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Reproductive & Sexual Health > Microbiology of UTI > Flashcards

Microbiology of UTI Flashcards

1
Q

What increases the probability of HIV acquisition?

A

Genital ulcers

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2
Q

What STIs cause urethritis?

A

Gonorrhea and chlamydia

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3
Q

Describe the normal vaginal flora

A

Lactobacillus predominate and are protective

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4
Q

Why is the normal pH of the vagina acidic?

A

Lactobacillis produce lactic acid +/- hydrogen peroxide

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5
Q

What organisms aside from lactobacillus species are normal vaginal flora?

A

Group B beta-haemolytic streptococcus

Candida spp.

Strep viridans group

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6
Q

What would be seen on a gram film of Candida albicans?

A

Budding yeasts and hypae

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7
Q

Candida infection; ___% of females are asymptomatically ________ with small numbers of mostly candida _______

A

Candida infection; 30% of females are asymptomatically colonised with small numbers of mostly candida albicans

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8
Q

What are the predisposing factors for candida?

A
  • Recent antibiotic therapy
  • High oestrogen levels (pregnancy, certain types of contraceptive)
  • Poorly controlled diabetes
  • Immunocompromised patients
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9
Q

What is this infection?

A

Candida albicans

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10
Q

What is the presentation of a candida infection?

A

Intensely itchy white vaginal discharge

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11
Q

How is candida diagnosaed?

A

High vaginal swab for culture- the majority of cases are caused by candida albicans

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12
Q

What are the treatments for candida infections?

A
  • Topical clotrimazole pessary or cream
  • Oral fluconazole
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13
Q

When might candida infections be resistant to azole treatment?

A

Non-albicans candida species responsible

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14
Q

What is this infection?

How is it acquired

A

Candida balanitis

Not sexually transmitted

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15
Q

What is this infection?

A

Gonorrhoea

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16
Q

Describe the pathogenesis of gonorrhoea?

A

Attaches to host epithelial cells and is endocytosed into the cell to replicate within the host cell and are released into the subepithelial space

17
Q

How does the inflammation occur in typical urethral gonococcal infections?

A

Release of toxic lipo-oligosaccharide and peptidoglycan fragments as well as the release of chemotactic factors that attract neutrophilic leukocytes

18
Q

Why are some gonococcal infections asymptomatic?

A

Related to differences in the organisms ability to bind complement-regulatory proteins that downregulate the productin of chemotactic peptides

19
Q

What parts of the body does neisseria gonorrhoea infect?

A

Urethra, rectum, throat & eyes, endocervix

20
Q

Describe the appearance of neisseria gonorrhoea

A

Looks like 2 kidney beans facing each other

Easily phagocytosed by polymorphs, so often appear intracellularly

21
Q

Neisseria gonorrhoea is a _________ organism, it _______ survive outside the body

A

Neisseria gonorrhoea is a fastidious organism, it doesn’t survive outside the body

22
Q

How is N. gonorrhoea tested for?

A
  • microscopy of urethral/endocervical swabs (90+% specificity in males)
  • culture on selective agar plates
23
Q

Culture on selective agar plates for n. gonorrhoea is done on what samples?

A

Endocervical, rectal and throat swabs NOT vaginal swabs

24
Q

What does selective agar do?

A

Suppresses growth of normal flora

25
Q

When can non selective media be used in culture

A

When no competing flora are expected (synovium)

26
Q

Where are cultures on selective agar plates taken?

A

Only done in SRH clinic- die in transit

27
Q

What are NAATs

A

Nucleic Acid Amplification Tests

28
Q

When are NAATs used?

A

To diagnose gonorrhoea and chlamydia

29
Q

What is the treatment for gonorrhoea?

A
30
Q

What is the commonest bacterial STI in the UK?

A

Chlamydia trachomatis

31
Q

Where does chlamydia infect?

A

Infects the urethra, rectum, throat and eyes, and endocervix

32
Q

Describe the nature of chlamydia trachomatis

A

Obligate intracellular bacteria with biphasic life cycle- does NOT reproduce outside host cell

33
Q

Which STI does not stain with gram stain

A

Chlamydia trachomatis

34
Q

What are the three serological groupings of chlamydia trachomatis?

A
  • serovars A-C = trachoma (eye infection) not STI
  • serovars D-K= genital infection
  • serovars L1-L3= lymphogranuloma venereum
35
Q

Describe the chlamydia infectious cycle

A
  • attachment and entry
  • migration to perinuclear area and EB -> RB transition
  • inclusion biogenesis and bacterial replication
  • RB -> EB transition and cell lysis (48h)
36
Q

Descirbe the diagnosis of chlamydia and gonorrhoea

A

Combined NAATs or polymerase chain reaction for both organisms in one test

Done on;

  • male patients- first pass uring sample
  • female patients- HVS or vulvovaginal swab (can be self-taken by patient or clinician-taken endocervical swab if bhaving speculum examination)
  • Rectal and throat swabs
  • Eye swabs (babies and adults)

Reproductive & Sexual Health (54 decks)

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