Bacterial Urinary Tract Infection
Bacterial Urinary Tract Infection
Bacterial Urinary Tract Infection
NONVENEREAL DISEASES OF SIGNS AND SYMPTOMS PATHOGENS AND PATHOGENESIS AND DIAGNOSIS, TREATMENT
THE REPRODUCTIVE SYSTEM VIRULENCE FACTORS EPIDEMIOLOGY AND PREVENTION
STAPHYLOCOCCAL ➢ Sudden – onset fever, • Staphylococcus = ❖ Strains of Staphylococcus ❖ Diagnosis is through signs
chills, vomiting, diarrhea, normally part of the skin produce toxic shock and symptoms,
TOXIC SHOCK
extremely low blood and mucous membrane syndrome toxic that particularly in
SYNDROME pressure, mental microbiota grows in the vagina or in menstruating women
confusion and a severe Toxic Shock Syndrome toxins wound, the toxin then is ❖ Culture of blood samples
red rash o Exotoxins that is absorbed into the blood grown colonies of S.
➢ Untreated TSS is fatal to produced by strains ❖ S. aureus grows on aureus
50% of patients when of S. aureus that superabsorbent ❖ TSS is a medical
their blood pressure falls cause STTS tampons, especially emergency
so low that the brain, o Soluble poisonous when a blood – soaked o Patients
heart, and other vital toxins released from tampon remain in place experiencing
organs have an cells for a prolonged period sudden onset of
inadequate supply of o Bind simultaneously ❖ Occurs in males and fever or rash
oxygen = “shock” to major females, but most cases particularly
histocompatibility have been identified in during
complex II molecules menstruating females menstruation or
on antigen – following surgery
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presenting cells and T ❖ At – risk individuals = should seek
cell receptors on T women who use immediate
cells tampons, vaginal treatment
o Bind to sites other sponges, or diaphragms, ❖ Treatment = removal of
than the normal newly delivered mothers, foreign material
antigen – binding surgery patients (tampon, sponge,
sites of these (especially after nasal diaphragm, nasal
immune system surgery), and anyone packing) and drainage of
molecules with an infection of S. infected wounds
o When a toxin aureus
molecule binds two
defensive cells
together, it activates
the T cell
o These activated T
cells release an
overabundance of
cytokines triggering
manifestations of TSS
• TSST -1 = 75% cases of
staphylococcal toxic
shock syndrome
Enterotoxins
o Exotoxins that cause
gastrointestinal
distress when
ingested
o 25% cases
BACTERIAL VAGINOSIS ➢ Homogenous white • Normal lactobacilli of the ❖ A decline in the number ❖ Diagnose through signs
vaginal discharge with a vaginas are replaced with of lactobacilli populating o Odor, discharge
“fishy” odor a large number of the vagina results in a pH characteristics,
➢ Some itching and facultatively or obligate in the vagina higher than and vaginal pH
irritation of the vaginal anaerobic bacteria such the normal 4.5 greater than 4.5
opening Gram positive o Promotes or ❖ Vaginal cells = clue cells;
➢ 50% women report no Gardnerella vaginalis and allows the completely covered with
symptoms Mycoplasma hominis growth of the anaerobic bacteria
bacteria supports the diagnosis
❖ Oral metronidazole = 7
days
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❖ Associated with having ❖ Vaginal metronidazole =
multiple sexual partners 5 days
and vaginal douching ❖ Sexual abstinence and
❖ Virgins are rarely refraining from douching
affected are beneficial
❖ Bacterial vaginosis not a
sexually transmitted
disease
VAGINAL CANDIDIASIS ➢ White mucoid colonies Candida albicans C. albicans ❖ Stained preparations of
growing on mucous - most common o Lives in the vagina in vaginal discharge reveal
membrane of the vagina species causing competition with clusters of budding yeast
and the skin covering the candidiasis lactobacilli and other and branching
vaginal labia - opportunistic bacteria pseudohyphae with
➢ The yeast produces ascomycete yeast o Multiply rapidly correlated symptoms
severe vaginal itching - forms long cellular (following changes in ❖ Azole suppositories or
and burning, which extensions called vaginal pH or cream or oral fluconazole
urination intensifies pseudo hyphae microbiota), ❖ Azole creams = oil –
➢ Sexual intercourse = o appear triggering based that weaken latex
painful similar to the inflammation and condoms
➢ Vaginal discharge = curd- true hyphae other manifestations ❖ Maintain the normal
like and slight of o Transmitted between vaginal microbiota by
filamentous individuals (can pass avoiding excessive use of
fungi to babies during antibacterial drugs
- Candida changing childbirth and rarely ❖ Vaginal candidiasis is
from yeast form to to males during acquired rarely via sexual
filamentous form is a sexual contact contact
virulence factor ❖ Immunocompromised
o Virulence is individuals (especially
not due to AIDS patients) = can
formation of become systematic
pseudo ❖ 75% women = will
hyphae but experience candidiasis at
to the genes least once
themselves ❖ 50% = will have two or
Candida spp. more episodes
- Common members ❖ Predisposing factors =
of the microbiota of cancer, invasive hospital
the skin and mucous procedure, antibacterial
membrane treatments (which inhibit
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- E.g. The digestive and normal bacteria that
reproductive tracts compete with Candida),
of 40% - 80% of all diabetes, severe burns,
healthy individuals intravenous drug abuse,
harbor the yeasts and AIDS
❖ 100% AIDS patient will
develop candidiasis in
their reproductive or
digestive tract
❖
SEXUALLY TRANSMITTED ➢ Presence of lesions ❖ Young people often ❖ Sexual abstinence or
DISEASES (STDs) • Known risk factor experiment with sex completely faithful
o also known as for the and many have an it – mutual monogamy
venereal diseases transmission of cannot- happen to me ❖ Latex or Polyurethane
o Major epidemic has HIV and condoms = reduce the
attitude, which leads
developed over the development of risk of contracting many
to exposing themselves
last 45 years AIDS STDs, but they are not
➢ Asymptomatic in younger
to serious health risks perfectly safe
o 333 million new
women ❖ Embarrassment over ❖ Diseases of the skin and
cases occur each year
• These patients do contraction of an STD digestive system such as
not seek treatment can impair normal scabies infection,
• Suffer horrendous psychological giardiasis, shigellosis and
long -term development hepatitis can be
consequences transmitted sexually
concerning sexuality
including
development of ❖ Female adolescent = at
birth defects in the risk for STDs (cervical
babies, ectopic lining is especially
pregnancy prone to bacterial
(implantation of a
invasion
fetus outside the
❖ Sexually active 15-year-old
womb),
girl has a 12.5 % chance of
miscarriage,
developing Pelvic
sterility, or the
inflammatory disease
development of
(inflammation and pain in
cervical cancer
the uterus, uterine tubes, or
ovaries); whereas at age 24
the probability decrease to
1.25%
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SIGNS AND SYMPTOMS PATHOGENS AND VIRULENCE PATHOGENESIS AND DIAGNOSIS, TREATMENT
BACTERIAL STDs FACTORS EPIDEMIOLOGY AND PREVENTION
GONORRHEA ➢ Men Neisseria gonorrhoeae ❖ Gonococci adhere, via ❖ Presence of Gram –
o Sometimes called • Insufferably - Also known as the their fimbriae, and negative diplococci in
“clap” from the symptomatic gonococcus capsules to epithelial pus from an inflamed
archaic French word • Acute - Gram negative bacteria cells of the mucous penis = diagnosis of
clapoir, meaning inflammation usually forms pairs of cells membrane lining much symptomatic gonorrhea
brothel occurs 2-5 days that have fimbriae, of the genital, urinary, in men
o Excess of semen after infection polysaccharide capsules and digestive tracts of ❖ Genetic probes =
(“flow of seed” in in the urethra and a major cell wall humans diagnosis of
Greek) of penis, antigen called ❖ 100 pairs of cells can asymptomatic cases of
o Occurs in humans causing lipooligosaccharide cause disease gonorrhea in mean and
only extremely (composed of lipid A or ❖ The bacterium cannot women
o Most civilian cases painful endotoxin and sugar attach to cells lining the ❖ No long- term specific
occur in urination and a molecules) vagina; instead, the immunity against N.
adolescents, purulent (pus – - Cells that lack these three bacteria most gonorrhoeae and thus
particularly among filled) discharge structural features are commonly infect the peoples can have
those in several • Rarely, avirulent cervix of the uterus gonorrhea multiple
southeastern states bacterium - Cocci = protect ❖ N. gonorrhoeae times
who have multiple invades the themselves from the o Via fimbriae, o Highly variable
sexual partners prostate or immune system by they attach to surface antigens
o Infection is four epididymis, secreting enzyme that sperm cells, in this bacterium
times more where the cleaves secretory IgA in which allows o Immunity
common among formation of mucus bacterium to against one
blacks than scar tissue can hitchhike to the strain often
nonblack render the man uterine tubes provides no
o Slightly common infertile and beyond protection
among males than ➢ Women producing against other
females • Often pelvic strains
o An individual’s risk asymptomatic inflammatory ❖ Use of antimicrobial to
of infection • 50%-80% of disease prevent genital diseases
increases with infected women ❖ Chronic infections = may select for hardier
increasing have no scarring of the tubes, resistant strains,
frequency of sexual symptoms or no resulting in ectopic worsening the situation
encounters obvious signs of pregnancies or sterility ❖ Preventive strategies:
o Women = 50% infection for ❖ Gonococcal infections o Sexual
chance of infection years of organs outside the abstinence
during a single • Try to have a reproductive tracts also o Monogamy with
sexual encounter baby, damage occur a monogamous
partner
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with an infected to the uterine o A woman’s o 100% consistent
man tube becomes urethral and proper use
o Men = 20% chance obvious opening is close of condoms
of infection during a • 25% suffer to her vaginal
single sexual pelvic opening, which
encounter with an inflammatory the bacteria can
infected woman disease infect the
o Infection of older urethra during
children with N. sexual
gonorrhoeae is a intercourse
strong evidence of ❖ Anal intercourse can
sexual abuse by an lead to proctitis
adult (inflammation of the
rectum)
❖ Oral sexual intercourse
= infect the pharynx, or
gums (pharyngitis and
gingivitis)
o Commonly seen
in men who
have sex with
men
❖ Phagocytized bacteria
survive and multiply
within neutrophils,
traveling within these
leukocytes throughout
the body
❖ Rare cases = gonococci
travel to the joints,
meninges, or heart
(arthritis, meningitis,
endocarditis)
❖ Gonococcal infection of
child during birth can
result to inflammation
of the cornea,
ophthalmia
neonatorum (inflammation
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of the conjunctiva in newborns)
or blindness
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SYPHILIS PRIMARY Treponema pallidum T. pallidum ❖ Specific antibody tests =
o Afflicts more than Chancre - Helical cells of this - Fastidious and diagnosis of primary,
12 million new • small, painless, spirochete are so narrow sensitive secondary, and
victims each year reddened hard (0.1 um) that they are - Obligate parasite of congenital syphilis
lesion forms at the difficult to see by regular humans ❖ MHA – TP
o Remains endemic
site of infection 10- light microscopy in Gram - Transmitted via (microhemagglutination
among sex workers
21 days after stained specimens sexual contact, assay against T.
who have sex with
exposure - Phase – contrast during the early pallidum) = uses red
men and users of
illegal drugs • typically, from on microscopy, dark field – stage of infection, blood cells that have
the external microscopy, or special when the been artificially coated
genitalia stains are used to spirochete are with Treponema
• 20% forms in the increase contrast numerous antigens
mouth, around the - Lives naturally only in - Can be spread from = Antibodies in the
anus, or on the humans mother to fetus and serum of infected
fingers, lips or - Cannot survive in the rarely through patients will agglutinate
nipples environment because it blood transfusion (clump) the red blood
• Often unobserved, can be destroyed by heat, - Cannot be spread cells – positive test for
especially in disinfectants, soaps, by fomites such as exposure of T. pallidum
women, in whom drying, concentration of toilet seats, eating, ❖ Spirochetes can be
these lesions oxygen in the air, and pH utensils or clothing observed in fresh
frequently form on - Have not be cultured in - 10% - 30% = risk of discharge from lesions,
the cervix cell – free media, though infection from a but only when
SECONDARY they have coaxed it to single, unprotected microscopic
➢ Sore throat, headache, multiply in rabbits, sexual contact with observations of clinical
mild fever, malaise, monkeys, and in rabbit and infected samples are made
myalgia, epithelial cell cultures partner immediately
lymphadenopathy - It multiplies slowly (binary o Treponema
(diseased lymph nodes), fission occurs every 30 PRIMARY SYPHILIS rarely survive
and widespread rash hours) and only for a few ❖ Chancre forms at the transport to a
(palms and soles of the generations site of infection laboratory
feet) - Using recombinant DNA ❖ The center of chancre o Nonpathogenic
➢ The rash does not itch technology, they inserted fill with serum that is spirochetes,
or hurt and persist for genes from Treponema extremely infectious which are
months into E. coli and isolated due to the presence of normal part of
LATENTS some genes’ proteins spirochete the oral
➢ No symptoms o These proteins ❖ Chancre remain for microbiota, can
TERTIARY enable three to six weeks and yield false
Treponema to then disappear without positive results,
scarring so mouth can’t
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➢ Some untreated adhere to human SECONDARY SYPHILIS be tested for
patients experience cells ❖ Treponema has invaded syphilis
dementia, blindness, - Hyaluronidase = enable the bloodstream and ❖ Tertiary syphilis =
paralysis, heart failure, Treponema to infiltrate spread throughout the extremely difficult to
or syphilitic gummas intracellular spaces body diagnose because any
➢ Gummas = rubbery, - Glycocalyx = protect it ❖ Rash lesions are filled spirochete present and
swollen, lesions that from phagocytosis by with spirochetes and because the signs and
occur in bones, in leukocytes are extremely symptoms may occur
nervous tissues or on contagious years apart and seems
the skin; rarely develops ❖ People are infected unrelated to one
in countries where when fluid from the another
antimicrobial drugs are lesions enter breaks in ❖ Penicillin G = not
available the skin effective for treating
❖ Nonsexual transmission tertiary syphilis because
is rare this phase is a
LATENT SYPHILIS hyperimmune response
❖ After several weeks or and not an active
months, the rash infection
gradually disappears
❖ Inactive stage of the
disease
❖ May last 10 or more
years
TERTIARY SYPHILIS
❖ Third of the originally
infected patients
❖ Not associated with the
direct effects of
Treponema, but rather
with severe
complications resulting
from inflammation and
a hyperimmune
response against the
pathogen
❖ Gummas, destruction of
cardiovascular or
central nervous system
tissue, personality
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changes, insanity, and
blindness
CONGENITAL SYPHILIS
❖ Results when the
bacteria crosses the
placenta from an
infected mother to her
fetus
❖ Death of the fetus =
transmission of the
fetus from a mother
experiencing primary or
secondary syphilis
❖ Mental retardation and
malformation of many
organs = transmission
of the fetus from a
mother latent syphilis
o Newborns with
latent infection
= widespread
rash like the
secondary
syphilis (2
years)
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CHLAMYDIAL ➢ 85% = Chlamydial Chlamydia ❖ C. trachomatis enters ❖ Specific fluorescent
genital tract infected - Non-motile the body through antibodies or nucleic
INFECTION
women are - Grow and multiply only abrasion or laceration acid probes
o Sexually transmitted
asymptomatic within the vesicles inside and infects cells of the ❖ PCR amplification
chlamydial infection are
➢ 75% = Shows signs and host cells conjunctiva or cells ❖ Surgical correction of
most prevalent among
symptoms similar to - Once considered to be lining a mucous eyelid deformities may
women under the age
those of gonorrhea viruses because of their membrane of the prevent the abrasion,
of 20 because they are
(urethritis, painful small size and obligate trachea, bronchi, scarring, and blindness
physiologically
urination, and pus intracellular parasite urethra, uterus, uterine ❖ Trachoma strains
susceptible to infection
discharge from the - Cellular and possess RNA, tubes, anus or rectum infecting the eyes of a
o LGV strains are
penis) DNA and functional 70S ❖ Typically, the lesion at a newborn are treated
primarily found in the
➢ Epididymitis = ribosomes site of infection is with erythromycin
tropics
inflammation of the - Two membrane, similar to overlooked because it is cream for 10-14 days
o Over 500 million people
epididymis; leads to those of a typical Gram – small, painless and
worldwide, particularly
sterility negative bacterium, heals rapidly
children, contract
➢ Orchitis = inflammation surround each chlamydial ❖ Headache, muscle pain,
ocular infection
of a testis; leads to cell, but there is no and fever may occur
• The bacterium
sterility peptidoglycan between ❖ 80% = infected people
infects children ➢ Trachoma = an eye the membrane have no symptoms
as they pass
disease that develops - Do not have cell walls ❖ Proctitis may occur in
through the
when babies are - Classified in the phylum men or women because
birth canal infected at birth; Chlamydiae of lymphatic spread of
• The pathogen leading cause of Chlamydia from the
may also be nontraumatic blindness Chlamydia trachomatis genitalia or urethra to
transmitted in humans worldwide - Very limited host range the rectum
from eye to eye ➢ Lymphogranuloma - All strains are pathogens ❖ 15% = Proctitis in
via droplets, o a severe form of of humans, infecting the homosexual men result
hands, chlamydial STD conjunctiva, lungs, urinary from the spread of the
contaminated o transient tract, or genital tract with bacteria via anal
fomites or flies genetical lesion one exceptional strain intercourse
o Chlamydial eye at the site of that may be classified as a ❖ LGV strains of
infections are endemic infection on the separate species Chlamydia infect the
in crowded, poor penis, urethra, - More than 10 strains lymph nodes in the
communities where scrotum, cause STDs in humans groin, producing
people have deficient vagina, cervix, o Three of these buboes
personal hygiene, or external called LGV strains ❖ Lymphogranuloma
inadequate sanitation female genitalia trigger venereum proceeds to
and inferior medical o Followed by a lymphogranuloma a third stage
care development of venereum characterized by genital
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bubo = a o Other strains sores, constriction of
painfully cause Trachoma the urethra, and severe
inflamed lymph Chlamydia genital swelling
node in the - Unique developmental o Arthritis may
groin, and cycle involving two also occur
fever, chills, cellular morphologies, particularly in
anorexia, and both of which occur young white
muscle pain within the phagosome of males for an
o Buboes may a host cell unknown
enlarge to the - Elementary bodies reason
point that they o Tiny cocci (0.2 – ❖ Pelvic inflammatory
rupture and 0.4 mm) cocci disease = destruction of
producing o Infective forms infected cells at the site
draining sores o Relatively of infection and from
dormant the inflammatory
o Resistant to response this
environmental destruction stimulates
extremes and can ❖ Reinfection in the same
survive outside site by the same or a
cells similar strain triggers a
- Reticulate bodies vigorous hypersensitive
o Large (0.6 – 1.5 immune response that
mm) pleomorphic can result in blindness,
o Obligate sterility, or sexual
intracellular dysfunction
forms that are ❖ Trachoma strains
reproductive multiply in cells of the
rather than conjunctiva, killing
infective them and triggering a
LIFE CYCLE copious, purulent
1. EB attaches to a host cell discharge that causes
and triggers endocytosis the conjunctiva to
2. Once inside the vesicle, become scarred
EB converts into an RB o Scarring =
3. RB rapidly divides to form patients’ eyelid
many RBs to turn inward,
4. After 21 hours after making the
infection, RBs within the eyelashes
vesicle, which is now abrade, irritate
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called an inclusion body, and scar the
begin by converting back cornea
to EBs o Triggers
5. After 19 hours, the EBs invasion of
are released from the blood vessels
host cell via exocytosis into this
6. It can now infect new normally clear
cells and completing the surface of the
life cycle eyes
o Scarred cornea
= becomes
filled with
blood vessels
and is no longer
transparent
o All results to
blindness
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