number of Americans infected each year - approximately 91 million people. Population of the US is about 250 million.

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Bakersfield College | Kern Community College District | Janet Fulks
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Date last updated 11/19/2011
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