Food-borne Afebrile, Watery Diarrheal Agents Flashcards
All Food-borne Afebrile, Watery Diarrheal Agents are mediated by
TOXINS
All Food-borne Afebrile, Watery Diarrheal Agents should be treated with
Symptomatic relief and rehydration
All Food-borne Afebrile, Watery Diarrheal Agents transmission is
food-borne, no person-to-person
All Food-borne Afebrile, Watery Diarrheal Agents will show what on fecal examination
organisms, BUT NOT WBCs or RBCs
Staphylococcus aureus characteristics
GPC, coagulase (+), catalase (+)
New strains of Staphylococcus aureus spreading in Europe are
MRSA, MLST and NT-MRSA strains spreading in animals and humans
Common food sources of Staphylococcus aureus
custards, potato salad, baked goods, canned meats
Reservoir of Staphylococcus aureus
humans (nasopharyngeal and skin carriage)
Virulence Factors of Staphylococcus aureus
Heat-stabile enterotoxins A-E
Characteristics of Staphylococcus aureus enterotoxins A-E
act on neural receptors; heat-stable (can withstand boiling for 30 min), odorless, colorless, tasteless, H2O soluble
Which Staphylococcus aureus enterotoxins A-E are most prevalent in the US?
A and B
How is Staphylococcus aureus transmitted?
ingestion of preformed enterotoxins in food
When is Staphylococcus aureus infections most common?
Warm seasons
What are the 2 most common causes of food-borne illness?
Salmonella and Staphylococcus aureus
Mechanism of Staphylococcus aureus’s Heat-stabile enterotoxins A-E
Act directly on neural receptors to stimulate the vomiting center in the brain
Symptoms of Staphylococcus aureus toxin ingestion
Vomiting, salivation, nausea, +/- diarrhea and abdominal cramps
Duration of symptoms Staphylococcus aureus toxin ingestion
1-4 days; self-limiting usually in 1 day
Incubation period of Staphylococcus aureus toxin ingestion
1-6 hours
Diagnosis of Staphylococcus aureus toxin ingestion
Presence of enterotoxin in vomit or food
How could you determine if Staphylococcus aureus toxin ingestion was form a common source
Phage-typing to trace source
Treatment of Staphylococcus aureus toxin ingestion
Symptomatic, fluids
Suspect metal toxemia if patient begins vomiting w/in _____ hour/s of ingestion
1 hour
Bacillus cereus Characteristics
GPR, spore-forming, aerobic, produces 2 different toxins
Bacillus cereus is closely associated with what foods
grains especially RICE also potatoes and veggies
Bacillus cereus produces what 2 toxins?
Pre-formed heat-stable toxin AND heat-labile toxin
Bacillus cereus’s Pre-formed heat-stable toxin causes
VOMITING and abdominal cramps
Bacillus cereus’s heat-labile toxin is formed by
ingestion of large numbers of vegetative cells that produce the heat-labile toxin in situ
Bacillus cereus’s heat-labile toxin causes
adenylate cyclase activation -> cAMP -> C- secretion = DIARRHEA and abdominal cramps
Incubation period for Ingestion of Bacillus cereus’s pre-formed heat-labile toxin
1-5 hours
Incubation period for Ingestion of Bacillus cereus’s heat-labile toxin
10-12 hours (or 6-24)
Mechanism for Bacillus cereus’s pre-formed heat-stable toxin
Caused by cereulide; Heat- and pH-stable cyclic peptide cytotoxin -> Destroys mitochondria -> Acts as ionophore with high affinity for K+ -> causes loss of the membrane potential and uncoupling of oxidative phosphorylation
Diagnosis of Bacillus cereus is made by
presence of GPR in vomit/feces/food
Treatment for Bacillus cereus
Rehydration
Duration of Bacillus cereus?
Self-limiting 1-4 days
Clostridium perfringens type A Characteristics
GPR, anaerobic, heat-stable-spore-former, non-motile
Clostridium perfringens type C causes
clostridial necrotizing enteritis or pigbel
Virulent factor of Clostridium perfringens type C
Beta toxin
Clostridium perfringens type C beta-toxin causes
small bowel necrotizing inflammation
Normally Clostridium perfringens type C beta-toxin is degraded, under what conditions is it not?
protein poor diet or coingestion of foods such as sweet potatoes that contain trypsin inhibitors
Clostridium perfringens type C, where is this most commonly found
psychiatric hospitals: chronic use of anticholinergic drugs
Why would anticholinergic drugs increase the risk of Clostridium perfringens type C
slowed motility = prolonged exposure to enterotoxins = increased intestinal damage
Reservoir for Clostridium perfringens type A
Gut of humans and animals
Transmission of Clostridium perfringens type A occurs by
ingestion of germinated spores -> vegetative cells
What foods are associated with Clostridium perfringens type A
Meat, poultry, poultry gravy that have been cooked and then sat @ RT (spores germinate)
Virulent factors of Clostridium perfringens type A
Heat-labile, acid-labile enterotoxin
Heat-stable spores
Mechanism for Clostridium perfringens type A’s Heat-labile, acid-labile enterotoxin
formed in the gut by vegetative cells, inhibit glucose and Cl- absorption, damage intestinal epithelium, denuding villus tips causing secretion of electrolytes and H2O
Mechanism for Clostridium perfringens type A’s Heat-stable spores
Viable at cooking temperatures, if meat sits at RT, spores germinate to vegetative cells
Incubation period for Clostridium perfringens type A
~14 hours
Epidemic pattern of Clostridium perfringens type A
Microepidemics
Symptoms of Clostridium perfringens type A
severe abdominal cramping and diarrhea
Diagnosis of Clostridium perfringens type A is made by
presence of vegetative cells in food or feces OR serology showing enterotoxin in feces
Treatment for Clostridium perfringens type A
rehydrate
Infectious dose of Clostridium perfringens type A
High (not person-to-person)
Clostridium perfringens type A duration of symptoms
1-4 days