gi tract infections Flashcards
gastroenteritis
-colon and small intestine
enterocolitis
-colon
antibiotic associated diarrhea (colitis)
infection by C diff after antibiotics
commonly under reported food borne illnesses
- salmonella
- yersinia
- campylobacter
- shigella
salmonella mostly effects
children below age 9
campylobacter mostly effects
age 10 and up
two ways of transmission
- fecal-oral
- foodborne or waterborne
foodborne or waterborne
contamination before processing
bacterial toxins
- pre-formed
- in vivo
pre-formed toxin
food poisoning
bacteria that produce pre-formed toxin
- staph aureus
- clstridium botulinum
- bacillus cereus
bacteria that produce toxin in vivo
- Verotixin producing e coli
- bacillus cereus (long incubation)
- clostridium perfringens
- c diff
- vibrio cholerae
staph aureus
- sudden onset of vomiting and diarrhea in 1-6 hrs
- gram + cocci clusters
- inflammation of mucosa
- low water absorption
treatment for staph aureus
spontaneous recovery with no treatment
B cereus
- gram +
- makes spores
- vomiting and diarrhea
high risk foods for B cereus
- meats and veggies
- sauces
- leftovers out too long
c diff
- 10-30% of diarrhea diagnosed in hospital
- after antibiotics
- spores are highly resistant
- rare in community
risk factors for c diff
- antibiotics
- comorbidities
symptoms of c diff
- diarrhea, cramps
- psydomembranous colitis
- toxic megacolon
c diff microbiology
- Gram +
- spores
- obligate anaerobe
c diff toxins
- A: enterotoxin
- B: cytotoxin (direct damage to intestine cells)
- binary
antibiotic associated colitis (AAC) diagnosis
- stool for toxin assay
- pcr or elisa
- endoscopy
AAC treatment
- stop antibiotic
- ORAL metronidazole or vancomycin
- fidaxomicin
- fecal microbial transplantation
which bacteria act via invasion, effacement, and inflammation
- EHEC
- E coli
- v cholera
EHEC
- undercooked beef, unpasteruized food, contaminated water, raw veggies, farm animal contact
- only need a few
EHEC produce
shiga toxin (vero-toxin)
symptoms of EHEC
cramps bloody diarrhea
EHEC can lead to
hemolytic uremic syndrome
-> kidney failure
why should u NOT prescribe antibiotics with EHEC
cause bacteria to release more toxin
major cause of childhood diarrhea in developing countries
ETEC (enterotoxigenic E coli)
leading cause of travelers diarrhea
ETEC
leading cause of infantile diarrhea in developing countries
EPEC
major cause of bloody diarrhea in developing countries
EHEC
causes outbreaks in developing countries
EIEC
treatment for ETEC
- fluid rehydration
- bismuth (pepto bismol)
which bacteria cause enteritis by invasion
- campylobacter jejuni
- shigella
- salmonella
- EIEC
campylobater jejuni
- gram NEGATIVE
- chicken and dairy
- can lead to GUILLAIN BARRE SYNDROME
salmonella
- gram NEGATIVE
- can get fever
major cause of enteritis
salmonella
most reported case
campylobacter
most underreported case
salmonella
major symtom of shigella
blood diarrhea and fever
shigella
- gram NEGATIVE
- only need a few to cause disease
- lead to hospitalization
most common cause of death due to bacterial enteritis
shigella
treatment for shigella
antibiotics
treatment for enteritis
- rehydration!
- no antibiotics (exception..)!
exceptions for antibiotics
- shigella
- bad campylobacter
- c diff
- immunocompromised
- invasive
should a person with verotoxin-producing e coli (EHEC) have antibiotics
NO!
viruses that cause enteritis
- calicivirus (norovirus, sapovirus)
- rotavirus
- adenovirus
- astrovirus
what causes 90% of all acute gastroenteritis in us
norovirus
known as stomach flu
rotavirus
which parasites can cause acute enteritis
- giardia
- crytosporidium
- cyclospora
- entamoeba histolytica
