GI Bacteria: H.Pylori, E.coli, C.difficile

Question 1

Helicobacter pylori
what type and pathophysiology

Answer 1

Gram negative aerobic bacteria
commensal in GIT

Bacteria colonize the stomach by adhering to the gastric epithelial cells

H pylori invades the mucosal layer protecting gastric epithelium from the acidic environment.

H.pylori secretes urease which converts urea to ammonia and co2. Neutralising gastric acid and creating more tolerable condition

H pylori virulent factors - increase gastrin secretion as such gastric acid secretion.

Damages the epithelial lining of the stomach resulting in in an inflammatory response - gastritis, ulcers and increased risk of stomach cancer

Question 2

H Pylori associated diseases

Answer 2

peptic ulcers , gastritis, gastric carcinoma

Question 3

DX H pylori

Answer 3

urease breat test
stool antigen test

Question 4

TX H Pylori

Answer 4

CAP
Clarithromycin
Amoxicillin
PPI

Question 5

E-coli
What type and pathophysiology

Answer 5

GIT Commensal bacteria
Gram -
pathology depends on strain:
Aggregative, pathogenic, haemorrhagic

Question 6

TX- ECOLI

Answer 6

amoxicillin
CI- trimethoprim/nitrofurantoin

Question 7

Clostridium Difficile
what about

Answer 7

Commensal GIT bacteria
GRAM + / Spore forming / V.Infectious

RF - 4C
cephalosporin
co-amoxiclav,
ciprofloxacin
clindamycin

SX - fever/abdo pain/ diarrhea

Abx disrupts microflora = c difficle is then exposed and begin to colonise.
c diff release toxin A/B ehich causes mucosal injury and inflamm (pseudomembranous colitis)

this can propagate to become toxic megacolon

which can lead to perforation and death

Question 8

what c diff implicated for?

Answer 8

pseudomembranous colitis - very severe watery diarrhoea

Question 9

TX C.DIFF

Answer 9

stop ABX immediatly
vancomycin