UTI for MSc Student, SIU

1. Dr. Mahadi Hassan Mahmoud
Assistant Professor of Microbiology

2. Genital tract infection & sexual
Transmitted disease
Most of the genital tract infection
transmitted by the sexual contact- but very
few infections are not transmitted by
sexual contact. The genital tract infection
can give serious complications may lead
to abortion, still birth, premature child in
case of congenital infection such as
syphilis, sterility or infertility. Most of
genital tract infections infect both male &
female but few of them infect one sex.

3. Urethritis
 Urethritis infection of urethra and cause by
N. gonorrhea, but also can be caused by
other organisms and then called non-
specific Urethritis (Chlamydia serotype O-
K, Mycoplasma hominis, Ureoplasma, T.
vaginalis, C. albicans, and Gardnella
vaginalis).
 In female has another term cervicitis the
organisms such as Neisseria found in the
cervix can not reach vagina due to acid
pH.

4. Syphilis
 Caused by T. pallidum.
Has three stage.
chancre (painless & hard chancre) in
genital organs.
GTI + congenital disease.

5. Cancroids
 It's lesion in genital tract.
 Caused by H. ducreyi soft chancre painful.
 Infect G.T& it is sexual T. disease .
 for both sexes.

6. Lymphograunloma venereum
(LGV)
 It is GTI & sexually T. disease.
 Lesion, ulcers & Enlargement of lymph
nodes.
 Caused by Chlamydia serotype L1, L2,
L3.
 lymph node contain fluid, pus, organisms.

7. Granuloma ingiunale
 It is GTI & sexual T. disease.
 for both sexes.
 Caused by Calymmatobacterium
granalomatis.
 Lesion contain fluid.

8. Granuloma ingiunale
 Can not be culture in culture media.
 Use Giemsa stain to diagnose it, giving
pink capsulated bacilli (called donovani
bodies).
 Strict in tropical area. (lymph nodes not
involve)
 The complication bone destruction

9. Herpes genitals
 It is GTI & sexual T. disease
 For both sexes.
 Caused by herpes simplex virus 2.
 Cause lesions very painful & highly
infectious.
 Diagnosis: direct Immunofluorescence,
serology & tissue culture.

10. Vaginitis
 Characterized by vaginal discharge mainly
caused by C. albicans & T. vaginalis
 It is GTI for female but can be transmitted
by sexual contact to male and then call it
Urethritis.
 Can also be caused by G. vaginalis and
then called non-specific vaginitis or called
vaginosis

11. Vaginitis
 other causes, anaerobic gram -ve group
Bacteroides & Prevotella & mobilincus.
 The infection happen when replacement
of lactobacilli occur.

12. Vaginitis
 C. albicans :
 C. albicans  monilia - cause Candidiosis
or Moniliasis in pregnant female. Diabetic
pt- female used contraceptive pills
(suspected to C. albicans infection
characterized by white vaginal discharge
(also called vaginal thrush).

13. Vaginitis
 Trichomonas vaginalis:
Characterized by thick, colored with very
bad smell discharge & vaginal irritation.
 Non-specific vaginitis:
Characterized by non purulent offensive
discharge grey without pus all - caused by
anaerobes.
 Ideal pH of vagina 3 - 4 ... but it will rise
due to replacement of lactobacilli.

14. Vaginitis
Non-specific vaginitis:
 Characterized by non purulent offensive
discharge grey without pus all - caused by
anaerobes.
 Ideal pH of vagina 3 - 4 ... but it will rise
due to replacement of lactobacilli.

15. Puerperal sepsis
 Infection of G.T of female only.
 Not sexual T. disease .
 Happen during gynecological procedures
(septicemia).
 The main causative agents: S. pyogens,
anaerobic cocci, Enterococci, Other B.
haemolytic strept, S. aureus ,
L. monocytogens. B. fragilis,
C. perfringens & Coliform.

16. Toxic shock syndrome
 It is GTI of female during period.
 Not sexual T. disease.
 Caused by S. aureus.

17. Prostitis
 It is GTI of male only and not sexual T.
disease can be as complication of UTI.
 causative agents Enterococci & E. coli.

18. Hepatitis B
 Caused by HB virus.
 Transmitted through blood, injection and
fluids.
 It's not genital T. infection but it's sexual T.
disease.
 Can infect both sexes.

19. AIDS
 Viral infection.
 Sexual T. disease but not GTI.

20. Genital wart
 Skin infection caused by papilloma virus
 Cause benign tumor.
 Infect the genital area (skin) but not the
GT.
 Transmitted sexually.

21. Scabies and public lice
 Caused by ectoparasite called Scabies
 Sexual transmitted but not GTI.

22. Valvovaginitis
 Occur in young female not adult one
mainly caused by using contaminated
bedclothes sharing of personal clothes.
 Also happen due to over growth of vaginal
commensals.
 The organisms present in vagina due to
absent of lactobacilli.

23. Salpingitis and granalomatis
infection
 Infection faloup tube.
 Characterized by granuloma.
 Caused by M - tuberculosis.
Actinomycetes.
 Not sexual T. disease but it's genital T. I

24. Salpingitis and granalomatis
infection
 The causative agent reach the genital tract
through the blood (M. tuberculosis -
Actinomycetes) .
 Also can be caused as a complication of
Urethritis.

25. LAB Diagnosis
Specimen:
 Urethral discharge - vaginal discharge -
cervical discharge - urine - fluids from
infected lesions & scraping.
 Blood for culture & serology.

26. LAB Diagnosis
I. Urethral discharge:
Mainly from male (the best sample) can be
taken by swab (called urethral swab)
collected in case of Gonorrhea.
Better collect 2 swabs:
1-For direct examination:
do smear immediately.
2-For culture: immediately or in transport
media

27. LAB Diagnosis
Direct examination:
Two smears:
 Gram stain. (Gram stain fixation by
methanol not heat )
 Immunofluorescence ( or Giemsa stain for
inclusion bodies).
Culture:
CBA & selective media (MNYC): for
Neisseria.

28. LAB Diagnosis
Culture:
Special media: for Mycoplasma.
Tissue culture: for Chlamydia.
2. Cervical specimen:
 Collect by endoscope.
 In case of gonorrhea (Treat as urethral
discharge [MNYC] ).

29. LAB Diagnosis
 Also collected in case of non-specific
Urethritis (Mycoplasma - Chlamydia ...
etc).
3. Vaginal discharge:
High vaginal swab (HVS) mainly collected
in case of vaginitis - non. Specific vaginitis
- toxic shock syndrome - puerperal sepsis
- Valvovaginitis.

30. LAB Diagnosis
 Collect two swabs:
1. For direct examination:
Smear immediately + wet preparation
2. For culture immediately or in transport
media.
if suspect T. vaginalis use T.V transport
media

31. LAB Diagnosis
 Direct examination:
1. Wet preparation for T.V.
2. Gram stain & M. B for Candida.
3. Immunofluorescence - ELISA - PCR for
Chlamydia.
 Culture:
BA mainly for S. pyogens.
SAB mainly for Candida .

32. LAB Diagnosis
In case of puerperal sepsis:
BA + an O2 BA - Kanamycin -
Vancomycin BA (Bacteroids) -
Neomycin BA for Clostridia - N.A BA for
listeria - MacC for Enterococci and
Coliform.
4. Fluids & Scrapings:
For treponema - syphilis

33. LAB Diagnosis
 Dark field microscope.
 Silver impregnation.
 Immunofluorescence.
 Donovan bodies for Catamatobacterium
granulomatis.
 Giemsa stain.
5. Urine & prostatic fluid:

34. LAB Diagnosis
 For Gonorrhea in male:
Can be detected if the urine or fluid is
fresh & first stream urine not MSU.
 To detect also urea plasma.
6. Blood for culture:
 Toxic shock syndrome.
 Puerperal sepsis.

35. LAB Diagnosis
7. Blood for serology:
The culture has a very poor role in
diagnosis of some Genital Tract Infections.