E:2.2 Flashcards
Where are intra-abdominal infections?
Contained to the peritoneum or retroperitoneal space
Where can intra-abdominal infections come from?
Can arise from contamination of these sterile sites by microbiota bacteria via perforation (spillage) of the GI tract
Intra-abdominal infection that is generalized
Peritonitis
Intra-abdominal infection that is localized
Abscess, appendicitis
Bacterial Peritonitis
General (diffuse) inflammation of serous lining of the peritoneum
Primary peritonitis
Inflammation without evident intra-abdominal disease
Also caused spontaneous bacterial peritonitis (SBP) usually only involves one pathogen.
Pathogens: E. coli
Primary peritonitis is most commonly associated with what?
Liver disease (cirrhosis)
Pathophysiology of Primary Peritonitis
Inflammation due to both bacterial toxin and WBC cytokines
*Exudate from blood floods the peritoneum containing the infection → dramatic decrease in circulating blood volume → death due to hypovolemic shock
Secondary peritonitis
Infection due to spillage of bowel content that usually will contain a mixture of microbiota (enteric) bacteria into the peritoneum
Secondary peritonitis pathogens
GI anaerobes (B. fragilis, Clostridium, Peptostreptococcus), Gram (-) bacilli (E. coli), Enterococcus
Tertiary peritonitis
Recurrent infection after therapy; usually occurs in health-care setting after surgery
Intra-abdominal Abscess
A pocket of infected fluid or pus that forms in the abdominal cavity.
Intra-abdominal Abscess common causes
Common causes include ruptured appendix and inflammatory bowel disease.
Intra-abdominal Abscess common pathogens
E. coli (aerobe) and B. fragilis (anaerobe)
Intraperitoneal Abscess
abscess in the abdominal cavity from colon fecal spillage
Intraperitoneal Abscess pathogens
Intestinal flora, infections are usually polymicrobial. GI anaerobes (B. fragilis*, Clostridium, Peptostreptococcus), Gram(-) bacilli (E. coli), Enterococcus
Retroperitoneal Abscess
Near the kidney or spine
Retroperitoneal Abscess pathogens
GI anaerobes (B. fragilis, Clostridium, Peptostreptococcus), Gram (-) bacilli (E. coli), Enterococcus
Visceral abscess
Within abdominal organs
Visceral abscess pathogens
GI anaerobes (B. fragilis, Clostridium, Peptostreptococcus), Gram (-) bacilli (E. coli), Enterococcus
Hepatic abscess
Due to perforation of biliary tract
Cholecystitis, Cholangitis cause
Caused by obstruction of the biliary tree (gallstone)
Septic cholecystitis (gallbladder) results from contamination by GI bacteria
Cholecystitis, Cholangitis pathogens
Infections are usually polymicrobial
GI anaerobes (B. fragilis, Clostridium, Peptostreptococcus), Gram (-) bacilli (E. coli), Enterococcus
Appendicitis
Septic appendicitis results from contamination by GI bacteria
Appendicitis is the most common cause of intra-abdominal sepsis
Appendicitis pathogens
GI anaerobes (B. fragilis, Clostridium, Peptostreptococcus), Gram (-) bacilli (E. coli), Enterococcus
Diverticulum
Diverticulum is an abnormal pouch/sac from a defect in the GI tract
Diverticulitis
Inflammation and or infection of diverticulum
Etiology of Diverticulitis
increased intraluminal pressure at points of weakness where perforating arteries enter colon wall lead to
diverticulum formation → colon erosion → inflammation and perforation → infection by GI bacteria
Diverticulitis pathogens
GI anaerobes (B. fragilis, Clostridium, Peptostreptococcus), Gram (-) bacilli (E. coli), Enterococcus
Many fatalities from infections diarrhea is from what?
Dehydration
Gastritis
Inflammation of stomach lining
Enteritis
Inflammation of small intestine
Colitis
Inflammation of large intestine
Enterocolitis
Inflammation of the small and large intestines
Gastroenteritis
AKA stomach flu
Inflammation involving both stomach and small intestines
Diarrhea
Abnormal bowel movement resulting in increase in water content, volume, and/or frequency of stool
Non-inflammatory diarrhea
(watery or secretory diarrhea)
infectious diarrheal disease of small intestines without mucosal inflammation
Types of non-inflammatory diarrhea
Travelers’ diarrhea and daycare diarrhea
Non-inflammatory diarrhea pathogen
E. coli (travelers diarrhea)
Travelers’ diarrhea
non-inflammatory acquired during international travel in underdeveloped (tropical) regions.
obtained via consumption of contaminated food and drink (foodborne)
Travelers’ diarrhea pathogen
E. coli
Daycare diarrhea
infants are more prone to diarrhea diseases b/c their immune system and GI microflora are in development,
put contaminated objects (fomites) in their month, and spread disease by fecal-oral contact
Inflammatory Diarrhea
infections diarrheal disease with mucosal inflammation
Inflammatory Diarrhea pathogens
Campylobacter jejuni most common cause in developed countries
E. coli is also a pathogen for this
How does Food poisoning occur?
GI inflammation can occur either if the pathogens of their enterotoxins are present in contaminated food and travel to the intestines
Staphylococcal food poisoning
Results from ingestion of preformed enterotoxins
Bacterial source is usually skin and nasal carriage of food preparers
Bacillus cerus food poisoning
“Fried rice syndrome” In flash fried rice, the spores remain intact and germinate in the intestines after ingestion
Campylobacteriosis pathogen
Caused by Campylobacter jejuni
Campylobacteriosis transmission
transmitted to humans most commonly through poultry products
Campylobacteriosis can cause what?
Inflammatory diarrhea and reactive arthritis
Salmonellosis pathogen and transmission
nontyphoidal infections (non-inflammatory diarrhea) often caused by Salmonella typhimurium.
Transmitted through food and handling of reptiles
Enteric fever (Typhoid fever)
caused by Salmonella typhi and paratyphoid fever is caused by S. paratyphi
Typhoidal salmonella differ from nontyphoidal species by their ability to pass through the intestinal lining
Can cause inflammatory diarrhea
Shigellosis is spread how?
fecal-oral contact
Where is shigellosis common?
common in preschool/daycare settings (daycare watery diarrhea)
Most common pathogen for shigellosis
Shigella sonnei which causes most shigellosis cases in the U.S.
Cholera pathogen
Vibrio cholerae
Cholera causes what?
massive diarrhea (“rice-water stool”) → fatalities due to fluid loss
Cholera is most commonly acquired how?
Most U.S. cases are due to eating raw shellfish from the Gulf of Mexico
Listeriosis pathogen
Listeria monocytogenes
Listeriosis is transmitted how? and who should avoid this?
Foodborne illness from diary, deli meats, seafood.
These foods should be avoided in persons at risk for serious infection of in pregnancy
E. coli Gastroenteritis can be what kind of diarrhea
Escherichia coli can cause either watery (common) or inflammatory diarrhea (less common).
ETEC stands for
Enterotoxigenic E.
coli
ETEC accounts for what?
(watery diarrhea) accounts for most of the U.S. cases,
(Travellers’ diarrhea)
EHEC stands for
Enterohemorrhagic
E. coli
EHEC does what?
including E. coli O157:H7 secretes large amounts Shiga toxin (i.e., verotoxin) that damages to the lining
of the intestine causing hemorrhagic colitis → bloody diarrhea
STEC stands for what
Shiga toxin producing E. coli
O157:H7
Form of EHEC and is cause of serious outbreaks in U.S.
Foodborne botulism
assoc. w/ the consumption of Clostridium botulinum spores in canned goods (e.g., baby food)
Floppy baby syndrome
Caused by foodborne botulism (Clostridium botulinum)
What does C. botulinum do in the body
C. botulinum releases BTX-A neurotoxins
Impairing muscle contractions
Clostridium difficile is responsible for what
Clostridium difficile is responsible for antibiotic-associated GI disease (i.e., C. difficile associated diarrhea (CDAD)
Clostridium difficile susceptibility to antibiotics?
C. difficile is nonsusceptble to most antibiotics, permitting it to overgrow when patients’ antibiotics kill off the GI microflora
How does C. diff take hold?
when patients are on broad spectrum antibiotics, the GI bacteria are killed leading to the overgrowth of C. difficile
Where do most C. diff infections originate?
C. difficile colonizes the GI while patients are in hospitals and long-term treatment facilities
spores are transmitted between patients by oral ingestion, often by healthcare workers
Chronic inflammation from C. diff can cause what?
chronic inflammation can lead to toxic megacolon complication
What are the enteroviruses?
Rotavirus and Norovirus
Rotavirus causes what
rotaviruses cause human infantile gastroenteritis
How is rotavirus transmitted and where is it common?
person-to-person by fecal-oral route, common in preschool/daycares
Symptom of rotavirus
Watery diarrhea
Norovirus former name
Norwalk virus
What is the most common cause of VIRAL foodborne disease in the U.S.?
Norovirus
How is Norovirus transmitted?
Person-to-person via fecal oral route
Symptom of norovirus
Watery diarrhea
