Microbial Diseases of the Genitourinary Tract

What comprises the genitourinary tract?

The urinary system and reproductive system.

How can infections in the genitourinary tract present?

Infections can be local or systemic.

What are the common routes of infection in the genitourinary tract?

Ascending (e.g. via urethra) and local invasion (via skin/mucosa).

Why are females at higher risk for urinary tract infections?

Due to a shorter urethra and proximity to the anus.

What was the previous belief about the urinary tract microbiome?

It was thought to be sterile.

Which genus primarily dominates the female urinary tract microbiome?

Lactobacillus spp.

Which microbes are commonly found in the male urinary tract microbiome?

Lactobacillus, Corynebacterium, Streptococcus, Pseudomonas.

What role does the urinary tract microbiome play?

It may outcompete pathogens.

Which bacteria dominate the vaginal microbiome?

Lactobacillus (especially L. crispatus and L. iners).

What does the vaginal microbiome produce to maintain pH?

Lactic acid and H₂O₂.

What are the symptoms of cystitis?

Urgency, dysuria (pain), frequency.

In which population is cystitis more common?

More common in women.

What are common treatments for cystitis?

Trimethoprim and Nitrofurantoin.

What are the symptoms of prostatitis?

Pain in pelvis, back, urination/ejaculation issues.

What serious complications can prostatitis cause?

Infertility, fever, urinary retention.

What are the symptoms of pyelonephritis?

Back/groin pain, fever, foul urine, blood/pus in urine.

What causes most urinary tract infections (UTIs)?

80% are caused by Uropathogenic E. coli (UPEC).

What is the role of FimH adhesin in UPEC?

It binds to bladder cells and resists flushing.

What risk factors contribute to urinary tract infections?

Sexual activity, menopause, hygiene, spermicide use.

What common pathogens are associated with catheter-associated UTIs (CAUTIs)?

Proteus mirabilis and E. coli.

What is a key characteristic of Proteus mirabilis?

Swarming motility and urease production.

What medical condition can arise from untreated cystitis?

Pyelonephritis.

What is bacterial vaginosis (BV) often caused by?

Microbiome disruption, particularly a decrease in Lactobacilli and an increase in anaerobes.

What are the four criteria for diagnosing bacterial vaginosis according to Amsel?

Fishy smell, thin grey discharge, pH > 4.5, and 20% clue cells.

What are common treatment options for bacterial vaginosis?

Metronidazole and Clindamycin.

Which sexually transmitted infection is the most common bacterial STI?

Chlamydia (C. trachomatis).

What forms does Chlamydia exist in?

Elementary body (EB) which is infectious and non-replicating, and reticulate body (RB) which is non-infectious and replicating.

What is the treatment for Chlamydia?

Doxycycline.

What serious complications can arise from untreated Pelvic Inflammatory Disease (PID)?

Scarring leading to infertility and ectopic pregnancy, as well as sepsis.

What are common symptoms of gonorrhea?

Pus discharge and painful urination.

What is the treatment for Gonorrhea?

Ceftriaxone.

What are the stages of syphilis?

Primary, Secondary, Latent, Tertiary.

What is the treatment for syphilis, especially for neurosyphilis?

Penicillin, especially IV.

What fungus is commonly associated with candidiasis?

Candida albicans.

Which antifungal medication is used to treat candidiasis?

Fluconazole.

What are the risk factors for developing candidiasis?

Antibiotics, contraceptives, pregnancy, scented products.