Case Studies Flashcards by Aífe Hayden

What organisms are currently vaccinated against in Ireland?

N. meningitidis (MenC and MenB)

H. influenzae type B (Hib vaccine)

Bordetella pertussis (pertussis vaccine against whooping cough)

S. pneumonia pneumococcal vaccines: PCV7, PCV13, PPV23

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What organisms cause food poisoning?

Staphylococcus aureus

Shigella

Salmonella

Yersinia enterocolitica

Clostridioides perfringens

Bacillus Cereus

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Zoonotic infections:
(2)

Pasteurella Multocida

Salmonella (lizards)

Yersinia pestis (animals, rats, pets etc)

B. anthracis

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Health Care Associated Infections

ESKAPE
- Enterococcus faecium (Vancomycin resistance)
- S. aureus (Methycillin resistance)
- Klebsiella Pneumonia (CBE)
- Acinetobacter baumanii (MDR)
- Psudomonas auriginosa (MDR)
- Enterobacter species (E.COLI) (ESBL)

Citrobacter freundii also is

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S. aureus infections

Superficial skin infections:
- Folliculitis
- Furuncles
- Carbuncles

Skin infections
- Impetigo
- Cellulitis
- Mastitis

Systemic infection
- Bloodstream infections
- Endocarditis
- Pneumonia
- Osteomyelitits
- pyelonephritis

Toxin infections
- Toxic shock syndrome
- Scaled skin syndrome
- Gastroenteritis

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S. aureus food poisoning

Foods:
- ready to eat foods
- salads: ham, egg, tuna, chicken, potato
- bakery products e.g. cream filled
- sandwiches
- mild and dairy products

Enterotoxin

Onset:
- 2-6 hours after ingestion
- resolved in 8 to 24 hours

Symptoms
- severe nausea, vomiting, abdominal pain and diarrhoea triggered by toxin

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S. epidermidis infections:

Device associated infection and HCAI BSI

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S. saprophyticus infections

UTI in sexually active women
Opportunistic HCAI
Opportunistic infection in immunocompromised

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Micrococcus infection:

Opportunistic e.g. UTI

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N. gonorrhoeae infections:

STI

prostatitis
epididymitis
gonoccaemia
joint disease
Pelvic Inflammatory disease
Infertility
ectopic pregnancy
transmitted to infants - conjunctivitis

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N. meningitidis infections:

BSI
Meningitis
Meningococcaemia
Invasive meningicoccal disease (acute meningitis or meningococcemia)

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M. catarrhalis infection

Otitis medium
Sinusitis
Pneumonia
Bronchitis

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H. influenzae type B infection

Meningitis
Epiglotis
BSI
Cellulitis
Arthritis
Osteomyelitis

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H. influenzae non typable infections:

Otitis
Sinusitis
Pneumoniae

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H. aegyptius infection

Conjunctivitis

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H. parainfluenzae infection

Pneumoniae
Endocarditis

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H. ducreyi infection

Chanchroid (lymph nodes and genital)

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Pasteurella Multocida infection:

Zoonotic: dog bites and cat scratches
Swelling
Cellulitis
Chronic pulmonary disease in compromised
Systemic infection in compromised

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Bordetella pertussis infection:

Whooping cough
Pneumoniae and encephalitis in convalescents

S. pneumonia infections:

Acute bacterial pneumoniae
Otitis media

Invasive pneumococcal disease:
- Blood stream infection
- Meningitis
- sterile site infection

S. viridans infections:

BSI through minor trauma to gums
Sub acute bacterial endocarditis in those with damaged heart valves

Strep mutans infections:

Plaque formation
Tooth decay

S. pyogenes infections:

Pharyngitis
Scarlet fever
Skin infections

Impetigo
Cellutis
Erysipelsia

Necrotising facitis
Streptococcal Toxic Shock Syndrome

Rheumatic fever
Glomerular nephritis

S. agalactiae infection:

Group B strep

Prenatal onset GBS
Early-onset GBS
Late-onset GBS

Most common cause of life threatening infection in newborn babies

Enterococci infections

UTI Intra abdominal abscess Endocarditis BSI

Shigella infection:

Food poisoning

Shigella (sonnei) food poisoning

Cause: - Shiga toxin Food: - Chicken, tuna and potato salad Transmission: - faecal to oral route - food, faeces, fingers, flies, fomites - very low infective dose (<200 cells) Incubation - 24 to 50 hours Symptoms - diarrhoeae (bloody) - abdominal pain - fever - possible invasive infection

Salmonella infections:

Food poisoning Septicaemia (cholera suis) Gastroenteritis (typhimurium and enteriditis) Parathyphoid fever (parathyphi) -> enteric fever Thyphoid fever (thyphi) -> leads to enteric fever

Yersinia infections:

Bubonic plague (Y. pestis) -> flea bites or contaminated animal tissue Food poisoning (Y. enterocolitica)

Yersinia Enterocolitica food poisoning:

Sources: - PORK, milk, poultry, shelfish, vegetables, cold foods (4 degrees +) Incubation: - 24 to 36 hours Symptoms: - Diarrhoeae (bloody in 25% of children) - fever - headache - abdominal pain - appendicitis like in children (pseudoappendicitis) - BSI in elderly Pathology - invasion of iluem - necrosis of peyers patches - inflammation of mesenteric lymph nodes

Proteus infection

UTI - second most common cause after EPEC

Klebsiella infections:

Commensal but frequently an opportunistic pathogen causing BSI, HCAI UTI, VAP pneumoniae

Enterobacter infections:

Opportunistic Infections  Health Care Acquired Infection  Antimicrobial Treatment  Catheters  Invasive Procedures  Burns/ wounds  Pneumonia  UT

Citrobacter infections:

 Inhabitant of soil and water and found in GIT  Citrobacter freundii- main pathogen  Healthcare-associated infection, UTI, bacteraemia

E. Coli infection

Neonatal meningitis -> ExPEC Watery diarrheae -> ETEC enterotoxigenic Watery diarrhea of long duration -> EPEC enteropathogenic Bloody diarrhea -> EHEC enterohaemorrhagic Bloody diarrhea -> EIEC enteroinvasive Persistant watery diarrhear in children and HIV -> EAEC enteroadherant

EHEC infection Enterohaemorrhagic E. Coli

Blood diarrhea Haemorrhagic colitis Haemolytic uremic syndrome (HUS)

EnteroInvasive E. Coli infection:

Inflammatory dysentry Bloody diarrhoea Large intestine Intracellular pathogen Fever

Enterotoxigenic E. Coli Infection:

Non inflammatory diarrhoea in children in developing countries Travellers diarrhoea

E. Coli 0157:H7 (EHEC/STEC/VTEC) infections

Intestinal - asymptomatic - watery diarrhoea - haemorrhagic colitis Systemic - haemlytic uremic syndrom HUS Causes: - Thrombotic thrombocytopenic purpura (TTP) - kidney failure - haemolytic anaemia

Psuedomonas infections:

Pneumonia Cystic fibrosis associated chest infection Otitis media Otitis externa Bacterial keratitis in eye Osteomyelitis in bones and joints Diarrhoea Enteritis Enterocolitis BSI Endocarditis

Bacillus infections:

B. cereus: food poisoning B. thuringenesis: insecticide B. anthracis: zoonotic

B. cereus food poisoning

Foods: - RICE, dairy products, spices, dried foods, vegetables - Dried infant formula Spores: - heat resistant - food processes - not removed by regular cleaning - food industry equipment - dairy pipelines Emetic or diarrhoeal - both self limiting Diarrhoeal - proteinaceous foods (meat, fish, milk, stews, sauces, veg) - watery diarrhoea - cramps - Diarrhoeagenic necrotising enterotoxin - 6+ hour incubation - 12 to 24 hours duration Emetic syndrome - starchy foods (rice, potato, pasta, noodles, pastry products) - vomiting - emetic toxin - cerulide - 0.5 hours to 6 hours incubation

B. cereus

B. anthrax

2-5 hour incubation

Clostridides perfringens food poisoning

Improperly-handled food is contraminated with spores, which survive cooking temperature Spores germinate with heating (anaerobiasis) and if > 10^5/g bacteria are ingested, illness may occur Sporulation in the small intestine releases enterotoxin CPE Diarrhoea occurs 6-18 hours later, and resolves in 1-2 days