CH.

26 Microbial Diseases of the Urinary and Reproductive Systems

1) Normal Microbiota of the Urinary and Reproductive Systems 745
a) Urinary bladder and upper urinary tract are sterile under normal conditions
b) Lactobacilli dominate the vaginal microbiota during the reproductive years.
c) Male urethra is normally sterile
2) Diseases of the Urinary system
a) Bacterial diseases of the urinary system 746-747
i) Urethritis, cystitis, and ureteritis are terms describing inflammation of
tissues o the lower urinary tract.
ii) Pylenephritis can result from lower urinary tract infections or from
systemic bacterial infections
iii) Opportunistic gram-negative bacteria from the inestines often cause
urinary tract infections
iv) Nosocomial infections following catheterization occur in the urinary
system. E coli causes more than half of these infections
v) Treatment of urinary tract infections depends on the isolation and
antibiotic sensitivity testing of the causative agents.
3) Cystitis 746
a) Inflammation of the urinary bladder, or cystitis is common in females
b) Microorganisms at the opening of the utrethra and along the length of the
urethra, careless personal hygiene, and sexual intercourse contribute to
the high incidence of cystitis in females
c) Most common etiologies are E. coli and staphylococcus saprophyticus.
4) Pyelonephritis 746
a) Inflammation of the kidneys is usually a complication of lower urinary tract
infections.
b) About 75% of pyelonephritis caused by e. coli
5) Leptospirosis 746-747
a) Leptospira interrogans
b) Transmitted to humans by urine contaminated water
c) Chills, fever, headache, muscle aches
6) Diseases of the Reproductive systems
a) Bacterial diseases of the reproductive systems
i) Most diseases are sexually transmitted
7) Gonorrhea 747-750
a) Neisseria gonorrhoeae

b) Attaches to mucosal cells of the oral pharyngeal area, genetials, eyes and
rectum by fimbrae
c) Symptoms in men: painful urination, pus discharge, blockage of the
urethra and sterility are complications
d) Women: might by asymptomatic unless the infection spreads to the uterus
and uterine tubes
e) Other complications
i) Gonorrheal endocarditis, gonorrheal meningitis, gonorrheal arthritis.
ii) Ophthalmia neonatorum: eye infection acquired from infected mother
via birth canal.
8) Nongonococcal urethritis NGU 750-751
a) Inflammation of the urethra not caused by N. gonorrhoeae
b) Caused by chlamydia trachomatis
i) Most common cause of STI
c) Symtpoms: mild or lacking
d) Transmitted to infants eyes at birth
e) Diagnosis is based on chlamydial DNA in urine
f) Other causes
i) Ureplasma urealyticum and mycoplasma hominis
9) Pelvic inflammatory Disease PID 751-752
a) Extensive bacterial infection of the female pelivic organs, especially of the
reproductive system.
b) Caused by N. honorrhoeae, C. trachomatis and other bacteria that gain
acess to the uterine tubes. Infection of uterine tubes: salpingitis
10) Syphilis 752-755
a) caused by treponema palladium
i) spirochete
ii) has not been cultured in vitro
iii) grown in rabbits or cell cultures
b) small. Hard based chancre at the site of infection. Bacteria then invade the
blood and lymphatic system and the chancre spontaneously heals
c) secondary stage
i) appearance of widely disseminated rash on skin and mucous
membranes. Spirochetes are present in lesions of the rash.
ii) Latent period
(1) secondary lesions spontaneously heal

(a) at least 10 years after the secondary lesion, tertiary lesions

called gummas can appear on many organs
d) Congenital syphilis resulting from T. palladium crossing the placenta
during the latent period can cause neurological damage in new born
11) Bacterial Vaginosis 756
a) gardnerella vaginalis
b) infection without inflammation, increased vaginal pH and fishy odor and
presence of clue cells.
12) Genital Herpes
a) herpes simplex viruses HSV-1 and HSV-2
b) painful urination, genital irritation, fluid filled vesicles.
c) Virus might enter latent stage in nerve cells. Vesicles reappear after
trauma and hormonal changes
13) Genital warts 758
a) caused by HPV human papilloma viruses
14) Candidiasis 758-759
a) causes yeast infection in women and NGU in men
i) characterized by lesions that produce itching and irritation
b) predisposing factors: pregnancy, diabetes, tumors, broad spectrum
antibacterial chemotherapy.
15) Trichomoniasis 760 Protozoan
a) trichomonas vaginalis, when pH of the vag increases.