Genitourinary Tract Infections: Microbiome, Pathogens, and Transmission Flashcards

Flushing of urine, Shedding of epithelial cells, Acidic pH, Lysozyme and Lactoferrins, and IgA

Both sexes have some normal biota in the outer urethra (Lactobacillus, Streptococcus). Males: external penis and urethra have Lactobacillus and Streptococcus. Females: vagina dominated by Lactobacillus; Candida albicans may be present in low numbers

Childhood and postmenopause: low estrogen, neutral pH, fewer Lactobacilli. During reproductive years: high estrogen → glycogen secretion → Lactobacillus fermentation → acidic pH, which protects against pathogens. Microbiome shifts during the menstrual cycle and pregnancy, stabilizes after menopause.

E. coli (≈80% of cases) and Klebsiella spp. Catheter Associated: S. saprophyticus, Enterococcus.

Opportunistic: Transfer from GI tract (Community-acquired) or Environmental or GI tract (via catheter)

Hygiene and limited catheter use

Leptospira interrogans (Spirochete with tight/regular individual coils with a bend or hook at the end) and Adhesins

Vehicle (urine of wild and domesticated animals), Contaminated soil and water

Doxycycline, Penicillin G, or Ceftriaxone

Leptospirosis Phase: Pathogen in blood and CSF. Symptoms: High Fever, Chills, Headache, Muscle Aches, Conjunctivitis, and Vomiting. Immune Phase: Symptoms: Mild Fever and headache (leptospiral meningitis). Weil's Syndrome: kidney invasion, hepatic disease, jaundice, anemia, and neurological disturbances

Schistosoma Haematobium (Helminth)

Vehicle: contaminated water. It invades intact skin and has antigenic cloaking behavior

Praziquantel (Anti-Helminth)

Eukaryotes: Candida albicans (Fungal/yeast infection) and Trichomonas Vaginalis (Protozoal)

Opportunistic due to disruption of the normal biota. White/curd-like discharge

Direct Contact (STI). Greenish Discharge

Mixed infection of Gardnerella vaginalis, Atopobium, and Mobiluncus

Opportunistic or UTI. Strong Fishy Odor (Whiff test) due to a reduction of Lactobacilli and Clue Cells.

GI tract biota

Endogenous transfer from GI tract. Symptoms: Pain in the groin/lower back, difficulty urinating, and painful ejaculation

Acute: virtually always caused by bacteria, usually normal biota from the GI tract. Chronic: also caused by bacteria, often unresponsive to antibiotics, caused by mixed BIOFILMS in the prostate

Neisseria gonorrhea (Gram Negative). Infection increases one's risk of HIV infection.

Direct contact (STI) and Vertical

Males: urethritis, painful urination, yellowish discharges, many cases asymptomatic. Females: mucopurulent, bloody vaginal discharge, painful urination. Salpingitis: inflammation of the fallopian tubes and Pelvic inflammatory disease (PID). Children born to gonococcus carriers can be infected as they pass through the birth canal and Gonococcal eye infections can result in blindness

Chlamydia trachomatis (Gram Negative) is an obligate intracellular parasite.

Direct contact (STI) and Vertical. Most common reportable infectious disease in the U.S. Lymphogranuloma venereum: STI that invades the lymphatic tissue. Males: discharge and painful urination. Females: cervicitis, discharge, salpingitis, and PID (Up to 75% of cases are ASYMPTOMATIC)

Azithromycin or Doxycycline

Treponema pallidum (Gram Negative) binds to epithelial cells by its HOOKED TIP and stimulates a strong inflammatory response.

Primary Syphilis: Chancre (Small, red, hard bump that appears at the site of the entry of the pathogen). Secondary Syphilis: Fever, headache, sore throat, Lymphadenopathy, red or brown rash on all skin surfaces, and hair loss. Latent and Tertiary Syphilis: Damage to small arteries and aortic wall, Gummas develop in the liver, skin, bone, and cartilage, Neurosyphilis: headaches, convulsions, atrophy of the optic nerve, blindness, dementia, and Argyll-Robertson pupils. Congenital Syphilis: Inhibits fetal growth. disrupts periods of development, and causes fetal abnormalities to spontaneous miscarriage or stillbirth

Direct Contact and Vertical.

Haemophilus ducreyi (Gram Negative) that forms a soft chancre.

Direct Sexual Contact. Common in tropics and subtropics.

Azithromycin or Ceftriaxone

Herpes simplex 1 and 2 virus

Direct Contact and Vertical. Latency but can be reactivated by stress, UV radiation, injury, menstruation, or other microbial infection.

Neonatal Herpes Simplex occurs when infants are contaminated during birth.

Acyclovir and its derivatives

Human Papillomavirus which causes genital warts. HPV-16 and HPV-18 associated with cervical cancer.

Direct contact (STI), Autoinoculation, and Indirect contact. Oncogenes (Females: cervical cancer. Males: genitourinary tract cancer. Both: Oral sex can increase risk of throat cancer.) Vaccine available

Females: growths on the vulva and in and around the vagina as well as silent infections of the cervix. Males: warts on the penis and scrotum. Both sexes: warts in or on the anus, and the skin around the groin between the thigh and pelvis. Condyloma acuminata: branching, cauliflower-like masses.

Poxvirus, sometimes called the molluscum contagiosum virus (MCV)

Direct contact (STI), Indirect contact (fomites), and Autoinoculation. Causes wart-like growths on the mucous membranes of the skin of the genital area

Group B Streptococcus

Vertical (Infants become colonized during passage through the birth canal.) Can cause life-threatening infections such as bloodstream infections, meningitis, or pneumonia.