Urinary tract and bacterial sexually transmitted infections

infection of the urethra?

urethritis

infection of the bladder?

cystitis

infection of the kidneys?

pyelonephritis

Why is pyelonephritis dangerous?

bacteria can spread into the bloodstream causing septic shock or bactermia.

What are the most common symptoms of the lower urinary tract?

dysuria

What are the most common symptoms of the upper urinary tract?

dysuria, fever, nausea, vomiting, diarrhea

Why is the sphincter, muscles at the base of the urethra, important regarding infection?

protection, keeps portal closed after urination

What keeps the pH in the urine low?

organic acids

What causes gastric ulcers? What enzyme does this produce? Why bacterium produce this enzyme?

helicobacter pylori, urease, to increase the pH in your urine

What is an indication of bacteria in someones urine?

high pH

What does urine contain?

inhibitory peptides and antibodies

Where does UTI bacteria come from?

bacteria from patients own digestive track

What are most UTIs caused by?

strains of E. Coli

How can e. coli be transmitted?

sexual contact, poor hygiene, catheter

e. coli can life in the digestive track without cause harm

What is the type of e. coli that causes UTIs?

euro pathogenic e.coli or IUPAC

What are most UTIs a result of?

ascending infection (bacteria from the GI tract colonized the urethra and ascend into the bladder and possibly the kidneys

What is hematogenus route of infection?

bacteria entering the kidneys from the bloodstream

Could a person with bacterial pneumonia develope pyelonephritis?

Do most UTIs occur in men or women? Why?

women, because the urethra is much shorter in women than it is in men, so bacteria that colonize the distal portion of the urethra have a shorter distance to travel, AND, urethra is much closer to the anus, another source of bacteria

What percentage of women will develope a UTI in their lifetime?

30%, many develope more than 1 UTI

What are risk factors for women developing UTIs?

sexual intercourse, use of diaphragm for contraception (it blocks flow of urine), having a short urethra, lack of regular voiding, kidney stones

What are risk factors for men developing UTIs?

enlarged prostate, kidney stones, catheterization

Are a small or large number of UTIs considered complicated?

small, usually in patients with indwelling catheters, immunosuppressed, or a history of antibiotic exposure, drug resistance

What are other members of the enterobacteriazeae family that cause UTIs, other than e.coli?

Klebsiella pneumoniae, Proteus mirabilis, enterococcus, VRE (vancomycin-resistant enteroccus), candida (yeast)

What virulence factors and traits allows e.coli to cause UTIs?

1) attaches using specialized pili

2) formation of intracellular biofilm (IBC) through the bacteria reproduction

3) filamentous cells resist phagocytosis

4) cells detach (exfoliate) from IBC to colonize new surfaces

5) host cell damage from toxins, proteases

6) dormant cells resist drugs, form reservoir for reinfection since antimicrobial drugs only work on actively dividing cells

What is another name of neutrophil?

polymorphonuclear leukocytes

What are lab researchers interested in finding in urine concerning UTI?

blood nirate and leukocyte esterase

What does luekocyte esterase indicate?

presence of neutrophils

What is the condition of WBCs in the urine?

pyuria, indicates infection is present

What will urine be cultured on?

a seletive and differential media, such as McCarthy agar

What will happen is cystitis is suspected?

patients are given a short course of antimircobial drugs

How is the correct drug determined to treat cystitis?

dependent on previous drug expsoure

If a patient has pyelonephritis, what will the patient undergo?

hospitalization with IV medication

What is a consequence of pyelonephritis?

bacteremia/bacteria in the blood, which can be deadly

What are examples of UTI infection?

adequate fluid intake, proper hygiene, urination after sex

What is given to patients with recurrent UTIs?

low dose of antimircobial medication

What can antibacterial drugs cause?

dysbiosis, an imbalance in the microbiome

Why do some patients get an overgrowth of candida in the vagina after taking anitmicrobial drugs?

protective bacteria are gone, so yeast can overgrow

How are yeast infections treated?

over the counter antifungal medication

How are female patients innately protected from yeast and other types of infections?

production of estrogen, it stimulates epithelial cells to produce glycogen, which can be broken down by lactobacillus and ferment the sugar, producing lactic acid which creates a low pH, which is inhospitable for harmful bacteria and yeast

lactobacillus produces hydrogen peroxidem, which may discourage the growth of anaerobic bacteri

How much of all IUPAC e.coli strands are resistant to Bactrim?

1/3

What is Bactrim?

1st line sulfa drug used to treat UTIs

How could e.coli get from a chicken to your urinary track?

if you eat chicken that hasn’t been cooked properly, some of the bacteria may survive the acidity of the stomach and go on to colonize your gut. If these new gut e.coli travel to the urethra, you could develope a UTI

Bacterial Vaginosis

associated with sexual activity, not necessarily caused by it

most common dysbiosis of vagina

polymicrobial, shifts away from Lactobacillus

Chlamydia

obligate intracellular pathogen with 2 forms

• reticular bodies

• elementary bodies

most common bacterium that causes sexually transmitted infections

caused by chlamydia trachomatis

symptoms: abnormal vaginal discharge, burning during urination, swelling of the testicles, rectal pain, bleeding

Gonorrhea

caused by gram-negative bacterium diplococcus

caused by: neisseria gonorrhea Fastidious

virulence factors: specialized pillai/fimbriae for attachment, IgA protease for antibodie inactivation, avoidment of phagocytosis, avoidment of immune system via intracellular, preventation of T-cell activation

often asymptomatic

if symptoms are present: abnormal vaginal discharge, pain furing urination

complications: infertifily, ectopic gregnancy, infection in other parts of the body, transmitted from momther to baby

Syphilis

spirochete, contains internal flagella and can penetrate mucosal cells with corkscrew like motion

does not stain well with gram stain

least common

male infection site: urethra, called urethritis

women infection site: cervix, called cervicitis

What is pevlic inflammatory disease?

if an infection moves into the upper female reproductive track, ovary, fallopian tube, uterus may become infected

Where does the fertilization of an egg take place?

fallopian tubes

How does an egg in the fallopian tubes become transported to the uterus?

cells of the fallopian tube use a concerted action of the cilia to move the egg towards the uterus, similar to the mucociliary escalator of the respiratory track

What causes an ectopic pregnany?

failure of ciliated cells in the fallopian tubes to relocated the egg, usually due to damage

What is dysbiosis?

a shift from a healthy microbial community to become associated with disease

What is the dysbiosis of bacterial vaginosis?

population of lactobacillus decreases while other types of bacteria increase

What is the types of bacteria associated with bacterial vaginosis?

unknown exact amount

Is bacterial vaginosis symptomatic or asymptomatic?

usually asymptomatic, although if symptoms are present they include; pain, itching, burning in the vagina, burning sensation during urination, thinwhite/gray vaginal discharge with a fishy smell

Why is it important to treat bacaterial vaginosis if the infection is asymptomatic or symptoms are mild?

because having bacterial vaginosis can increase your chance of getting a sexually transmitted infection

If a patient is pregnant, what may bacterial vaginosis cause?

premature labor or a low birth weight baby

Who does the CDC recommend annual chlaymida screening for?

women: 25 years old, multiple sex partners, pregnant women, mLm

Why is testing for chlamydia important?

it can travel to the upper reproductive tract to cause pelvic inflammatory disease, leading to infertility or ectopic pregnancy

Can chlamydia can be transmitted from mother to baby?

yes

What are similarities between chlaymidia and gonorrhea?

not easily treated with antibacterial drugs

can be transmitted from mother to baby

Why is gonnorrhea not easily treated with antibotics?

many strains are multi-drug resistant

Why is syphilis called the great imitator?

its infection causes many symptoms confusable with other diseases

What is syphilis caused by?

Treponema pallidum

What are the stages of syphilis?

Primary: firm, painless ulcer (hard chancre) at site of infection, lymph node, enlargement. Infectious.

Secondary: rash, aches, and pains; rash and mucous membrane lesions. Infectious.

Latent: no signs of symptoms. If early, infectious. If late, not infectious.

Tertiary: gummas, damage to large blood vessels, eyes, nervous sytem; mental illness. Not infectious. Developed by 50% of pts with disease. 

Result of pregnant women with syphilis?

premature birhts, stillborns, disfiurging deformities with childern 2 yrs (cleft palate/saddle nose),

Common themes for bacterial infections of the reproductive track?

• abstinence, monogamous relationships, condoms,

• asymptomatic (bacterial vaginosis, chlamydia, gonorrhea)

Why is screening essential for controling disease?

many reproductive diseases have no symptoms