1
Urinary Tract Infections Disease (E. coli)
- Causative organism: Escherichia coli
-
Mode of Transmission: opportunism: transfer from GI
tract
(community-acquired) or environment or GI tract (via catheter) - Virulence Factors: Adhesins, motility
-
Culture/Diagnosis: usually culture-based;
antimicrobial susceptibilities always
checked - Prevention: hygiene practices; in case of CA-UTIs, limit catheter usage
- Treatment: Usually nitrofurantoin
- Signs and Symptoms: typically present with dysuria (burning urination), urinary frequency and urgency, suprapubic pain, and cloudy or foul-smelling urine; if the infection ascends to the kidneys, it can cause flank pain, fever, and nausea/vomiting (pyelonephritis).
2
Urinary Tract Infections Disease (Staph)
- Causative organism: Staphylococcus saprophyticus
-
Mode of Transmission: opportunism: transfer from GI
tract
(community-acquired) or environment or GI tract (via catheter) - Virulence Factors: N/A
-
Culture/Diagnosis: usually culture-based;
antimicrobial susceptibilities always
checked - Prevention: hygiene practices; in case of CA-UTIs, limit catheter usage
- Treatment: Usually nitrofurantoin
- Signs and Symptoms: typically present with dysuria (burning urination), urinary frequency and urgency, suprapubic pain, and sometimes hematuria; symptoms are similar to other UTIs and may occasionally be accompanied by mild fever if the infection ascends.
3
Urinary Tract Infections Disease (Entercoccus)
- Causative organism: Enterococcus
-
Mode of Transmission: opportunism: transfer from GI
tract
(community-acquired) or environment or GI tract (via catheter) - Virulence Factors: N/A
-
Culture/Diagnosis: usually culture-based;
antimicrobial susceptibilities always
checked - Prevention: hygiene practices; in case of CA-UTIs, limit catheter usage
- Treatment: Based on susceptibility testing; vancomycin-resistant, Enterococcus is in Serious Threat category in CDC, and Antibiotic Resistance Report
- Signs and Symptoms: typically present with dysuria (burning urination), urinary frequency and urgency, suprapubic pain, and cloudy or foul-smelling urine; in more severe or complicated cases, fever and flank pain may occur if the infection spreads to the kidneys (pyelonephritis).
4
Leptospirosis Disease
- Causative organism: Leptospira interrogans
- Mode of Transmission: Vehicle: contaminated soil or water
- Virulence Factors: Adhesins, invasion proteins
-
Culture/Diagnosis: Slide agglutination test of
patient’s blood for
antibodies: in the United States, CDC will culture specimens - Prevention: Avoiding contaminated vehicles
- Treatment: Doxycycline, penicillin G, or ceftriaxone
- Signs and Symptoms:
- Leptospirosis
phase:
• sudden high fever, chills, headache, muscle aches,
conjunctivitis, and vomiting - Immune
phase:
• Mild fever, headache due to leptospiral meningitis
• Weil’s syndrome: kidney invasion, hepatic disease, jaundice,
anemia, and neurological disturbances - Long-term disability and death can result
5
Urinary Schistosomiasis
- Causative organism: Schistosoma haematobium
- Mode of Transmission: Vehicle: contaminated water
-
Virulence Factors: Antigenic “cloaking,” induction
of granulomatous
response - Culture/Diagnosis: Identification of eggs in urine, PCR methods
- Prevention: Avoiding contaminated vehicles
- Treatment: Praziquantel
-
Signs and Symptoms: Itchiness in the area where the
helminth enters the
body, Fever, chills, diarrhea, and cough
• Urinary tract symptoms occur at a later date and can cause chronic infection
6
Vaginitis (Candida)
- Causative organism: Candida albicans
- Mode of Transmission: Opportunism
- Virulence Factors: N/A
- Culture/Diagnosis: Wet prep or Gram stain
- Prevention: N/A
- Treatment: Topical or oral azole drugs, some over-the-counter drugs
-
Signs and Symptoms: Inflammation of the vagina,
characterized by some
degree of vaginal itching, burning, and White, curd-like discharge
7
Vaginitis (Trichomoniasis) [Most common nonviral sexually transmitted disease]
- Causative organism: Trichomonas vaginalis
- Mode of Transmission: Direct contact (STI)
- Virulence Factors: N/A
-
Culture/Diagnosis: Protozoa seen on Pap smear or
Gram stain; culture is the
gold standard - Prevention: Barrier use during intercourse
- Treatment: Metronidazole, tinidazole
-
Signs and Symptoms: Inflammation of the vagina,
characterized by some
degree of vaginal itching, burning, and discharge may be greenish in women but men seldom have symptoms and many cases are asymptomatic
8
Vaginosis
-
Causative organism: Mixed infection of Gardnerella
vaginalis, Atopobium, and
Mobiluncus - Mode of Transmission: Opportunism or STI
- Virulence Factors: N/A
- Culture/Diagnosis: Visual exam of vagina or clue cells seen in Pap smear or other smear
- Prevention: N/A
- Treatment: Metronidazole or clindamycin
-
Signs and Symptoms: Does not induce inflammation in
the vagina
• Produces discharge with a fishy odor, and itching is common, Can lead to PID, infertility, and ectopic pregnancies
• Not sexually transmitted, but more common in sexually active
women
9
Prostatitis
- Causative organism: GI tract biota
- Mode of Transmission: Endogenous transfer from GI tract; otherwise unknown
- Virulence Factors: Various
- Culture/Diagnosis: Digital rectal exam to examine prostate; culture of urine or semen
- Prevention: None
- Treatment: Antibiotics, muscle relaxers, alpha blockers
- Signs and Symptoms: Pain in the groin and lower back, Frequent urge to urinate, Difficulty urinating, Blood in the urine, and Painful ejaculation
10
Gonorrhea
- Causative organism: Neisseria gonorrhoeae
- Mode of Transmission: Direct contact (STI), also vertical
- Virulence Factors: Fimbrial adhesins, antigenic variation, IgA protease, membrane blebs/endotoxin
- Culture/Diagnosis: Gram stain in males, rapid tests (PCR, ELISA) for females, culture on Thayer-Martin agar
- Prevention: Avoid contact; condom use
-
Treatment: Coinfection by gonorrhea and Chlamydia
should be assumed; treat
with ceftriaxone + azithromycin; antibiotic-resistant strains on Urgent Threat list from CDC - Signs and Symptoms:
- Males: urethritis,
painful urination, yellowish discharges,
many cases asymptomatic
• Females: mucopurulent or bloody vaginal discharge,
painful urination
11
Chlamydia
- Causative organism: Chlamydia trachomatis
- Mode of Transmission: Direct contact (STI), vertical
- Virulence Factors: Intracellular growth resulting in avoiding immune system and cytokine release, unusual cell wall preventing phagolysosome fusion
- Culture/Diagnosis: PCR or ELISA, can be followed by cell culture
- Prevention: Avoid contact; condom use
- Treatment: Coinfection by Chlamydia and gonorrhea should be assumed; treat with doxycycline or azithromycin
- Signs and Symptoms:
- Males: discharge and
painful urination
• Females: cervicitis, discharge, salpingitis, and PID
• Up to 75% of Chlamydia infections are asymptomatic
12
Syphilis
- Causative organism: Treponema pallidum
- Mode of Transmission: Direct contact and vertical
- Virulence Factors: Lipoproteins
-
Culture/Diagnosis: Direct tests
(immunofluorescence, dark-field microscopy),
blood tests for treponemal and nontreponemal antibodies, PCR - Prevention: Antibiotic treatment of all possible contacts, avoiding contact
- Treatment: Penicillin G
- Signs and Symptoms: progresses in stages: primary stage causes a painless chancre at the infection site; secondary stage includes a widespread rash (often on palms/soles), fever, and lymphadenopathy; latent stage is asymptomatic; and tertiary stage can cause severe neurologic, cardiovascular, and gummatous tissue damage if untreated.
- Effects on Fetus: Congenital syphilis
13
Chancroid
- Causative organism: Haemophilus ducreyi
- Mode of Transmission: Direct contact (vertical transmission not documented)
- Virulence Factors: Hemolysin (exotoxin)
- Culture/Diagnosis: Rule out other ulcer diseases
- Prevention: Avoiding contact
- Treatment: Ceftriaxone or azithromycin
- Signs and Symptoms: causes painful, soft genital ulcers with ragged edges, often accompanied by tender, swollen inguinal lymph nodes that may form abscesses (buboes). Painful chancre in men and often unnoticed in women
- Effects on Fetus: None
14
Herpes
- Causative organism: Herpes simplex 1 and 2
- Mode of Transmission: Direct contact, vertical
- Virulence Factors: Latency
-
Culture/Diagnosis: Clinical presentation, PCR, Ab
tests, growth of virus in cell
culture - Prevention: Avoiding contact, antivirals can reduce recurrences
- Treatment: Acyclovir and derivatives
- Signs and Symptoms: causes painful, fluid-filled vesicles or blisters on the mouth or genitals that rupture into ulcers, often preceded by tingling or burning; the virus remains latent in nerve ganglia and can reactivate causing recurrent outbreaks.
- Effects on Fetus: Blindness, disseminated herpes infection
15
HPV
- Causative organism: Human papillomaviruses
- Mode of Transmission: Direct contact (STI), also autoinoculation, indirect contact
- Virulence Factors: Oncogenes (in the case of malignant types of HPV)
-
Culture/Diagnosis: PCR tests for certain HPV types,
clinical diagnosis; Pap
smear -
Prevention: Vaccine available; avoid direct contact
and prevent cancer by
screening cervix - Treatment: Warts or precancerous tissue can be removed; virus not treatable
- Signs and Symptoms:
- 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 - Effects on Fetus: May cause laryngeal warts
16
Molluscum Contagiosum
-
Causative organism: Poxvirus, sometimes called the
molluscum contagiosum
virus (MCV) - Mode of Transmission: Direct contact (STI), also indirect and autoinoculation
- Virulence Factors: N/A
- Culture/Diagnosis: Clinical diagnosis, also histology, PCR
- Prevention: Avoid direct contact
- Treatment: Warts can be removed; virus not treatable
-
Signs and Symptoms: Causes wart-like growths on the
mucous membranes or
the skin of the genital area - Effects on Fetus: N/A
17
Group B Streptococcus Colonization Disease (Neonatal Disease)
- Causative organism: Group B Streptococcus
- Mode of Transmission: Vertical
- Virulence Factors: N/A
- Culture/Diagnosis: Culture of mother’s genital tract
- Prevention/ Treatment: Treat mother with penicillin/ ampicillin
- Signs and Symptoms: often asymptomatic in adults, especially in the gastrointestinal and genitourinary tracts, but can cause serious neonatal infections (sepsis, pneumonia, meningitis) during childbirth if transmitted from mother to infant; in adults it may rarely cause UTI, bacteremia, or skin/soft tissue infections in immunocompromised patients.