ID- Genitourinary Tract Flashcards
Defenses of genital system
Males- flushing actions of urine. Females-depends on the lifetime of woman. Childhood and after menopause-muccous is the major defense with secretory IgA antibodies. During reproductive years- changes in pH.
Normal biota of the urinary tract
Outer region of the urethra harbors somr normal biota including nonhemolytic streptococci, staphylcocci, corynebacteria, and some lactobacilli.
Normal biota of the genital system
Males- same as desribed for the urethra, since the urethra is the terminal tube. No movement of bacteria here. Females- vagina harbors a normal population of bicrobes including fungi and yeast.
Gonorrhea
Known as a STD since ancient times. Most prominent. In history was confused with syphillis. Later microbiologists culture Neisseria gonorrhea aka gonococcus.
Signs and symptoms of gonorrhea
Males- urethritis, painful urination, yellowish discharge (main symptom). Can occasionally spread from the urethra to the prostate and epididymis. Scar tissue in the spermatic ducts during healing can render the man infertile (rare).
Female- likely that both urinary and genital tracts will be infected. Muccopurulant or bloody vaginal discharge, painful urination if urethra is infected, major complications occur when the infection ascends from the vagina and cervix to higher reproductive structures. Salpingitis (scarring of fallopian tubes), pelvic inflammatory disease.
Consequences outside reproductive tract
Bacterium enters the blood stream, disseminated to joints and skin causing arthritis and rash. Rare complications include meningitis, endocarditis, blindness (opthalmia neonatorum) gonococcal conjuctivitis of a newborn.
Virulence factors of gonorrhea
Fimbrae anchor bacterium to mucosal epithelium and invades cells. More pathogenic due to antibodies not recognizing rearranged fimbrae as they can be turned off and on changing the phenotype. Produces IdA protease resulting in free reign of tissue for bacteria. Produces endotoxin which stimulates nonspecific immunity and leads to localized tissue damage.
Transmission and epidemiology of gonorrhea
Does not survive more than 1 or 2 hours on fomites as very specific environmental conditions required. Most common route of transmission is sexual which requires appropriate portal of entry such as genital, rectum, eyes, and throat. Strictly a human infection among most common reported (350,000 cases annually in US). 10% for males 50% for females being asymptomatic.
Culture and diagnoses of gonorrhea
Males- determined by gram stain. Females- determined by PCR or ELISA. No vaccine available. Use of condoms acts as barrier.
Treatment of gonorrhea
Penicillin is traditional, but large number produce penicillinase enzymes which causes bacterium to be resistant. Some use of ciprofloxacin but bacteria is developing resistance. Physicians use local resistance patterns published by CDC before prescribing.
Defenses of Genitourinary tract
Flushing action of urine, shedding of epithelial cells, acidity of urine, antibacterial proteins in urine, secretory IgA.
