Pathogens of the Vagina

Gardnerellavaginalis
This bacteria is a contributor to bacterial vaginitis, a condition where the normal flora of the vagina is disrupted with overgrowth of bacteria. A change in normal bacterial flora including the reduction of lactobacillus, which may be due to the use of antibiotics or pH imbalance, allows more resistant bacteria to gain a foothold and multiply. Cases of bacterial vaginitisare more likely to occur in sexually active women between the ages of 15 to 45. Overview: -gram variable rod -facultative anaerobe -small, gray, circular colonies -grows on chocolate agar Reservoir: vaginal canal in females Symptoms: musty or fishy odor coming from vagina, discharge, and vaginal and/or vulvar irritation Treatment: oral metronidazole Virulence Factors: biofilm and cytotoxicity

Trichomonasvaginalis
Trichomoniasis is the most common curable STD in young, sexually active women. An estimated 7.4 million new cases occur each year in women and men. The parasite is sexually transmitted through penis-to-vagina intercourse or vulva-to-vulva (the genital area outside the vagina) contact with an infected partner. The infection is more likely to occur if the normal pH of the vagina is shifted from a healthy semi-acidic (3.8 - 4.2) to a much more basic or alkaline one (5 - 6). T. vaginalis lacks mitochondria and other necessary enzymes and cytochromes to conduct oxidative phosphorylation and therefore obtains nutrients by transport through the cell membrane and by phagocytosis. Overview: -single celled protozoan parasite Reservoir: most common site is the urethra and -anaerobic, flagellated vagina in women, has the ability to exist on -increases susceptibility moist fomites for up to 1-2 hours In women for HIV Symptoms: inflammation, greenish yellow frothy discharge, itching Treatment: prescription drugs such as metronidazole or tinidazole Virulence Factors: adherencefactors which allow cervicovaginal epithelium colonization in women -these factors are specific to vaginal epithelial cells which are dependent on temp., and pH.

Candida albicans
Candidiasis is an infection caused by a group of microscopic fungi or yeast. There are more than 20 species of Candida, the most common being Candida albicans. In women, candidiasis is most commonly known as a yeast infection. Much like bacterial vaginitis, Candidiasis occurs when the normal vaginal flora is disrupted by, for example, antibiotic use, creating an environment where yeast overgrowth occurs. Overview: -diploid fungus -opportunistic infection; is generally commensal -the same fungus that causes thrush Reservoir: genital tract, oral, gastrointestinal tract, skin surface, moist, warm areas (ie. underarm, vagina) Symptoms: vaginal burning, itching, and discharge Treatment: antifungal drugs such as clotrimazole Virulence Factors: polyphenic changes in temp. and pH causes a shift to psuedohyphae growth although role in candidiasis remains unclear

Genital Human Papillomavirus (HPV)
Genital human papillomavirus is the most common sexually transmitted infection. There are more than 40 HPV types that can infect the genital areas of males and females. HPV infection is limited to the basal cells of stratified epithelium, the only tissue in which they replicate. Infection typically occurs when basal cells in the host are exposed to infectious virus through a disturbed epithelial barrier as would occur during sexual intercourse or after minor skin abrasions. Overview: -enveloped -HPV is passed on through genital contact -establishes itself in mucous membranes and stratified epithelium -certain types of HPV can cause genital warts in men and women as well as cervical cancer in women -can also cause recurrent respiratory papillomatosis(warts in the throat) Reservoir: humans Symptoms: often times women may have HPV and not know it, although it does cause cervical cancer and Treatment: vaccine, Gardasil (men and women) and Cervarix (women) Virulence Factors: inhibitors of tumor suppressor genes

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