Antibiotic associated Diarrhea

Question 1

Bacteria that produce toxins:

Answer 1

S. aureus (enterotoxin)

B. cereus (emetic toxin)

Question 2

Ingestion of the spores of this organism leads to infection:

Answer 2

Clostridium botulinum - spores go into vegetative state and produce toxins

Question 3

What is the temperature danger zone in which bacteria can easily grow?

Answer 3

5 and 60 degrees C

Question 4

Which bacteria is associated with the consumption of food prepared by a food handler ?

Answer 4

S. aureus - on hands/skin of food handler

Question 5

Staphylococcal intoxication causes symptoms within:

Answer 5

1-6 hrs of ingestion of contaminated food (nausea, vomiting, camps with or without diarrhea and no fever)

Question 6

Staph aureus symptoms are mostly due to:

Answer 6

Enterotoxins

Question 7

Is culture routinely performed to confirm S. aureus food poisoning?

Answer 7

NO - the toxins are present in the food. bacteria itself is not causing the problem

Question 8

Bacillus cereus lab features:

Answer 8

Aerobic
gram positive bacilli
spore-forming
catalase positive

Question 9

2 distinct forms of clinical disease due to Bacillus cereus infection:

Answer 9

1. Emetic syndrome: heat stable toxin - resistant to high temp, enzymes and extreme pH –> rapid onset vomiting
2. Diarrheal disease - organism ingested –> heat labile enterotoxin
   produced in the gut

Question 10

Clostridium perfringens lab features:

Answer 10

spore-forming
anaerobic
gram positive bacillus

Question 11

Clostridium botulinum:

Answer 11

classic 
infant botulinism (in vivo production of toxin) 
wound botulinism (not common) 
inhalational botulinism

Question 12

Flaccid paralysis and death from resp failure is caused by this toxin:

Answer 12

Botulinim toxin - Clostridium botulinum. Patients are put in ventilators.

Question 13

Clostridium difficile:

Answer 13

anaerobic
spore forming
gram positive
NOSOCOMIAL INFECTION

Question 14

With C. diff think:

Answer 14

1. antibiotic-associated diarrhea (AAD)
2. antibiotic-associated colitis(AAC)
3. antibiotic-associated pseudomembranous colitis (PMC)

Question 15

3 C. diff toxins:

Answer 15

Toxin A (enterotoxin)
Toxin B (cytotoxin)
Binary toxin

Question 16

The nastiest C. diff stain:

Answer 16

NAP1 - BI - 027

Question 17

C. diff transmission:

Answer 17

fecal-oral route (vegetative or spores). Spores germinate in small intestine.

Question 18

Clindamycin is one of the highly-implicated antibodies in:

Answer 18

C. diff infection

Question 19

Environmental risk factors of C. diff infection:

Answer 19

poor hand hygiene, poor environmental hygiene and Inadequate isolation facilities

Question 20

What confirms the diagnosis for C. diff infection:

Answer 20

Presence of toxin in stools - positive bacterial culture does not always indicate infection. it’s the TOXINS that are a problem

Question 21

Rapid cassette assay that simultaneously detects both glutamate dehydrogenase (GDH) antigen and toxins A & B of C. difficile in fecal specimens (aids in diagnosis):

Answer 21

C. DIFF QUIK CHEK COMPLETE - Detects C. difficile antigen, GDH, as a screen for the presence of C. difficile & confirms the presence of toxigenic C. difficile by detecting toxins A and B

Question 22

Are alcohol-based hand sanitizers effective against spores?

Answer 22

NO THEY ARE NOT - MUST HAND-WASH WITH SOAP AND WATER

Question 23

Recurrent CDI occurs in:

Answer 23

Elderly patients. (Patient has CD infection and within less than 8 weeks of the first infection, develops CDI again). Antibiotics further disrupt the intestinal microbiota.

Question 24

CD recurrence usually happens because of:

Answer 24

SPORES - new treatment with fecal transplant.