GI infections

Question 1

What is the difference between microbiome and microbiota?

Answer 1

-microbiome referes to all the genome within the gut environment but microbiota is all the organisms in the gut enviorment

Question 2

What is the function of the gut microbiota?

Answer 2

1) interacts with the immune system to inform GALT of which organisms should and shouldn’t there
(immune protection and pathogen inhibition)
2) helps to metabolise and synthesise vitamin D, K and FA

Question 3

What is different between the gut microbiota in uterine, after childbirth and adults?

Answer 3

lack of fungal diversity in the uterus, dependent on mode of delivery

• after child brith, breast milk has its own microbiome
• adults with eating change their microbiome again to support themselves

Question 4

What do you need to know with someone presenting with GI infection?

Answer 4

• diarrhoea?
• vomiting?
• pain?
• immunodeficient?
• other GI conditions?
• travel history?
• drug history?
• social history?

Question 5

What organisms are stool cultures done for?

Answer 5

E. COli
Salmonella
Shigella
Campylobacter

Selective - will give the antibiotics to culture that kill normal gut flora if wrong so need thorough history

Question 6

NOTE

Answer 6

with enzyme immunoassay and PRC you need to know exactly what species you are looking for as you have to use correct assay for the organism you are testing for

Microscopy only used for ova, cysts and parasites as is very labour intensive and needs to be a concentrated stool sample so will only be done if there is a travel history

Question 7

What are acute infectious causes of watery diarrhoea?

Answer 7

• norovirus
• rotavirus
• C. difficile
• ETEC (enterotoxigenic Ecoli)
• Giardia lamblia
• Crytosporidium parvum

Question 8

What symptoms would you tend to associate with watery diarrhoea?

Answer 8

• abdominal bloating and cramping

- volume depletion

Question 9

What are acute infectious causes of inflammatory diarrhoea?

Answer 9

• non-typhoidal salmonella
• campylobacter
• shigella
• E-coli
• Entamoneba histolytica

Question 10

What symptoms would you tend to associate with inflammatory diarrhoea?

Answer 10

• sometimes bloody
• small volume
• pain associated with opening bowels

Question 11

What are the bacterial causes of GI infections?

Answer 11

-salmonella

Question 12

What is salmonella?

Answer 12

-gram negative rod bacteria
has 2 classes
-typhoidal salmonella dn and non-typhoidal salmonella

Question 13

What is typhoidal salmonella?

Answer 13

associated with fever in return travellers causing enteric fever

Question 14

What is non-typhoidal salmonella?

Answer 14

primarily causes gastorentiritis

Question 15

What is the incubation period of NT salmonella?

Answer 15

8-72 hrs

Question 16

What is the route of transmission of NT salmonella?

Answer 16

food, faecal oral (poor hand hygiene)

invades the SI

Question 17

What are the general symptoms of NT salmonella?

Answer 17

non-bloody diarrhoea, nausea, vomiting, abdominal cramps

Question 18

What are the complications fo NT salmonella?

Answer 18

• bactaraemiam
• endovascular infections
• abscesses
• osteomyelitis
• septic arthritis

Question 19

Who is most susceptible for NT salmonella?

Answer 19

• sickle cell disease

- more likely to get bone and joint diseases with salmonella

Question 20

What is the treatment for salmonella?

Answer 20

• usually self limiting and cures within 2-3 days

- if with bacteraemia need to administer antibiotics (ciprofloxacin, erythromycin and ceftriaxone)

Question 21

What is campylobacter?

Answer 21

-gram negative rod bacteria

s-shaped

Question 22

Where is Campylobacter found?

Answer 22

in the GI tract of animal especially poultry

Question 23

How is Campylobacter transmitted?

Answer 23

through food, water and animal contact (eating meats)

-faecal oral