GI III Flashcards
What are the two vibrio species that cause GI disease?
Vibrio cholerae
Vibrio Parahaemolyticus
What is the gram stain, morphology, and aerobic/anaerobic properties of vibrio genus?
Gram negative, comma (curved) facultative anaerobes
Where are vibrio species found in the environment?
Free-living in water
What are the two diseases that vibrio cholerae causes?
Gastroenteritis
Bacteremia
What are the three diseases that vibrio cholerae causes?
Gastroenteristis
Bacteremia
Wound infx
What is the nutrient that vibrio species require for growth?
NaCl
True or false: vibrio grows at a very narrow range of pH
False-very broad pH range
How fast does cholerae onset?
Abruptly
How long does cholerae last?
7 days
What type of stool do pts with cholerae produce?
Rice water stool (mucus + electrolytes)
How does cholerae spread?
Water
True or false: there is long term immunity to cholerae
True, but there are many serotypes d/t O-antigen changes
What is the part of cholerae that is used to type it?
O antigen
What is the strain of cholerae that is currently causing a pandemic?
El Tor
What are the two major virulence factors of cholerae?
Toxin co-regulated pilus (TCP)
Cholera toxin
What type of toxin is the cholerae toxin?
AB toxin
What is the MOA for cholerae toxin?
Activates adenylate cyclase to increase cAMP
True or false: there is significant cell damage with cholerae infections
False
The cholerae toxin works very similarly to what other bacterial toxin?
ETEC LT toxin
Where did cholerae get its toxin?
Via the CTX(phi) prophage
How do you diagnose cholerae?
Culture with differential media
What is the treatment for cholerae?
Rehydration (IV if bad)
Is vibrio cholera an inflammatory bacteria?
No
Is vibrio parahaemolyticus an inflammatory bacteria?
Yes
What is the disease that vibrio parahaemolyticus causes?
Explosive diarrhea, n/v abdo pain
What is the virulence factor that vibrio parahaemolytocus produces? How does it produce diarrhea?
Kanagwa hemolysin–induces Cl secretion, thus watery diarrhea
What is vibrio parahaemolyticus associated with?
Raw shellfish
What is the treatment for vibrio parahaemolyticus?
Supportive
Is Yersinia enterocolitica an inflammatory or non-inflammatory bacteria?
Inflammatory
What is the gram stain and morphology of Yersinia enterocolitica?
Gram negative coccobacilli
Wher eis Yersinia enterocolitica usually found?
Nature and animals
What are the symptoms of an infection with Yersinia enterocolitica?
Fever, abdominal cramps, water/bloody diarrhea
How long do symptoms of Yersinia enterocolitca last?
1-2 weeks
How does Yersinia enterocoliticus cause disease?
Not well understood, but it appears to bind M cells and invade the terminal ileum, producing enterotoxins
What is the protein that Yersinia injects into M cells that allows it to enter the cell?
Yops
Is the enterotoxin that Yersinia produces heat stable?
Yes
How do you diagnose Yersinia enterocolitica infx?
Culture
What is the treatment for Yersinia enterocolitica infx?
Supportive
What are the gram staining and morhology of C.diff? Aerobic or anaerobic
Gram positive bacilli anaerobic
Is C.diff invasive? Does it form spores?
Non-invasive
DOES form spores
Which bacteria causes pseudomembrane colitis?
C.diff
What is the pathogenesis of C.diff?
Produces a pseudomembrane that inhibits water reabsorption–this may lead to necrosis
What are the three diseases the C.diff can cause?
CDAD
Pseudomembrane colitis
Fulminant colitis
Which disease that c.diff causes requires a surgical consult?
Fulminant colitis
Is abdominal TTP present with C.diff inx?
Yes
What are the symptoms of fulminant colitis aside from diarrhea? (4)
Lethargy, fever, tachycardia, dilated colon
What are the symptoms of pseudomembrane colitis?
Same as CDAD, but more severe
How does C.diff cause disease?
Produces an AB toxin that damages the mucosa
Does infx with C.diff cause an inflammatory response?
yes
Which bacterial infection disrupts host cell cytoskeleton to cause diarrhea?
C.diff
How do you diagnose C.diff? Why isn’t a culture helpful?
Toxin in stool
NOTE culture is not helpful b/c it is normal flora
What is the treatment for c/diff infection?
Oral vanco or metroidazole
What is the prevention technique for C.diff?
Fecal transplant
Is EHEC inflammatory or noninflammatory pathogen?
Inflammatory
What are the gram staining, morphologic, and aerobic/anaerobic characteristics of EHEC?
Gram-negative bacilli, facultative anaerobe
Is EHEC an invasive pathogen?
Generally no
What are the reservoirs of EHEC?
Cattle or other ruminants
What is EHEC associated with?
Beef or veggies washed from rivers/streams
What is the disease caused by EHEC?
Hemorrhagic colitis (hematochezia)
Is there fever in EHEC infx? Abdominal ttp?
NO fever, but there is marked abdominal TTP
What is the sequelae of EHEC?
Hemolytic uremic syndrome (renal failure)
What is the pathogenesis of EHEC?
Attaches to epithelium and produces a shiga-like toxin that blocks translation by cleaving part of the 60S subunit of the ribosome
How does EHEC cause HUS?
The shiga toxin attaches to Gb3, which the kidney is rich in
How do you diagnose EHEC? (3)
Presumtive (diarrhea WITHOUT fever)
Culture
PCR
What is the treatment for EHEC?
Supportive
Abx Is harmful
For which bacterial infx of the large intestine is the use of abx absolutely contraindicated?
EHEC and non-typhoidal Salmonella
How do you prevent EHEC infx?
Properly cook hamburger
A pt comes in complaining of diarrhea, abdominal pain after eating a hamburger earlier in the day. A fever is absent. What is your diagnosis?
EHEC
Why is the use of abx contraindicated for EHEC infx?
Damages bacteria, and activates phage/toxin production
Is shigella an inflammatory or noninflammatory bacteria?
Inflammatory
What is the gram stain of shigella? Morphology? Aerobic or anaerobic?
Gram negative rods, facultative anaerobe
True or false: humans are the only reservoir for shigella
True
Which bacteria discussed in lecture is acid resistant, and thus requires a low inoculation dose?
Shigella
What are the three intracellular pathogens discussed in lecture?
Shigella, listeria , and EIEC
What are the three species of shigella? Which is found in developed, developing, and underdeveloped countries?
Developed - S. soneii
Developing - S. Flexneri
Underdeveloped - S. Dysentariae
What is shigella associated with in developed nations? Why?
Day care centers because children are disgusting
How long does shigella infx last?
2-5 days
What are the symptoms of infx with S. sonneii?
Fever, malaise, and water diarrhea
What are the symptoms of infx with S. flexerni and S. dysenteriae?
Fever, malaise, watery diarrhea, abdo pain, tenesmus, hematochezia
What is the cell type that shigella infects?
M cells in peyer’s patches
What happens once shigella infects M cells?
Eaten by macrophages, then bust out and do stuff
Shigella is intracellular motile like which pathogen discussed earlier? What allows for this?
Listeria
Actin polymerization
How does salmonella induce its own uptake into M cells?
T3 secretion systems
How does the shiga toxin produce renal failure?
binds to host Gb3 receptor on kidneys
What is the MOA of shigella toxin?
Inhibits translation
How do you diagnose shigella?
Stool culture using selective media
Serological testing
What is the treatment for shigella?
Rehydration
Abx if you want
Does infection with shigella confer immunity?
No
Is there a vaccine available for shigella?
No
Is EIEC an inflammatory or noninflammatory bacteria?
Inflammatory
EIEC has the same MOA of pathogenesis as what other bacteria? Why?
Shigella
Picked up the toxin from shigella
What three bacterial infections do not cause fevers?
ETEC
V cholerae
EHEC
What three bacterial infections always cause bloody diarrhea?
EHEC
Shigella
EIEC
Which strain of E.coli has a shiga-like toxin?
EHEC
Which strain of E.coli has a similar pathogenesis to shigella, but does not have a shiga toxin?
EIEC
What are the toxins produced by ETEC?
LT and ST (cAMP and cGMP respectively)
Pus/blood stools are associated with which bacterial infections?
Shigella
EIEC
HUS is a problem with which bateria?
EHEC
Shigella
What is the toxin that Listeria produces?
LLO
Which bacterial infx can be transmitted from mother to fetus?
Listeria