Enteric Infections

Question 1

What types of bacteria can cause an enteric infection?

Answer 1

gram negative bacilli: shigella, salmonella, e.coli, campylobacter, vibro cholerae, gram +ve: c.diff (antibiotics associated)

Question 2

what viruses cause enteric infections?

Answer 2

rotavirus, norovirus,

Question 3

what protozoa can cause enteric infection/

Answer 3

giardia, cryptosporidium

Question 4

what bacteria often causes enteric fever?

Answer 4

salmonella typhi (paratyphi)

Question 5

what enteric infections lead to food related gastroenteritis?

Answer 5

bacteria: ecoli, salmonella, campylobacter, clostridium perfingens (also staph A.
protozoa: giardia, cryptosporidum

Question 6

what enteric infection can lead to infectious gastroenteritis?

Answer 6

bacteria: shigella, cholera
virus: norovirus(SRVS), rotavirus

Question 7

how can antibiotics cause diarrhoea?

Answer 7

interruption in the normal gut flora
allow what is normally the GI commensals/ non virulent bacteria (i.e. c.diff) to proliferate to levels which will cause sickness/diarrhoea

Question 8

what antibiotics can cause diarrhoea? and what bacteria is the most common causative organism of antibiotic related diarrhoea? 5Cs

Answer 8

cephalosporins
co-amoxiclav
clindamycin
ciprofloxacin

c.diff

Question 9

what is c.diff and what needs to be done if there is a case in hospital?

Answer 9

gram positive and spore producing bacteria (so can spread rapidly)

require barrier/isolation

Question 10

what is gastroenteritis?

Answer 10

syndrome characterised by diarrhoea, abdomonial cramps, nausea and vommitting

Question 11

how is dysentry different from diarrhoea?

Answer 11

diarrhoea but with blood and pus.

Question 12

what is the consequence of helicobacter to the GI system?

Answer 12

doesn’t cause gastroenteritis
can cause gastric/duodenal ulcers and gastritis +
if chronic, infection is associated with gastric malignancy

Question 13

describe the pathogenesis of H.pylori

Answer 13

has urease enzyme which allows it to live in the mucin in stomach
secretes chemicals, which attract neutrophils (cause acute inflammation) -GASTRITIS
also produces more acid, which can’t be buffered and gets through the mucin layer- can cause further inflammation, ULCERS and potential for METAPLASIA

Question 14

how would you treat H.pylori infection?

Answer 14

2x antibiotics AND a proton pump inhibitor (PPI) which means less acidic in stomach

Question 15

how is shigella spread?

Answer 15

no animal carriage, faecal-oral route- highly infectious. often in young children - nursery school outbreaks

Question 16

most bacteria and viral gastroenteritis is self limiting. Which infection would you treat with antibiotics?

Answer 16

paratyphi (salmonella typhi)
all others are normally self limiting, so no antibiotics.
but if severe may need (ORT), and antibiotics if persists.