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TORTORA • FUNKE
• CASE
Microbiology
AN INTRODUCTION
EIGHTH EDITION
B.E Pruitt & Jane J. Stein
Chapter 26
Microbial Diseases of the Urinary and
Reproductive Systems
PowerPoint® Lecture Slide Presentation prepared by Christine L. Case
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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)
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Female Urinary Organs
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Figure 26.1
Female Reproductive Organs
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Figure 26.2a
Male Reproductive & Urinary Organs
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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
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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
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Leptospirosis
• Leptospira interrogans
• Reservoir: Dogs and
rats
• Transmitted by
skin/mucosal contact
from urinecontaminated water
• Diagnosis: Isolating
bacteria or serological
tests
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Figure 26.4
Sexually Transmitted Diseases (STDs )
• Prevented by condoms
• Treated with antibiotics
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Gonorrhea
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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
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Gonorrhea
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Figure 26.7
Gonorrhea
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Nongonococcal Urethritis
• Chlamydia trachomatis
• May be transmitted to newborn's eyes
• Painful urination and watery discharge
• Mycoplasma hominis
• Ureaplasma urealyticum
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Pelvic Inflammatory Disease
• N. gonorrhoeae
• C. trachomatis
• Can block uterine tubes
• Chronic abdominal pain
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Syphilis
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Figure 26.9a
Syphilis
• Treponema pallidum
• Invades mucosa or through skin breaks
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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
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Syphilis
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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
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Lymphogranuloma Venereum (LGV)
• Chlamydia trachomatis
• Initial lesion on genitals heals
• Bacteria spread through lymph causing enlargement of
lymph nodes
• Treatment: doxycycline
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Chancroid (Soft Chancre)
• Haemophilus ducreyi
• Ulcer on genitalia
• May break through surface
• Infection of lymph nodes
• Treatment: erythromycin and ceftriaxone
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Bacterial Vaginosis
• Gardnerella
vaginalis
• Diagnosis by
clue cells
• Treatment:
metronidazole
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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
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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
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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
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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
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Figure 26.15
Vaginitis and Vaginosis
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Table 26.1