Genitourinary System Infections
- TORCH agents - pathogens that cross placenta > bacterial infections of vaginal tract
-
• cause serious complications: stillborn, congenital • vaginal microbiome built in protection
defects, spontaneous abortion - epithelial cells constantly shed, mucus enriches
• TORCH pathogens - vertical transmission with antimicrobial peptides and lysozyme
- toxoplasma gondii - lactobacillus species produce lactic acid (lowers
- other (HIV, syphilis, parvovirus B19, varicella-zoster, pH)
zika) - bacteriocins limit growth of competing microbes
- rubella virus - antibiotics can kill of vaginal flora, increase pH:
- cytomegalovirus leads to opportunistic infections
↳ bacterial vaginosis - increase in mixed bacterial
- herpes simplex viruses
- urinary tract infections species
• 10 million doctor visits/year in US (8x more common • mainly lack of lactobacillus - antibiotic use, birth
in female) control, diabetes, pregnancy, hormone imbalance,
douching
• CAUTI - catheter associated
• vaginal pH about 4.5 - cause irritation, foul
• lower UTI: urethritis (urethra) and cystitis (bladder) smelling white gray discharge
• upper UTI: ureteritis (ureters) and pyelonephritis • treatment: metronidazole, clindamycin
(kidneys) ↳ chlamydia - chlamydia trachomatis
• chronic pyelonephritis can leave scar tissue in
kidneys, impair function, may lead to renal failure • obligate intracellular bacteria (inside cells)
• E. coli - most common cause • relatively easy to cure w/ antibiotics
- UPEC - uropathogenic E. coli • many asymptomatic
• bind to tissues throughout tract, form biofilms • chronic
• may spread to bloodstream (bacteremia) - men: epididymitis and infertility
• virulence - adhesions, toxins, proteases, flagellated - women: pelvic inflammatory disease, most
> genital herpes - viral STD
-
common cause of infertility, increase cervical cancer,
ectopic pregnancies
• HHV2 - second most common form • perinatal exposure: pneumonia, neonatal
• can be transmitted w/ no lesions/symptoms conjunctivitis
• no vaccination/cure - lifetime carriers ↳ gonorrhea - neisseria gonorrhoeae
• lesions usually heal within couple weeks • fimbriae bind to mucosa of urethra, cervix, anal
- clear pustules on red base (infectious virus) canal, sperm, throat, conjutiva
- external genitalia, urethra, cervix, rectum, • endotoxin damages mucosa
pharyngeal • female - mild vaginitis: painful urination,
• primary infection - flu like illness (fever, HA, muscle increased discharge, spotting
aches) • male - urethral infection: pus discharge, dysuria,
• can make more susceptible to bloodborne STDS (HIV) epididymitis, prostatitis
• immunocompromised - can become systemic and • untreated can lead to PID, scar tissue, sterility,
fatal become systemic (gonorrheal endocarditis,
• neonatal herpes - through placenta or during delivery meningitis, arthritis)
- 25-30% have CNS involvement • in birth canal: neonatal gonorrheal ophthalmia,
become systemic
- 25% fatality
- CDC recommend screening, prophylactic
- genital warts - most common in world
erythromycin eyedrops in all babies
• human papilloma viruses (HPVs) • treatment: antibiotics, some resistance
- cause 90% of cervical cancers
• most infections asymptomatic
• warts on penis, vulva, cervix, perineum
• vaccination covers 9 strains - most common cancer