GI infections Flashcards
How does the amount of bacteria vary in different parts of the GI tract
How are GI infections typically transmissed and prevention for them
- Typically faecal-oral/contaminated food
- Prevented by good hygiene or self-limiting
Gastroenteritis: symptoms, transmission, cause, treatment
- Anti-diarrhoelas: loperamide, diarolyte
- Maintain hydration
What is ROTAVIRUS, transmission, symptoms, treatment and vaccine details
Its the most common cause of viral gastroenteritis (diarrhoea) especially in children
- TRANS: Fecal-oral (and contaminated surfaces)
- SYM: Watery diarrhoea, fever, vomiting, abdominal pain
- TM: Self limiting (2-8D), treat symptoms
- Vaccines: for babies at 2, 3 months
NOROVIRUS: transmission, symptoms and treatment
Type of gastroenteritis
- TRANS: Faecal-oral, person to person and contamination
- SYM: Projectile vomitting, diarroea, nausea, vomitting, abdominal cramps
- TM: Self limiting 1-3 days, hygiene, re-hydration
CRYPTOSPORIDIOSIS: Cause, transmission, symptoms, treatment
- CAUSE: by a protozoa, cryptosporidium parvum
- TRANS: Spread from water, contaminated food, surfaces
- SYM: Watery diarrhoea, nausea, vomitting, cramps, weight loss
- TM: No specific treatment, dangerous for immunocompromised (pregnant, HIV, children)
Amoebic dysentery & amoebiasis: cause, symptoms, transmission and treatment
- CAUSE: protozoal
- TRANS: faecal-oral
- SYM: commonly asymptomatic, mild diarrhoea
- TM: Self limiting but if confirmed metronidazole followed by paromomycin/diloxanide furoate
C. diffile infection (CDI): What is it, whats it caused by
- Caused by gram positive bacteria, anaerobic, spore forming
- Spores spread infection and are difficult to contain
C. diffile infection: cause, symptoms, risk factors, diagnosis, treatment
- CAUSE: gram +ve bacteria, form spores.
- SYM: mild to severe diarrhoea, abd cramp, fever, dehydration
- RF: antimicrobials, PPIs, staying in ICU, old, surgery or chemo
- DIAGNOSIS: Clinical symp and risk factors (e.g. diarrhoea, ABx exposure)
- TM: Stop causative drug, symptomatic treatment (NOT anti-diarrhoeals), antiobotics
How to assess severity of CDI
- Mild:normal white cell count (WCC). Usually <3 episodes of loose stools (type 5-7 on Bristol Stool Chart).
- Moderate:associated with increased WCC (but <15x109/L) and typically associated with 3–5loose stools/day.
- Severe:associated with a WCC >15x109/L, or acutely increased serum creatinine (>50% increase above baseline), or temperature >38.5°C, or evidence of severe colitis. Number stools may be less reliable indicator of severity.
- Life-threatening:signs & symptoms include hypotension, partial or complete ileus, toxic megacolon, or computerised tomography (CT) evidence of severe disease.
Risk factors for CDI
- Increasing age
- PPIs
- Long duration of hospital stay
- ICU stay
- Chemotherapy
- Surgery
Antimicrobials associated with causing CDI
- Clindamycin
- Penicilin
- Carbapenems
- Aminoglycosides
Progress of C. diffile disease
Treatment for C. diffile and treatment for relapse, recurrence
- Initial: Vancomycin 125mg QD for TEN days
- Metronidazole - only used in combo with vancomycin if 1st line fails
- Metronidazole used as IV
- Fidaxomicin: newer but more expensive, can be used for relapse, or second line
- RELAPSE (under 12W): Fidaxomicin first line
- REOCCURENCE (after 12W): First line is vancomycin or fidazomicin
Preventing gastroentisis using ‘SIGHT”
Suspect (diarrhoea may be infectious)
Isolate (patient)
Gloves (and aprons) for all contact with patient & their environment
Hand washing (before and after contact)
Test (the stool for evidence CDI)
Using the three types of helminths, name the main anti-helminth drugs
