Exam I - Buxton - Gastroenteritis Flashcards
What is gastroenteritis?
Applied to syndromes of diarrhea or vomiting that tend to involve non-inflammatory infection of the upper small bowel or inflammatory infection of the colon
T/F - In many heavily populated areas, deaths from diarrheal illnesses exceed those from any other single cause.
TRUE
What is the leading cause of childhood death in developing countries?
Diarrheal disease
Over _____ of children born in certain parts of Latin America die before their 5th birthday, and in more than half, diarrhea is the major or associated cause of death.
13%
GI illness in the US ranges from _____ to ______ illnesses per person per year.
1.5 to 5
T/F - Over $10 billion, 5,000 deaths and 300,000 hospitalizations of gastroenteritis.
TRUE
What are some host factors that affect gastroenteritis?
Genotype
Age
Hygiene
Acidity
Motility
Micro flora
Immunity
At normal gastric pH (<4), over 99.9% of the ingested coliform bacteria are killed w/in _____ minutes.
30
How can gastric acid be neutralized that many have an effect on V cholerae?
2 grams of sodium bicarbonate
What is the #1 anaerobe of normal enteric microflora?
Bacteroides fragillis
What is the #1 facultative anaerobe of normal microflora?
E. Coli
What is the first microbial virulence factor?
Toxins
- Neurotoxins
- Enterotoxins
- Cytotoxins
Neurotoxins. Tell me about them.
Usually effect CNS, rather than the intestine per se
Preformed toxins
- S aureus
- Bacillus cereus
- Clostridium botulinum
Tell me about enterotoxins.
Cause fluid secretion from intestinal mucosa - outpouring of electrolytes and fluid
-Alter metabolic activity of the intestinal epithelial cells
Vibrio cholerae E. coli Salmonella Clostridium perfringens Shigella Bacillus cereus
Tell me about cytotoxins.
Mucosal destruction
Results in inflammatory colitis.
DYSENTERY
Shigella dysenteriae C perfringens V parahemolyticus S aureus C diff E. coli
What is the 2nd virulence factor?
Attachment
-These destroy the ability of cells to participate in normal secretion and absorption
E. coli
Giardia lamblia
Cryptosporidium
Isospora
What is the 3rd virulence factor?
Capacity of organisms such as shigella and certain invasive strains of E. coli to invade and destroy
Shigella
E. coli
Salmonella
Vibrio
It is estimated that _____% of all food Bourne disease in the US is caused by bacteria and viruses.
84%
Campylobacter jejuni and salmonella are the leading causes of what?
Bacterial foodbourne disease
Preformed toxins work quickly or slowly?
QUICKLY
S aureus likes what types of foods?
Fats, meats, dairy
What does clostridium perfringenes like to infect?
Meat
Salmonella is know to infect what types of food?
POULTRY
Eggs
Meats
Milk
Produce
T/F - Salmonella is normal flora in chicken.
TRUE
How do you get a shigella infection?
Oral-fecal route
-IT ONLY INFECTS HUMANS
Shigella can come from produce becomes of what?
Using human feces for fertilization
What is the main source of campylobacter?
PUPPIES
- Also normal flora in turkeys/chickens
- Can be in water, milk, poultry as well
Vibrio parahaemolyticus comes from what?
Raw/undercooked seafood
-Salt tolerant and lives in brackish waters
Bacillus cereus comes from what?
Rice
Meat
Vegetables (from dirt)
*This forms spores and they have to germinate to get humans sick
Aeromonas hydrophilia comes from where?
Water
-From brackish to fresh
Vibrio cholera comes from what?
Contaminated water or food
*A disease of crowding
**Pushing water thru cotton fabric has been shown to help rid the water of the bacteria
SLT E. coli (Related to shigella) comes from what?
Beef
Raw milk
Produce
*Rare steak is ok, as long as outside is seared, but cook hamburger all the way
Listeria monocytogenes is usually from where?
Soft cheeses
Unpasteurized milk
Deli meats
*Some type of milk product
**Can cause stillborn births
**Oral-fecal transmission
What are some unusual sources of foodbourne infections?
Off-season fruits and vegetables - can be from somewhere where they might be using human feces for fertilizer
Exotic pets - lizards, snakes, turtles, have campylobacter and others as normal flora
What is a hysteria reaction?
Minutes
What takes minutes to hours to get humans sick?
Pre-formed toxins - toxins were made in the food, not the body
- Bacillus cereus
- S aureus
-Chemicals, heavy metals, shellfish toxins
What takes several hours to make humans sick?
Botulism
Clostridium perfringenes
What takes about a day or so to make humans sick?
Salmonella (sometimes quicker)
Shigella (sometimes longer)
Campylobacter
Viruses
What takes days to weeks to make humans sick?
C diff
Giardia
Amoeba
What is the greatest danger with microbial cause diarrhea?
FLUID REPLACEMENT
-Some source of potassium, sodium, and salt
What about treatment with antibiotics?
Should be avoided, mostly
Used for shigella and cholera
Life-saving for invasive salmonella and typhoid fever
*Do not use for staph, cereus, or c perfringens
**Antibiotics have minimal value
POOP IT OUT AND DRINK FLUIDS
