Bacterial sexually transmitted infections I Flashcards
What chlamydia species is the most common cause of genital infection and conjunctivitis?
Chlamydia trachomatis
Does chlamydia have peptidoglycan in its cell wall?
No
What is the shape of chlamydia bacteria?
Cocci
What is the infectious particle in chlamydia?
Elementary body
What is the replicating / metabolically active particle in chlamydia?
Reticulate body
Chlamydia inclusions are made up primarily of elementary bodies or reticulate bodies?
Reticulate bodies
The multiple chlamydia trachomatis serovars are based on what protein?
Major outer membrane protein
Chlamydia has a tropism for what type of cell?
Nonciliated, columnar, cuboidal, and transitional epithelial cells
How does chlamydia do cytotoxic damage?
Destruction of epithelium (cell lysis) and proinflammatory cytokine response
Without treatment, chlamydia can lead to what condition?
Fibrosis (infertility)
Which serovars are responsible for trachoma?
A, B, Ba, C
Which serovars are responsible for urogenital tract infection?
D-K
Which serovars are responsible for lymphogranuloma venerum?
L1, L2, L2a, L2b, L3
Why are LGV serovars more invasive than the other serovars?
Replication in mononuclear phagocytes
What is the leading cause of preventable blindness in the world?
Chronic chlamydia conjunctivitis
What are the symptoms of acute conjunctivitis in sexually active adults?
- Mucopurulent discharge2. Keratitis 3. Corneal infiltrates 4. Occasional corneal vascularization
What can help prevent transmission of neonatal conjunctivitis?
Erythromycin eye drops
What is the presentation for male C. trachomatis UG infection?
Dysuria and thin urethral MUCOPURULENT discharge
What are the complications of male C. trachomatis UG infection?
Epididymitis, prostatitis
What is Reiter syndrome?
- Complication of male C. trachomatis UG infection 2. Urethritis, conjunctivitis, polyarthritis
What is the presentation for female C. trachomatis UG infection?
Mucopurulent discharge
Is UG chlamydia infection more common in men or women?
Women
What disease presents with primary (painless) lesions / papules and inflammation and swelling of lymph nodes draining the site of infection with inguinal lymphadenopathy?
Lymphogranuloma venereum (LGV)
What is a common result of lymphatic spread in LGV?
Proctitis
What are the tests for C. trachomatis?
- Giemsa stain 2. Iodine stain 3. Immunofluorscence 4. PCR
What does the Giemsa stain detect in C. trachomatis infection?
Cytoplasmic inclusions (need epithelial cells)
What does the iodone stain detect in C. trachomatis infection?
Reticulate bodies (need epithelial cells)
What does immunofluorescence detect in C. trachomatis infection?
Elementary bodies (need epithelial cells)
What sample is needed for PCR diagnosis of C. trachomatis?
Urine or urethral discharge
What is the treatment for C. trachomatis infection?
Doxycycline or macrolides
Does chlamydia infection confer immunity?
No
Is neisseria gram negative or gram positive?
Gram negative
What is the shape of neisseria?
Diplococci
Is neisseria aerobic or anaerobic?
Aerobic
Is neisseria catalase positive or negative?
Positive
Is neisseria oxidase positive or negative?
Positive
Does neisseria form spores?
No
How can N. meningitidis and N. gonorrhoeae be distinguished?
N. meningitidis ferments maltose, N. gonorrhoeae does not
What are the N. gonorrhoeae virulence factors?
- Pilin 2. Por protein 3. Opa protein 4. LOS 5. Outer membrane blebs 6. IgA1 protease 7. B-lactamase
What is the role of pilin in N. gonorrhoeae?
Attachment, anti-phagocytic
What is the role of por protein in N. gonorrhoeae?
Promotes intracellular survival
What is the role of opa protein in N. gonorrhoeae?
Attachment to eukaryotic cells
What is the role of LOS in N. gonorrhoeae?
Endotoxin
What is the role of the outer membrane blebs in N. gonorrhoeae?
Contain LOS and OM proteins, enhance toxicity and absorb antibodies
What is the role of IgA1 protease?
Destroys IgA
What is the role of B-lactamase?
Hydrolyzes B-lactam ring in penicillin
Which N. gonorrhoeae virulence factors undergo antigenic variation?
- Pilin 2. Por protein 3. Opa protein 4. LOS
Neisseria infections are associated with deficiencies in what complement components?
Late complement components C5b-C9
What are the late complement components responsible for?
Formation of the membrane attack complex (MAC) - lysis of pathogen
What is the horizontal spread of N. gonorrhoeae?
Eye - mouth - genitals
Does N. gonorrhoeae have a capsule?
No
How do the gonococci attach to mucosal cells?
Pili, PorB, Opa
What do gonococci do after invasion of mucosa?
- Replicate inside cells, lysis 2. Phagocytosis by macrophage / neutrophil 3. LOS stimulates inflammation
What kind of discharge accompanies N. gonorrhoeae infection?
Mucopurulent discharge
What are the disseminated effects of N. gonorrhoeae infection?
Septicemia, skin and joint infections, suppurative arthritis, pustular rash on extremities
What always accompanies N. gonorrhoeae genital infection?
Pharyngitis
What is the diagnosis for N. gonorrhoeae infection?
- Direct smear 2. Culture 3. PCR
What would a gram stain for N. gonorrhoeae reveal?
Gram negative bean shaped diplococci in NEUTROPHILS
How can N. gonorrhoeae be cultured?
- Chocolate agar (nonselective) 2. Thayer-Martin media (selective)
What is the treatment for N. gonorrhoeae?
Ceftriaxone plus doxyclycline or azithromycin (for chlamydia since they probably have that too)