Skildum's genital micro; 4.11 Flashcards
Lactobacilli are the dominant microorganism in reproductive vaginas. What kind of bacteria are lactobacilli?
Gram+ rods/bacilli
Facultative anaerobes
What do lactobacilli breakdown?
Glycogen → racemic lactic acid
What is the significance of lactobacilli producing racemic lactic acid?
Humans can only take up L lactic acid…D lactic acid remains and decreases the pH
What is necessary for glycogen formation in the vaginal epithelium?
Estradiol
Other than lactic acid, what else is produced by lactobacilli?
Hydrogen peroxide (likely little consequence)
Hydroxyl radicals
Bacteriocins (form pores in other bacteria)
What increases the likelihood of getting BV?
Not having a lactobacilli dominating vaginal flora…Gardnerella predominate instead
How is BV treated?
Oral/intravaginal metronidazole Boric acid (symptom relief)
What is required for metronidazole efficacy?
Anaerobic organisms…like gardnerella
What is SaPI1? What does it do?
Staph aureus Pathogenicity Island 1 → TSST-1 → superantigen
What does SaPI1 contain?
Non-essential genes
Toxins
Other proteins that enhance virulence
How does SaPI1 happen?
Viral (phage) transduction
Toxic shock syndrome (TSS) is usually caused by staph a (90%). Do patients with TSS usually have Staph a sepsis?
No…patients WITH Staph a sepsis RARELY get TSS
And, patients that GET TSS usually DON’T have Staph a sepsis
How does circumcision help protect from STDs?
Decreased anaerobes…increased aerobes and facultative anaerobes → reduced inflammation and decreased CD4+/CCR5+ macrophages in urethra
What causes epididymitis in prepubertal patients?
E. coli
What causes epididymitis in post-pubertal patients < 35yo?
Chlamydia
N. gonorrhea
What causes epididymitis in patients > 35yo?
E. coli
Pseudomonas spp.
Prostatitis is divided into types (I-IV). What is type I?
Type I is acute bacterial prostatitis
What are the symptoms seen with type I prostatitis?
Dysuria Suprapubic or perianal pain Fever Nausea Sepsis
What gram- bacteria can cause type I prostatitis?
E. coli (most common)
Klebsiella, proteus, pseudomonas
Neisseria, chlamydia
What gram+ bacterium can cause type I prostatitis?
Enterococcus
How is type I prostatitis diagnosed?
Culture organism from urine
>10 WBC per field in urine
Palpate prostate
What is type II prostatitis?
Type II is chronic bacterial prostatitis?
What are the symptoms of type II prostatitis?
Dysuria Pain (penis, testicular, lower back) Recurrent UTI Urethritis Epididyitis NO systemic symptoms
What is the second most common cause of type II prostatitis…because E. coli is still number 1?
Enterococcus is number 2
How is type II prostatitis diagnosed?
Culture organism from expressed prostatic secretions or post-prostate massage urine
>10 WBC per field in urine
What is type IIIa prostatitis?
Type IIIa is inflammatory chronic pelvic pain syndrome
What are the symptoms of type IIIa prostatitis?
Pain
Sometimes dysuria
What causes type IIIa prostatitis?
Maybe not bacteria…
Type IIIb and IV are both asymptomatic…
but type IIIb is called noninflammatory chronic pelvic pain syndrome…and type IV is called asymptomatic prostatitis
