STI's

STI's

1. SYPHILIS

   • Treponoma Pallidum
     • Gram negative
     • Axial filaments
   • Infection
     • 1. Primary
       • Chancre
       • 4-6 wks
     • 2. Secondary
       • Fever
       • Rash
       • Liver infection
       • Swollen lymph nodes
     • 3.Tertiary
       • Gumma
         • Soft granular lesion
       • Antibiotic resistance
         • Immune complexes
           • Inflammation
           • Tissue destruction
     • Congenital
       • Skin lesions
       • Deafness
       • Bone malformation
   • Diagnosis
     • Microscopy
     • Serological testing
   • Treatment
     • Chemotherapeutic
       • Salvarsan
     • Antibiotic
       • Penicillin
   • Immune evasion
     • Cell wall
       • Tpr outer membrane protein
         • Phase variation
           • Poly G tract
             • <8 = transcribed
             • >8 = reduced transcription
             • Strand slippage and excision repair
         • Tpr K
           • Antigenic variation

2. Trends

   • Age
   • Geography
   • Sexual orientation

3. CHLAMYDIA

   • Chlamydia Trachomatis
     • Diagnosis
       • PCR
       • Immunoassays
     • Treatment
       • Doxycyclin
     • Gram negative
     • Small genome
     • Cell wall
       • Cross linked membrane proteins
         • MOMP
           • OmpA
   • Symptoms
     • Males
       • Epididymis inflammation
       • Painful urination, water discharge
     • Females
       • Cervical inflammation
         • Immune activation
           • Infected cells secrete IL's and GM-CSF
             • Attract immune cells
               • Fibrosis and scarring
       • Painful urination, vaginal discharge
       • PID
         • Fallopian tube adhesions
         • Infertility
         • Ectopic pregnancy
         • AIDs
     • Infants
       • Chlamydial ophthalmia
       • Chlamydial pneumonia
       • Trachoma
         • Corneal scarring and blindness
   • 2 stage life cycle
     • Reticulate body
       • Replication
     • Elementary body
       • Infection
     • Cell cycle
       • 1.Attachment
         • OmpA binds heparan sulphate
       • 2.Entry
         • T3SS injects TARP
           • Induces uptake
       • 3.Primary differentiation
         • EB to RB
       • 4.Cell division
         • Rapid multiplication
       • 5.Effector secretion
         • CPAF
           • Degrade host TF's
         • Chronic inflammatory response
       • 6.Secondary differentiation
         • RB to EB (Intermediate form)
         • Chromosomal condensation
         • OMC formation
         • T3SS formation
       • 7.EB release

4. GONORRHOEAE

   • Neisseria Gonorrhoeae
     • Gram negative
     • diplococcus
     • Oxidase positive
     • 2nd most common
   • Symptoms
     • Females
       • Vaginal discharge
       • Abdominal pain
       • Burning pee
         • Urinal ouchy pee pee times
       • PID
     • Males
       • Burning pee pee
       • Pus discharge
       • Epididymitis
     • Neonates
       • Gonoccocal opthalmia
   • Diagnosis
     • Microscopy
     • Thayer Martin agar
       • Vancomcin, inhibits gram positive Colistin, inhibits most gram neg
       • Inhibits most others
     • Immunoassays
     • PCR
   • Treatment
     • 3rd gen cephalosporins
   • Virulence mechanisms
     • Attachment pili
       • Type 4
         • T2SS
           • Transformation
             • DNA binding
             • Uptake
             • RecA mediated recombination
         • Binds CR3 and CD46
     • Tight attachments
       • Opa proteins
         • OpaHS
           • Binds heparin sulphate
         • OpaCEA
           • Binds CEACAM
             • Uptake
     • Change surface proteins
       • Recombination
         • Transformation
         • Gene exchange
       • Antigenic variation
         • Abberant recombination
           • L-pilin
             • PilS and PilE unequal exchange
             • Stuck in periplasm
             • Evades immune system recognition
           • S-pilin
             • Secreted soluble pilin molecular decoy
         • PilE and PilS exchange
           • E for expressed
           • Genetic recombination between homologous segments
       • Phase variation
         • Homopolymeric repeats
         • Tetranucleotide repeats
         • PilC
           • 11-12G = off
           • <11->12 = on
         • CTTCT repeats
           • 3,6,9,12 = on
           • Opa proteins
       • Sialylated lipopolysaccharide
         • Resistant to complement and antibodies
         • Mimics host cell surface