Microbiology Exam 3 (Part 5) -- Microbial Diseases of the Urinary and Reproductive Systems

What bacterial disease is a strong, persistent urge to urinate, a burning sensation when urinating, dysuria, painful urination, passing frequent, small amounts of urine, with urine that appears cloudy, bright pink, or "cola covered", and is strong-smelling?

Urinary Tract Infections (UTI)

Where is the difference in pain referral between women and men in Urinary Tract Infections (UTI)?

Women = pelvic pain

Men = Rectal pain

What 8 pathogens can cause UTIs? What is the two MOST COMMON one?

1) Escherichia coli (absolute MC)

2) Staphylococcus saprophyticus (2nd MC)

3) Proteus mirabilis

4) Providencia stuartii

5) Morganella morganii

6) Serratia maracescens

7) Klebsiela pneumoniae

8) Citrobacter

How are Urinary Tract Infections (UTI) transmitted?

Self-inoculate fecal bacteria into the urethra

(MC in females; 6-10 women will experience one)

Urinary catheters common source nosocomially

How is Urinary Tract Infections (UTI) diagnosed? Treated? Prevented?

Diagnosis = Urinalysis (UA)

Treatment = Many self-resolve

Prevention = limiting contamination by fecal microbes; CRANBERRIES

(hydrated, shower instead of bath, minimize douching/sprays/powder in area, wipe front to back)

What are some risk factors of Urinary Tract Infections (UTI)?

Age, Gender, Sexual activity, Menopause, Catheter, Diabetes, pregnancy, Spermicide use, Kidney disease

What bacterial urinary disease is abrupt fever, myalgia, muscle stiffness, headache, and later meningitis, rash, and in severe cases jaundice and kidney failure?

Leptospirosis (Weil's Disease)

What pathogen causes Leptospirosis (Weil's Disease)?

Leptospira interrogans

How is Leptospirosis (Weil's Disease) transmitted?

Direct contact between urine droplets or urine contaminated water and the mucous membrane of eye, nose, mouth, or abraded skin

-- Rare in US

How is Leptospirosis (Weil's Disease) Diagnosed? Treated? Prevented?

Diagnosed = antibody test

Treated = antibiotics

Prevention = avoid contaminated water (ex: flood water)

What bacterial urinary disease is the sudden appearance of edema, hematuria, proteinuria, and hypertension, with irreversible kidney damage that can occur in adults?

Acute Post-Streptococcal Glomerulonephritis

What pathogen causes Acute Post-Streptococcal Glomerulonephritis?

Streptococcus pyogenes

How does someone get Acute Post-Streptococcal Glomerulonephritis? Who is it most common in?

10-14 days after strep infection

-- children & elderly

How is Acute Post-Streptococcal Glomerulonephritis treated?

Antibiotics & supportive therapies

What is the Nonvenereal Bacterial Disease with a sudden-onset fever, chills, vomiting, diarrhea, extremely low BP, confusion, severe red rash, loss of sheets of skin, and if untreated individuals can go into shock, which can be fatal and is a medical emergency?

Staphylococcal Toxic Shock Syndrome (STSS)

What does venereal mean?

Sexually transmitted infection/disease

What pathogen causes Staphylococcal Toxic Shock Syndrome (STSS)?

Staphylococcus aureus

How does Staphylococcal Toxic Shock Syndrome (STSS) arise? Who is more at risk?

TSS toxin grow in wound or in an abraded vagina (toxin absorbed in blood)

-- occurs in both, but menstruating females most at risk

-- S. aureus grows well in super-absorbent tampons; change tampon every 4-8 hours; never exceed 8 hours

How is Staphylococcal Toxic Shock Syndrome (STSS) diagnosed? Treated? Prevented?

Diagnosed = Considered medical emergency

Treated = removal of foreign material and antimicrobial drugs

Prevented = avoid tampons or using less absorbent tampons reduces risk

What is a nonvenereal bacterial disease with a white vaginal discharge with a "fishy" odor, vaginal itching or irritation, pain during intercourse, and burning during urination?

Bacterial Vaginosis

What pathogen causes Bacterial Vaginosis?

Various anaerobic bacteria

What is Bacterial Vaginosis associated with?

Multiple sex partners & vaginal douching

-- NOT sexually transmitted though!!

How is Bacterial Vaginosis Diagnosed? Treated? Prevented?

Diagnosed = signs/symptoms

Treatment = oral & vaginal antibiotics

Prevent = limiting # of sexual partners, avoid douching

What nonvenereal fungal disease has severe vaginal itching and burning, pain, thick, white, odor-free vaginal discharge with a cottage cheese appearance*?

Vaginal Yeast Infection (Fungal vaginitis, Candidiasis)

What pathogen causes Vaginal Yeast Infection (Fungal vaginitis, Candidiasis)?

Candida albicans

How does Vaginal Yeast Infection (Fungal vaginitis, Candidiasis) arise? What is it often associated with? Who is most commonly affected?

Vaginal pH or microbiota changes

-- often secondary to ANTIBIOTICS

Very common (75% of all adult women)

How is Vaginal Yeast Infection (Fungal vaginitis, Candidiasis) Diagnosed? Prevented? Treated?

Diagnosed = presence of Candida

Treatment = antifungals

Prevention = excessive use of antibacterial drugs; recommend probiotics for patients taking antibiotics

What is the MC fungal pathogen to cause disease?

Candida albicans

STDs/STIs are very common worldwide, and is in ka higher incidence in what age group? Who is at higher risk of STDs/STIs?

Adolescents/young adults, Baby boomers

Female adolescents higher risk

Presence of lesion from STD is a risk factor for transmission of what?

HIV

How do people prevent STDs/STIs?

Abstinence, mutual monogamy, safe sex practices

What bacterial STI in men is acute inflammation for 2-5 days after infection, and extremely painful urination and pus-filled discharge (urethritis), and in women is often asymptomatic (50-80%), and often mistaken symptom for bladder infection or vaginal yeast infection and can trigger pelvic inflammatory disease*?

Gonorrhea

What pathogen causes Gonorrhea?

Neisseria gonorrhoeae (gonococcus)

How is Gonorrhea transmitted? Who is it more common in?

50% chance of infection during single sexual encounter (women)

20% chance of infection during single sexual encounter (men)

MORE COMMON IN FEMALES

- higher number of partners = higher risk

How is Gonorrhea diagnosed? Treated? Prevented?

Diagnosed = body fluid or urine tested for presence of N. gonorrhoeae

Treatment = broad-spectrum antibiotics

Prevention = abstinence, mutual monogamy, safe sex

T/F: Once you get Gonorrhea, you have life-long immunity to never get it again

FALSE

- can be infected multiple times

What Bacterial STI in females is usually asymptomatic, and males have painful urination an dpus discharge from penis (non-gonococcal urethritis)?

Chlamydia

What pathogen causes Chlamydia?

Chlamydia trachomatis

What is the infective form of Chlamydia trachomatis? What is the reproductive form?

Elementary bodies (infective form)

Reticulate bodies (reproductive form)

What is the leading cause of nontraumatic blindness?

Trachoma

What can Chlamydia be a risk for?

Can trigger pelvic inflammatory disease

--> infection in adolescence increases risk of cervical cancer

How is Chlamydia diagnosed? Treated? Prevented?

Diagnosed = bacteria inside cell from site of infection

Treated = antimicrobial drugs

Prevented = abstinence, mutual monogamy, safe sex

What Bacterial STIs is a chronic infection of the lymphatic system that causes a genital lesion and bubo in the groin, more common in central and south America than North America?

Lymphogranuloma Venereum

What pathogen causes Lymphogranuloma Venereum?

Different strains of Chlamydia trachomatis

Is Lymphogranuloma Venereum more common in men or women?

Men

What bacterial STI is small, painless nodules form, then burst, creating open, fleshy, oozing lesions (*"beefy red lesion") which destroys tissue until treated?

Granuloma inguinale (Donovanosis, granuloma genitoinguinale, granuloma venereum)

What pathogen causes Granuloma inguinale (Donovanosis, granuloma genitoinguinale, granuloma venereum)?

Klebsiella granulomatis

How is Granuloma inguinale (Donovanosis, granuloma genitoinguinale, granuloma venereum) transmitted?

Sexually transmitted (through contact w/ the open sores)

How is Granuloma inguinale (Donovanosis, granuloma genitoinguinale, granuloma venereum) diagnosed? Treated? Prevented?

Diagnosed = signs/symptoms; confirmed w/ biopsy

Treated = antibiotics

Prevention = abstinence, mutual monogamy, safe sex

What bacterial STI has 4 different stages, primary, secondary, latent, and tertiary, and is caused by Treponema pallidum pallidum?

Syphilis

What stage of Syphilis is small, painless, reddened Chancre at site of infection 10-21 days following exposure, typically on external genitalia, remaining 3-6 weeks then disappear without scarring?

Primary Syphilis

What stage of Syphilis is a sore throat, headache, mild fever, malaise, myalgia, lymphadenopathy, widespread rash (no pain/itching, but can persist for months)?

Secondary Syphilis

What stage of Syphilis is clinically inactive, with majority of cases not advancing beyond this stage?

Latent Syphilis

What stage of Syphilis does 1/3 of cases progress to, affecting virtually any tissue or organ, and can cause dementia, blindness, paralysis, heart failure, and GUMMAS (rubbery, painful swollen lesion that can occur in bones, nerve tissue, or skin)?

Tertiary Syphilis

How is Syphilis transmitted?

Sexual contact

-- sometimes transmitted from mother to child

-- WORLDWIDE

What effect does primary or secondary stage of Syphilis have on a fetus? What effect does latent stage have on a fetus?

Primary/Secondary = death of fetus

Latent = intellectual disability and malformation of fetal organs, baby usually exhibits widespread rash before 2 years

How is Syphilis diagnosed? Treated? Prevented?

Diagnosed = antibody test, tertiary Syphilis hard to diagnose

Treated = Penicillin G (all but tertiary Syphilis)

Prevention = abstinence, mutual monogamy, safe sex

What Bacterial STI has soft chancres (genital ulcer), aka chancroid sore, most often diagnosed in men because ulceration is more painful and visible, and is often asymptomatic in women?

Chancroid

What pathogen causes Chancroid?

Haemophilus ducreyi

How is Chancroid transmitted?

Sexually transmitted

-- most cases in US due to foreign travel (MC cause of genital ulceration in Kenya, Gambia, Zimbabwe)

How is Chancroid treated? Prevented?

Treated = Antimicrobial drugs

Prevented = Abstinence, mutual monogamy, safe sex

What viral STI is small, painful blisters on or around the genitals or rectum, and disappear after a short time, but will have recurrent episodes of genital ulcers?

Genital Herpes

What pathogen causes Genital Herpes? Where is this virus latent?

Human herpesvirus 2 (HHV-2) in MOST cases

Latent in sacral ganglia

How is Genital Herpes transmitted?

Sexually transmitted

- can be spread even w/o visible ulcers/blisters

Genital Herpes can quadruple the risk of what infection?

HIV infection

How is Genital Herpes diagnosed? Treated? Prevented?

Diagnosed = characteristic lesions

Treated = antiviral medications can lessen frequency/duration of symptoms; but DONT CURE

Prevention = abstinence, mutual monogamy, safe sex

What Viral STI is warts on the genitalia and surrounding areas, with large growths (Cauliflower-like) called condylomata acuminata that may form?

Genital Warts

How is Genital Warts transmitted?

Sexually transmitted

-- more than 30 different types of HPV sexually transmitted

How is Genital Warts diagnosed? Treated? Prevented?

Diagnosed = presence of warts

Treated = wart removal

Prevention = vaccine against HPV strains associated with cervical cancer (Gardasil)

There are 20,000+ HPV associated cancers in women per year, with ___________ being the most common?

Cervical cancer

11,000+ HPV associated cancers in men per year, with ___________ being the most common?

Oropharyngeal cancers

T/F: AIDS is a disease, not a syndrome

FALSE

AIDS is NOT a disease, but a syndrome

(complex signs/symptoms/disease associated w/ a common cause)

What pathogen causes AIDS (Acquired Immune Deficiency Syndrome)? What type of virus is this?

Human Immunodeficiency Virus (HIV)

-- immunosuppressive retrovirus

(HIV 1 more prevalent in US and Europe, HIV2 more prevalent in West Africa)

What are 8 other infections that AIDS (Acquired Immune Deficiency Syndrome) can lead to?

1) Candidiasis (Candida albicans)

2) PCP (Pneumocystis jirovecii)

3) Shingles (HHV-3)

4) CMV (HHV-5)

5) Kaposi's sarcoma (HHV-8)

6) Disseminated herpes (HHV-1/2)

7) Tuberculosis (Mycobacterium tuberculosis)

8) Toxoplasmosis (Toxoplasma gondii)

How is AIDS (Acquired Immune Deficiency Syndrome) transmitted?

HIV found in blood, semen, saliva, vaginal secretions, and breast milk

-- infected fluid must contact a tear or lesion in skin or mucous membranes

-- infected fluids can also be injected into body

How is AIDS (Acquired Immune Deficiency Syndrome) diagnosed?

Blood tests detect antibodies against HIV

- ELISA/Western Blot

T/F: Being HIV+ and having AIDS means the same thing

FALSE

HIV+ is NOT the same as having AIDS

-- some long-term nonprogressors appear not to develop AIDS such as due to defective virions or may have unusually well-developed immune system

How is AIDS (Acquired Immune Deficiency Syndrome) treated?

Cocktail of anti-viral drugs to reduce viral replication

How is AIDS (Acquired Immune Deficiency Syndrome) prevented?

Behavioral changes can slow progression of AIDS epidemics

-- abstinence/safe sex, clean needles, screening of blood products, administering AZT to infected pregnant women

NO successful vaccine developed

What is a type of skin cancer with tumors most often appearing as bluish-red or purple bumps on the skin?

Kaposi's Sarcoma

What pathogen causes Kaposi's Sarcoma?

Human Herpes Virus 8 (HHV-8)

Who is Kaposi's Sarcoma more commonly seen in?

Rarely seen in immunocompetent

(very common in people w/ HIV/AIDS)

What Protozoan STI in females has vaginal discharge ("frothy green"), musty/foul odor, and vaginal irritation and males are typically asymptomatic?

Trichomoniasis ("Trich")

NOTE: ONLY ONE where women are the one who's is affected by symptoms while men asymptomatic

What pathogen causes Trichomoniasis ("Trich")?

Trichomonas vaginalis

How is Trichomoniasis ("Trich") transmitted? What does this increase the risk of?

Primarily via sexual intercourse

-- increases risk of HIV infection

How is Trichomoniasis ("Trich") diagnosed? Treated? Prevented?

Diagnosed = presence of Trichomonas in clinical samples

Treated = single dose of oral metronidazole (antibiotic for protozoan infections)

Prevention = avoid sexual intercourse with infected persons

What is the most common STD in the US?

Genital Warts

What is the most common curable STI?

Trichomoniasis (Trich)

What is the most common reportable/notifiable STI in the US?

Chlamydia