urinary and reproductive infections

• Organs of the Urinary System

  • Kidneys
  • Ureters
  • Urinary bladder
  • Urethra
• Kidneys


  • Contains ~ 1 million nephrons
  • Forms urine
• Ureters


  • Receive urine from kidneys
  • Sends to bladder
• Urinary bladder


  • Stores urine
• Urethra


  • Sends urine to exterior
  • Also transports semen in males
  • Much shorter in females
• Male Reproductive System Structures

  • Testes
  • Scrotum and Penis
  • Accessory Organs: Genital Ducts
  • Accessory Glands
• Testes


  Primary sex organs, produce sperm and testosterone
• Scrotum and Penis


  External genitalia; scrotum holds testes
• Accessory Organs: Genital Ducts

  • epididymis
  • ductus (vas) deferens
  • ejaculatory ducts (convey sperm and semen)
  • urethra (convey urine)
• Accessory Glands


  • seminal vesicles
  • prostate
  • bulbourethral gland (produce semen)
• Female Reproductive System Structures

  • Ovaries
  • Accessory Organs: Uterine tubes, uterus, and vagina
  • Internal genitals: uterine tubes, uterus, vagina, ovaries
  • External genitals: vulva (clitoris and labia)
• Ovaries


  Primary sex organs; produce eggs and hormones
• Microbial invasion via mucous membranes of vagina
• Uterine tubes
• The urinary system urethra supports colonization by some microorganisms eg Lactobacillus, Staphylococcus, Streptococcus
• The urinary system provides microbial antagonism to protect the body
• Microorganisms in the urethra can move up to infect the kidneys (rare)
• The other urinary organs and the urine in them are axenic
• Urinated urine will have microbes; urine taken directly from bladder via catheter is sterile
• Regions above the prostate in the male reproductive system are sterile
• Vagina in the female reproductive system

  Colonized by various microorganisms, depending on hormone levels
• As estrogen levels rise, cells lining vagina produce glycogen; lactobacilli converts it to lactic acid; acidity (~4.5 pH) inhibits opportunistic pathogen growth
• The vaginal microbiome provides microbial antagonism to protect the body
• Opportunistic and sexually transmitted microbes can infect the reproductive system (male and female)
• Bacterial Urinary Tract Infections have signs and symptoms of frequent, urgent, painful urination; abdominal, back pain; urine=cloudy, bloody, foul odor
• Bacterial Urinary Tract Infections may trigger pain/inflammation in the urethra, bladder, kidney, or prostate
• Bacterial Urinary Tract Infections may be asymptomatic or with slight fever; mental confusion if bacteria spreads to blood (bacteremia); fatal-often seen in elderly
• Pathogens that cause Bacterial Urinary Tract Infections

  • Enteric bacteria, part of intestinal microbiota, most common cause eg Escherichia coli (70%), Proteus, Klebsiella
  • Non-intestinal bacteria eg Pseudomonas, Staphylococcus
• Pathogenesis and epidemiology of Bacterial Urinary Tract Infections

  • Often results when fecal bacteria are introduced into urethra
  • More common in females (shorter urethra, closer to anus)
• Many cases of Bacterial Urinary Tract Infections are self limiting (resolve without treatment)
• Some Bacterial Urinary Tract Infections require antimicrobial drugs for treatment
• Leptospirosis


  Zoonotic disease seen primarily in animals
• Signs and symptoms of Leptospirosis


  • Abrupt fever, myalgia (muscle pain/ache), muscle stiffness, and headache
  • Nausea, vomiting, diarrhea in 50% of cases
  • Rarely fatal-when it is, due to kidney liver failure, meningitis, respiratory distress
• Pathogen of Leptospirosis


  Leptospira interrogans, gram negative, motile spirochete; 200+ strains
• Leptospira lives in many wild and domestic animals: rats, raccoons, foxes, dogs, horses, cattle, pigs
• Leptospira can survive in streams, moist soil
• Pathogenesis and Epidemiology of Leptospirosis

  • Transmission: direct contact with urine of infected animal or urine-contaminated water
  • Spirochete can penetrates mucus membrane, small cuts in skin, travels via the bloodstream through the body, infects and lives in kidneys, excreted in urine
• Leptospirosis is treated with oral or intravenous antimicrobial drugs
• Staphylococcal Toxic Shock Syndrome

  • Sudden-onset fever, chills, vomiting, diarrhea, low blood pressure, confusion, severe red rash
  • Untreated = fatal to 50% of cases: shock, severely low BP
• Pathogen and virulence factors of Staphylococcal Toxic Shock Syndrome

  • Caused by strains of Staphalococcus aureus that produce the exotoxins toxic shock syndrome toxins
  • These toxins act as superantigens, a class of antigens that activate T cells and cause an excessive cytokine production ('cytokine storm', causing an excessive immune response)