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MS3 - Microbiology > Enteric infections > Flashcards

Enteric infections Flashcards

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1
Q

common serotypes of salmonella

A

S. enteritidis
S. typhimurium
S. virchow

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2
Q

source of salmonella infection

A

Contaminated poultry/ dairy products common source

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3
Q

which time of the year most common for salmonella

A

summer (warm season)

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4
Q

salmonella antigens

A

lipopolysaccharide O antigen, flagella is H antigen

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5
Q

what happens as a result of salmonella infection

A

Excessive fluid secretion from ileum/jejunum, If transported through cells, leads to systemic infection

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6
Q

which part of GI wall is affected by salmonella

A

Does not extend beyond basement membrane

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7
Q

salmonella incubation

A

12-72 hours

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8
Q

salmonella Sx

A
  • Malaise, fever
  • n/v/diarrhoea watery brown
  • Typhoid and paratyphoid fevers
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9
Q

how quickly salmonella resolves

A

several days (up to several weeks)

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10
Q

abx for In salmonella,

A

Ciprofloxacin first line (alternative is cefotaxime)

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11
Q

Shigellosis transmission

A

Person to person spread and via contaminated food and water

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12
Q

Shigellosis subtypes

A

S.sonnei,

Others: S.flexneri, S.boydii, S.dysenteriae

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13
Q

which part of GI wall affected in Shigellosis?

A

Invade gut by destroying submucosa, infecting enterocytes, spread from cell to cell

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14
Q

S.dysenteriae type 1 toxin?

A

produces exotoxin (shiga toxin)

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15
Q

incubation period for Shigellosis?

A

Incubation 1-7 days

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16
Q

Shigellosis sx

A
  • High fever
  • high WBC
  • fever resolves and diarrhoea and colic begin
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17
Q

Shigellosis mx

A
  • Symptomatic: antispasmodics, rehydrate

- ABx in severe cases, ciprofloxin (trimethoprim may be active, ceftriaxone also alternative)

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18
Q

flexneri and dysenteriae features?

A

More severe:

  • mucus and blood in stools, marked colic
  • Asymptomatic excretion for days-weeks
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19
Q

sonnei and boydii features?

A

mild, rarely colitis

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20
Q

Campylobacter transmission

A
  • undercooked poultry, bird pecked milk

- Large food/waterborne outbreaks can occur

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21
Q

Campylobacter subtypes

A

C. jejuni,
C.coli,
C.fetus,
C.lari

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22
Q

Incubation of Campylobacter

A

2-5 days

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23
Q

presentation of Campylobacter

A
  • 24hr prodrome, fever, headache
  • Watery diarrhoea, can be bloody, vomiting
    Pain significant, constant, not colicky
24
Q

Mx of Campylobacter

A

Mild cases self-limiting

Severe/ prolonged, use 3-4 day course oral erythromyci/ ciprofloxacin

25
Q

3 types of Escherichia coli

A
  • Enterotoxigenic E. coli (ETEC)

- Verocytotoxic (VTEC) or Enterohaemorrhagic (EHEC)

26
Q

Escherichia coli incubation period

A

1-5 days

27
Q

Escherichia coli sx

A
  • Abrupt onset vomiting and diarrhoea
  • Later profuse watery diarrhoea - only Mild fever, little pain
    (Similar to viral gastroenteritis/salmonellosis)
28
Q

Escherichia coli complication

A

Haemolytic Uraemic Syndrome

29
Q

Escherichia coli mx

A
  • Many E.coli resistant to broad spectrum penicillins,
  • Ciprofloxacin 500mg BD, 3-5 days
  • Avoid antibiotics in HUS (antimotility drugs increase chance of HUS)
30
Q

Enterotoxigenic E. coli toxins

A

produce 2 main types of toxin

  • Polypeptide, like cholera toxin
  • Stimulates hypersecretion
31
Q

Verocytotoxic (VTEC) or Enterohaemorrhagic (EHEC) toxins?

A
  • cytotoxin, kills cells

- and causes Haemorrhagic colitis and HUS (haemolytic uraemic syndrome)

32
Q

ETEC transmission

A
  • Reservoir-human GI tract
33
Q

VTEC transmission

A
  • Reservoir-GI tract of healthy cattle
  • Contaminated food/ animal carcasses (hamburgers), unpasteurised milk,
    farms, paddling pools, person to person rare e,g nurseries
34
Q

Haemolytic Uraemic Syndrome sx

A
  • Rising urea and creatinine,
  • haemolytic anaemia and thrombocytopenia
  • Raised BP,
  • fitting
35
Q

Haemolytic Uraemic Syndrome mx

A

More than half need haemodialysis, almost all cases recover (most
deaths in elderly, fatal <5%)

36
Q

why common cause of hospital acquired diarrhoea

A

Some antibiotics disturb balance of microbial flora -> rapid multiplication ->
toxin production -> mucosal injury and inflammation -> diarrhoea

37
Q

sx c dif

A

Antibiotic-associated diarrhoea

Antibiotic-associated colitis

38
Q

complications of c dif

A

Acute abdominal syndrome/toxic megacolon, colonic perforation, pseudomembranous colitis, recurrence (in 20%)

39
Q

mx of c dif

A
  • Stop or change antibiotics if possible
  • Fluid/electrolyte replacement
  • Avoid antiperistaltics
  • If above not possible or unsuccessful, treat with metronidazole (2nd line
    vancomycin)
40
Q

Viral gastroeneteritis ix?

A

I. Stool electron microscopy, ‘catch all’
II. Stool enzyme immunoassays (e.g. rotavirus)
III. Molecular diagnosis: Stool PCR

41
Q

Pathogen of viral gastroenetitis

A

rotavirus

42
Q

incubation of Viral Gastroenteritis

A

Incubation around 1 day

43
Q

sx of Viral Gastroenteritis

A
  • Abrupt onset D and V (D>V)

- Mild fever, short-lived

44
Q

recovery of Viral Gastroenteritis

A
  • Recovery in 48 hrs usual (D for up to a week)
45
Q

prevention of Viral Gastroenteritis

A
  • live attenuated vaccines (Rotarix and RotaTeq)
46
Q

Norovirus incubation

A

Incubation 10-50 hrs

47
Q

sx Norovirus Gastroenteritis

A
  • Asymptomatic to explosive vomiting and diarrhoea

- Headache and abdominal cramps

48
Q

Norovirus Gastroenteritis lasts for

A

Lasts 24-48 hrs

49
Q

Norovirus Gastroenteritis transmission

A

Breathe in aerosolised vomit, faeces and swallow

50
Q

Norovirus Gastroenteritis season

A

winter vomit

51
Q

Enteric adenovirus incubation

A

up to 10 days

52
Q

Enteric adenovirus sx

A
  • watery diarrhoea,

- mild fever,

53
Q

Enteric adenovirus lasts for?

A
  • illness may last longer in general (3-11 days)
54
Q

Astrovirus pts demographics

A

Infants and elderly exhibit significant illness

55
Q

Astroviruses

co-infection with

A

rotavirus/ norovirus

56
Q

Astroviruses

Season

A

winter

MS3 - Microbiology (11 decks)

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