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Normal Microflora found

In the distal urethra, E. coli, Staphylococcus, Corynebacterium, Haemophilus, Streptococcus & Lactobacillus are most common

Female vagina is heavily

populated with microbes (Those above E. coli, Staphylococcus, Corynebacterium, Haemophilus, Streptococcus & Lactobacillus) + Lactobacillus, Clostridium, Bacteroides, Candida albicans, Fusobacterium

Normal Defenses

Urine flow flushes out microbes
Sphincters keep most pathogens out
Epithelial cell junctions are tightly joined
Other mechanisms: Anti-microbial chemicals and Low pH of urine & vaginal environment

Ascending UTI

Begin in the distal urethra & ascend to the kidneys

Descending UTI

Usually originate outside of the urinary tract.
-Organisms can enter the blood stream from a focal infection (Ex. abscessed tooth) can be filtered by the kidneys to cause infection


+/- pus in the urine (UTI)


urethra inflammation (UTI)


bladder inflammation (UTI)


Painful urination (UTI)


Frequent urination (UTI)

Diagnosis for UTI

Urine dipstick -
Positive nitrates (Metabolite produced by bacteria)
Presence of large #s of bacteria
Presence of WBCs & RBCs
-Leukocyte esterase positive (Enzyme from WBCs)

Positive nitrates

Metabolite produced by bacteria- UTI


Inflammation of the prostate gland
Urgent & frequent urination, fever, lower back pain, +/- joint/muscle pain
Possible routes of infection
Back-flow of contaminated urine
Descent of blood-borne pathogens
Ascent through urethra
Passage through lymphatics of fecal organisms from the rectum
Can cause infertility


Kidney inflammation
Usually caused by ascent of microbes
E. coli causative agent in > 90%
Occasionally Candida
May be asymptomatic
Similar to cystitis +/- chills & fever
Dilute urine & polyuria
Nocturia - Nighttime urination

Glomerulonephritis (Bright's disease)

Damage/inflammation the glomerulus of the nephrons
Immune complex disease +/- following streptococcal (S. pyogenes) or viral infection
Nephrogenic strains of S. pyogenes have similar cell wall components as found in glomerular capsule components
Results in Ag-Ab complexes being formed & filtered by the kidney
Activates inflammatory response of glomerular capillaries initiated
Inflamed vessels leak protein, blood & pus in the urine


Leptospira interrogans (Gram negative motile spirochete)


Nighttime urination
happens in Pyelonephritis


A breakdown of Antibodies
virulence factor in Neisseria gonorrhoeae

Treatments for Gonorrhea and Chlamydia

Ciprofloxin / Tetracyclines / Penicillins
Drug resistance is becoming a problem
Some areas 20% of Gonorrhea infections are multidrug resistance

Treponema palladium

Gram negative, highly motile, spirochete
Only parasitic to humans
Must be grown in the testicles of rabbits in vivo
Killed by drying & cooling & is transmitted almost exclusively by sexual or oral contact
3 stages


Herpesvirus Outbreaks treated with______
Virus can be shed even if skin outbreaks not seen.
Blocks viral DNA polymerase

Herpes simplex virus type 1 (HSV-1)

Fever blisters or cold sores

Herpes simplex virus type 2 (HSV-2)

Genital herpes
-dsDNA, enveloped virus
-Sexually transmitted, but rarely can be spread through hot tubs


Genital warts
Human papillomaviruses
Small, non-enveloped, dsDNA viruses
> 60 HPVs with ~ 15 sexually transmitted
Occur around the anus, vagina, penis, or on the cervix
Types 16 and 18 associate with cervical cancer in females & throat anal cancer in males
Vaccine available

Cytomegalovirus (CMV)

Often asymptomatic (an estimated 80% of adults carry the virus)
Spread via body fluids
Most infections occur in older children & older adults
Symptoms include generalized malaise, myalgia, fever, abnormal liver function tests, swollen lymph nodes
Symptoms are more severe in immune compromised patients
Again, can remain latent (episomal form)

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