Micro Ch 30 Bacterial Urogenital Diseases

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changing societal mores and reliable birth control in 1960s have caused

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STDs to become pandemics

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many people with STDs

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have no symptoms and spread STDs unknowingly, many present with multiple infections

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STDs may gain the upper hand in infections from

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use of broadspectrum ABTS

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In normal healthy ovulating or pregnant women

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lactobacillus species predominate in the normal flora and protect the urogenital tract by producing hydrogen peroxide that inhibits growth of catalase negative pathogens

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lactobacillus species also

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produce lactic acid and lower the pH to about 4, which also inhibits growth of many pathogens

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when ABT tx kills

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lactobacillus species, antibiotic resistant bacteria and yeast growth becomes much more frequent and STD rates increase.

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Gonorrhea characterisitcs

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bacteria, gram-, bean shaped diplococci, pili holdfast- for attachment to overcome flushing mechanism or urine- antiphagocytic,

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Gonorrhea aka

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gonococcus and GC for short

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incidence of Gonorrhea

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nearly 2mill new cases/y in US

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reservoir or source of Gonorrhea

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humans are the only one

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nutrition requirements of gonorrhea

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fastidious - require vitamines and CO2

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in females, gonorrhea

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asymptomatic carriage is common

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most gonorrhea rectal infxns

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are asymptomatic in either sex

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gonorrhea is caused by the organism

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Neisseria gonorrhoeae

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the male with gonorrhea commonly develops

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urethritis (inflammation of the urethra) with dysuria (pain and increased frequency) and an intense inflammatory response that induces pus like exudate (called "drip" or "clap" in the vernacular.

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the female with gonorrhea usually has

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cervititis (cervical inflammation. Pharyngitis and proctitis (rectal inflammation) are also common

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pregnant women who birth vaginally

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pass on conjunctivitis to the newborn

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______% of infected women progree to________

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10%; an invasive PID (pelvic inflammatory disease) that may lead to infertility because of scar tissue in the fallopian tubes

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as with N. meningitidis,

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PCN has been used for tx, but many strains are resistant, so cephtriaxone is widely used.

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to prevent neisserial conjunctivitis newborns have been given

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eye drops of silver nitrate for a number of years, or pcn more recently

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DX of gonorrhea:

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gram- diplococci that are oxidase positive (have the ability to oxidize certain chemicals). Speciation requires addition sugar fermentation tests.

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Pilin negative strains of the gonococcus are

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nonpathogenic because they can't attach well enough and are washed away by ua

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pilin is

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the protein that comprises pili

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vaccine for gonorrhea

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use of the protien that comprises pili seemed hopeful initially, however the pilin type changes rapidly within a single strain because each strain has the capability to produce some 200 types of pili

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gonorrhea prevention

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condom usage is helpful in preventing the spread of gonorrhea.

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Syphilis characterisitcs

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spirochete; 0.2x15microns - need dark field microscopy to visualize in light microscope; highly motile; fastidious- growth only in living rabbit testes, which has made study difficult; neither gram + or -

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____________causes the disease syphilis

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treponema pallidum,

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syphilis occurs in

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3 stages, cancre, rash, gummas

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primary disease exhibits as

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the first stage- painless chancre, usually on genitalia, 3 wks after infection. usually seen by male but not female d/t location and lack of pain. a layer of fluid that is highly contagious covers the lesions

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the 2nd syphilitic stage

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begins after bacteria latent 2-10wks when they spread via blod/lymph thru body. usually a rash on palms of hands/soles of feet that lasts wks-mos and is highly contagious. mucous patches in mouth contain masses of bacteria transmitted by kissing

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secondary syphilis can appear

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in many forms and has been called the great imposter because it is frequently confused with other dieseases.

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tertiary stage of syphilis

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years later. may/not appear in form of gummas. few organism are present; damage is d/t immunohypersensitivity

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a gummas is characterized by

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destruction of soft tissue of bone, heart, brain, internal viscera etc

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tx of gonorrhea

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PCN effective in first 2 states but not after the tertiary stage has appeared

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20 y after infxn of syphilis

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a general group of mental illnesses called general paresis (dementia d/t syphilis) develop. the illnesses include emotional instability, memory loss, impaired judgement, delusions, hallucinations, loss of vision, eye damage, and speech defects. this outcome has changed hx because of its effects on kings in Europe.

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in syphilis, asymptomatic carriers are of great concern becuase

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they don't obtain medical tx and provide a large pool to keep the organisms spreading in the general population

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Chlamydia characteristics:

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gram-, roundish- no PG; obligate intracellular pathogen (no growth on bacterial media); unable to make ATP - must transport from host cells, called energy parasites

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chlamydia has ____forms

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2 forms, vegetative intracellular and infectious extracellular forms

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chlamydia is the #

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1 infectious bacterium in the world

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Chlamydia grows in

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phagocytes; induces nonphagocytes to ingest them to initiate infxn

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asymptomatic incidence

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70% of infected females; 30% infected males

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incidence in US

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4-5mill/y new cases. 500mill in world

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Nongonococcal urethritis (NGU)

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is most commonly cause by C. trachomatis

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The diseases cervicits, pharygitis, proctitis, and conjunctivitis are very similar to gonorrheal diseases except

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that eye infection in the newborn is called inclusion conjunctivitis because of inclusions (endosomal bags of growing chlamydia) seen in the cytoplasm of eye cells.

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C. trachomatis also causes the

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eye disease trachoma, a problem in areas of the world that don't have ABT tx

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Trachoma derives from

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hypersensitivity rxns d/t multiple infxns and is the greatest cause of preventable blindness in the world

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asymptomatic infxns of chlamydia are

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a serious problem, perhaps greatest in the female with cervicitis the bacteria can ascend asymptomatically into fallopian tubes, cause scarring/infertility

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salpingitis

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salpinges-fallopian tubes

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C. trachomatis is the principle cause of

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salpingitis and tubal infertility is the most common type of infertility in the US

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because chlamydial envelopes contain

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no cell walls, PCN is not used to tx infxns;

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drug of choice for chlamydia is

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tetracyclines. the drug must penetrate the host cell, the inclusion body, and finally the bacterium itself to be effective against chlamydia