GI INFECTIONS

Question 1

what is an example of a bacterial GI infection

Answer 1

vibrio cholera
cloistridium difficile

Question 2

common means of transmission for gi infections

Answer 2

faecal oral route,
surfaces,
contaminated water/food,
contact

Question 3

where does the pathogen reside in gi infections?

Answer 3

GIT

Question 4

portal of exit for gi infections

Answer 4

usually faeces, diarrhoea, vomiting

Question 5

who is a susceptible host for gi infections?

Answer 5

weak immune systems, hospitalised , old , antibiotics

Question 6

virus that causes gi infections

Answer 6

norovirus

Question 7

what is not effective against norovirus?

Answer 7

alcohol based hand sanitizers not effective , nhs staff should stay at home until recovered

Question 8

why is norovirus a concern?

Answer 8

highly contagious

large genetic diversity, can get reinfected

environmental survival persistence,

survives freezing temp and long periods on different surfaces, esp in hospitals

Question 9

what is an example of a fungal infection of the git

Answer 9

Mycotoxins
Aflatoxins produced by moulds such as aspergillus flavus

Question 10

parasite infection of the git?

Answer 10

Cryptosporidium species

Question 11

what structure of the cryptosporidium species allows it to survive for a long time?

Answer 11

thick walled oocysts

Question 12

example of a prion that causes gi infection?

Answer 12

BSE bovine spongiform encephalopathy

it is a type of TSE transmissible spongiform encephalopathy

Question 13

do prions have dna or rna?

Answer 13

no, they are just abnormal form of a body protein

Question 14

is c diff gram positive or negatve

Answer 14

positive

Question 15

is c diff aerobic or anaerobic

Answer 15

anaerobic, spore forming

Question 16

what does c diff cause

Answer 16

Severe git problems, mild diarrhoea to life threatening colitis

necrosis of mucosal epithelial cells,

infiltration of neutrophils ,

outpouring of fluid into intestinal lumen

Formation of pseudomembrane

Question 17

how is c diff related to dentistry?

Answer 17

antibiotics prescribed can alter gut flora and cause c diff infection

it is a HAI

Question 18

Mortality rate of c diff?

Answer 18

12.3% in scotland 5-10% general

Question 19

why do you need to use soap and water for c diff infection control

Answer 19

• resistant to various detergents and disinfectants
• tolerant to alcohol

Question 20

CHAIN OF INFECTION of c diff

Answer 20

Pathogen: C. diff

Reservoir: GIT, food

Portal of exit: faeces

Mode of transmission: faecal oral route (main is spores), shared equipment or environment

Portal of entry: oral

Susceptible host: broad spectrum antibiotics, immunocompromised, elderly, hospitalised, prior c.diff patients, surgical procedures esp bowel, use of PPI

Question 21

recurrence rate for past c diff patients ?

Answer 21

20%
- re infection from contaminated environment + poor hand hygiene
- relapse from germinating spores in gut
- increase of death upon reinfection

Question 22

3 points for how antibiotics can cause c diff

Answer 22

1. ANTIBIOTICS ALTERS GUT FLORA and decreases diversity,
2. colonized with toxigenic C.diff strain
3. allows spores to germinate and produce toxins

Question 23

which antibiotic commonly prescribed in dentistry can cause c diff infection

Answer 23

CLINDAMYCIN
Cephalosporins
Ciprofloxacin
Co amoxiclav

Question 24

how to break the chain of infection for c diff

Answer 24

• SIPCEPS
• WATER AND SOAP HAND HYGIENE
• review antibiotics
• ward isolation
• separate toilets for c diff patients
• use PPE
• also, c diff patients should not be treated in dental clinic unless emergency

Question 25

antibiotics should not be used when in dental setting?

Answer 25

Antibiotics should not be prescribed for oral surgery, toothaches, dental cleaning - warn patients of side effects - document

Question 26

most common symptom of c diff

Answer 26

diarrhoea !! but not always present