Enterobacteriaceae II, Salmonella, Enterobacteriaceae resistance Flashcards
Identification/Diagnosis of Salmonella (typhoidal and non-typhoidal)
Gram (-ve), motile rods, that Do NOT ferment Lactose
–> PNF via freshly passed stool
Transmission of Typhoidal/ NTS Salmonellase
Human restricted, Ingestion of foecally contaminated water or food
- Gallbladder –> site of chronic Carriage
Clinical syndromes attributed to Complicated Typhoidal Salmonellae
1) Intestinal Haemorrhage
2) Intestinal Perforation
3) Neurologic- encephalopathy, meningitis, Guillain-Barre S. , Transverse myelitis
4) Osteomyelitis, liver & splenic abscesses
Clinical syndromes attributed to Uncomplicated Typhoidal Salmonellae
1) ENTERIC FEVER w/o localized symptoms
2) Myalgia
3) CONSTIPATION
4) abdominal cramps
5) Rose spots
5) Hepatosplenomegaly - elevated liver enzymes
Treatment of Typhoidal Salmonellae
S.typhi vaccination:
1) Vivotif –> avoid in immunosuppressed
2) Typhim –> safe in immunosuppressed
What is Chronic carriage of NTS & typhoidal Salmonellae
Asymptomatic shedding of S.typhi and S.paratyphi for >1yr in stools or urine
* They both establish chronic carriage in the Gallbaldder
Transmission of NTS
Foodborne, animal faeces
Transmission: Eggs, undercooked meat, contaminated water
Treatment of NTS ?
Do no treat w/ abx –> Antibiotics prolong carriage
* Treat if only high risk for complications
Clinical syndromes attributed to Uncomplicated NTS
SELF-LIMITED
1) Gastroenteritis
–> self-limited gastroenteritis, Within 48hrs, watery diarrhea, nausea, vomiting, fever & abdominal cramps that lasts 3-7d
Clinical syndromes attributed to Complicated NTS
1) Bacteraemia: propensity for vascular sites
2) localised infections
–> endocarditis, arteritis, meningitis, brain abscess, chronic osteomyelitis, reactive arthritis, splenic abscesses (sickle cell disease)
Which 2 are the most important resistance phenotypes of Enterobacteriaceae
1) ESBL- Extended Spectrum β-Lactamases
2) CRE - Carbapenem Resistant Enterobacteriaceae
What’s the treatment of choice for ESBL-producing Gram-negative Bacilli
Carbapenem
What clinical syndrome is this ? Caused by what pathogen ?
Enteric fever Rose spots caused by Typhoidal Salmonella
CRE- Carbapenem resistant Enterobarcteriaceae is an anti-microbial resistant and HA infection
What exactly is it resistant/ sensitive to?
Resistant to :
1) Carbapenem
2) β-lactamase inhibitors
Sensitive :
1) Colistin
What precautions can be done to prevent transmission of nosocomial pathogens?
Proper hand washing
