Gastritis: Helicobacter pylori; Campylobacteriosis Flashcards
Gastritis refers to inflammation of the ___________
gastric mucosa.
Gastritis
It is associated with nausea and upper abdominal pain; vomiting, and fever may also be present.
T/F
T
Helicobacter pylori is seen on the surface of ________________ cells of patients with gastritis.
The organism is recovered from __________ material obtained _______ but not from _______.
gastric epithelial
gastric biopsy
endoscopically; stool
Helicobacter pylori
H. pylori has been primarily linked to _______ infections
Helicobacter pylori’s primary habitat is the ______________
gastric; human gastric mucosa.
Helicobacter pylori
Once acquired, H. pylori colonizes the _____ for a (short or long?) time and can cause a (low or high?) -grade inflammatory process, producing a (acute or chronic?) (superficial or deep?) gastritis.
stomach
Long
Low
chronic superficial gastritis.
Helicobacter pylori
An _____,__________, and a common environmental source are possible routes of transmission
oral-oral
fecal-oral
Helicobacter pylori
mother-to-child transmission can occur.
T/F
T
Research studies suggest mother-to-child transmission can occur.
H. pylori colonizes the mucous layer of the ______ and ______ of the stomach but not the ________.
antrum and fundus
epithelium
H. pylori
The organism produces _______ that hydrolyzes _________________ significantly ___easing the pH around the site of infection.
The change in pH protects the organism from the _____ environment produced by gastric secretions.
urease
urea-forming ammonia (NH3)
incr; acidic
H. pylori
It also produces a protein called _______ and injects the protein into the ____________ cells.
CagA
gastric epithelial
Pathogenesis of H.pylori
The CagA then affects host ___________ inducing _______ and altering ________, and interactions with neighboring cells enabling H. pylori to successfully invade the gastric epithelium.
Other possible virulence factors include:
- ________ (for colonization of mucosal surfaces, mediators of inflammation)
-________ (capable of causing damage to host cells)
cell gene expression
cytokine release
cell structure
adhesins; cytotoxin
Helicobacter pylori is strongly associated with _________________________ ulcers as well as with ___________ carcinoma.
gastric, peptic, and duodenal
gastrointestinal
Helicobacter pylori
The higher incidence is attributed to ___________ conditions,
Although it is not conclusively proven, _________ is said to be the likely source of many infections
poor sanitary
fresh groundwater
Helicobacter pylori
long-term H. pylori infection resulting in (acute or chronic?) gastritis is an important risk factor for ______________ resulting in H. pylori being classified as a _________.
Chronic
gastric carcinoma
carcinogen
Helicobacter pylori
Other species of helicobacters, (like H. ________ and H. _________) have been associated with _____________, generally in immunocompromised patients.
cinaedi
fennelliae
human gastroenteritis
Campylobacter spp.
Campylobacter and Campylobacter-like
species are:
- (fermentative or non-fermentative)
- oxidase (positive or negative?)
fermentative
oxidase positive
Campylobacter spp. Campylobacter and Campylobacter-like
species are:
- grown in a __________ environment.
microaerophilic
Microaerophilic organisms require _______, but at a concentration ____________
_____% is normally optimal.
oxygen
less than that of room air
5
Campylobacter Pylori
Primarily ________ organisms.
Cause ________ in domestic animals, such as cattle,
sheep, and swine
zoonotic
abortion
Most common cause of bacterial gastroenteritis worldwide is ________________
Campylobacter jejuni.
Campylobacter jejuni
Transmission of campylobacterioses has been attributed to _______ with animals and handling infected pets, such as dogs, cats, and birds, and
direct contact
Campylobacter Jejunj
Indirect transmission by the consumption of _________ and __________ and improperly ———- ________.
Person to person transmission can occur
contaminated water and dairy products a
cooked poultry
Some Campylobacter spp. are also sexually transmitted.
T/F
T
Campylobacter jejuni
__________ in most common causes of foodborne gastrointestinal illness, behind _______________________________
Fourth
norvovirus, Salmonella, and Clostridium perfringens.
Campylobacter jejuni
Mostly affect ________ and ________, although all age groups are at risk.
infants and young adults
In addition to C. jejuni, other Campylobacter spp. that cause gastrointestinal disease (enteric campylobacters) are C. ______ and C. _____.
coli
Lari
Campylobacter jejuni
Several Campylobacter spp. have been implicated in human infection—
C. _____, C. ______, C. _____, C. _____, C. _____, C. _____, and C. _____.
C. fetus, C. jejuni, C. coli, C. sputorum, C. concisus, C. curvus, and C. rectus.
Campylobacter jejuni
Patients infected with C. jejuni present with a ________ disease that begins with __________ within ____ to ______ after ingestion of the organisms.
_________ and _________ often follow the initial signs.
diarrheal
mild abdominal pain
2 to 10 days
Cramps and bloody diarrhea
Campylobacter jejuni
May experience fever and chills and, rarely, nausea and vomiting.
In most patients, the illness is ________ and usually resolves in ____________
Untreated patients can remain carriers for ______________.
self-limited
2 to 6 days.
several months
Campylobacter jejuni
Other enteric Campylobacter infections (those caused by C.____ and C.____) have similar clinical manifestations.
coli
lari
Campylobacter jejuni
Campylobacter infection plays a role in GBS (________________)
Guillain barre syndrome
GBS is ____________ disorder characterized by (acute or chronic?) paralysis caused by damage to the ____________
an autoimmune
Acute
peripheral nervous system.
Many patients with GBS test positive for antibodies to ________
Campylobacter
Campylobacter Jejuni
Antibodies produced during a Campylobacter infection bind to __________ found on __________.
___________ with these nerve cells in an autoimmune response may be responsible for this debilitating nerve disorder.
gangliosides
peripheral nerves
Cross-reactivity
Laboratory Diagnosis: Specimen of campylobacter
Collection and Transport
_____ culture media
______ samples
______ swabs (the less preferred specimen)
____________ materials.
Samples must be transported quickly to the laboratory
Blood
stool
rectal
gastric biopsy
Specimen Collection and Transport of campylobacter
If a delay in processing the stool specimen is anticipated, it can be placed in a transport medium (to maintain the viability of the organisms) such as:
- ________
-_______ medium
- Tissue samples may also be placed in _________ broth with ____%______ and frozen at _____° C.
Cary-Blair
Stuart
Cysteine-Brucella
20; glycerol
−70
Culture Media: Campylobacter jejuni
Campy-______(_________):
•an enriched selective agar
•Contains ______ base, 10% ______ red blood cells, and a combination of ______ (vancomycin, trimethoprim, polymyxin B, amphotericin B, and cephalothin)
BAP; blood agar plate
Brucella agar; sheep
antimicrobials
Culture Media: Campylobacter jejuni
_______
__________ medium
_________ medium
Medium ___
Campy-BAP
Butzler
Skirrow’s
V
Culture Media: Campylobacter jejuni
Medium V (modified ______)
- (contains cefoperazone, rifampin, colistin, and amphotericin B) medium can be incubated at _____° C.
Butzler medium
37
Enteric Campylobacter and Helicobacter spp. require a _______ and ________ environment.
microaerophilic and capnophilic
Enteric Campylobacter and Helicobacter spp.
Laboratory diagnosis
The ideal atmospheric environment for these organisms is a gas mixture of
- ____% O2, ___% CO2, and ____% N2 for
Campylobacter spp. - ____% to ____% O2 and __% to ____% CO2 for Helicobacter spp.
5% O2, 10% CO2, and 85% N2 for
Campylobacter spp.
- 5% to 10% O2 and 5% to 12% CO2 for Helicobacter spp.
Campylobacter spp. are
(straight or curved ?)
(spore or non–spore?)- forming
gram- _______ rods that measure approximately 0.2 to 0.9 μm × 0.5 to 5.0 μm
Curved
non–spore
negative
Campylobacters may appear as _______, or ______ or ____________- wing shapes.
They may appear as ______ in smears prepared from older cultures.
long spirals or ‘S’ or seagull
coccobacilli
Campylobacter : Laboratory diagnosis
They exhibit a characteristic “_______” motility on ________ preparations or when visualized under _________ microscopy.
darting
hanging drop
phase contrast
H. pylori appears similar to campylobacters, but Helicobacter has ________ flagella at one pole, unlike the _____________ of campylobacters.
multiple
single polar flagellum
Presumptive Identification: Colony
Morphology.
The typical colony morphology of C. jejuni and other enteric campylobacters are (dry or moist?) , usually (haemolytic or nonhemolytic?)
Some are (round or flat ?) and raised and others may be ______.
moist
nonhemolytic
Round and raised
Flat
Laboratory mechanism
Isolates from stool specimens and rectal swabs can be presumptively identified as Campylobacter spp. by:
a __________-oxidase
the characteristic Gram-stained microscopic morphology
the characteristic motility.
positive
Helicobacter infections usually are identified by culture methods.
T/F
F
nonculture
H. pylori can be presumptively identified in a gastric biopsy specimen by testing for the presence of a ___________
rapid urease reaction
H. pylori can be presumptively identified in a gastric biopsy specimen by testing for the presence of a rapid urease reaction
The collected tissue sample is placed onto _________ medium and incubated at ____° C for ____
A _________ suggests the presence of H. pylori.
Christensen’s urea
37
2hours
color change
Helicobacter pylori
Other tests include:
___________ tests
Urease activity can also be detected by the _______
Fecal ______ detection
Microscopic examination of stained gastric tissue
DNA amplification tests (e.g., polymerase chain reaction assay).
Rapid urea/urease
urea breath test
antigen
Laboratory diagnosis: Immunologic Assays
___________ tests are available for the rapid identification of colonies of enteric campylobacters on primary isolation media.
___________ tests in fecal samples.
Specific antibodies in serum can be detected by enzymelinked immunosorbent assay or indirect immunofluorescent assay methods.
Latex agglutination
Campylobacter antigen
Treatment: H. pylori
Triple-drug therapy: _________,_______
An alternative regimen for patients with _________ resistant strains includes: ________ and _______ and _______ or ______
metronidazole, a bismuth salt, and either amoxicillin or tetracycline.
metronidazole
omeprazole or lansoprazole
amoxicillin or clarithromycin.
Treatment: H. pylori
Treatment for H. pylori infections should be administered for _______ to _______ to eradicate the infection.
Relapses occur (often or rarely?)
7 to 14 days
Often
Treatment: Campylobacter spp.
C. jejuni and C. coli are susceptible to many antimicrobial agents, including macrolides, tetracyclines, aminoglycosides, and quinolones.
__________ is the drug of choice for patients with severe gastroenteritis
_________ is an alternative therapeutic option.
Erythromycin
Ciprofloxacin
Treatment: Campylobacter spp.
C. jejuni and C. coli are susceptible to many antimicrobial agents, including ———-,————-,————- and _________
macrolides, tetracyclines, aminoglycosides, and quinolones.
