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7. Microbiology II > Gram Positive GI Infections > Flashcards

Gram Positive GI Infections Flashcards

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1
Q

Describe the epidemiology of staph. aureus GI infection. Consider:

EPIDEMIOLOGY:
Transmission

A

Transmission:

-Contaminated food

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2
Q

Describe the pathogenesis of staph. aureus GI infection. (1)

A
  1. Staph. aureus produces enterotoxins (types A-E) which are heat stable and acid resistant
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3
Q

Describe the clinical features of staph. aureus GI infection. Consider:

a) Incubation period
b) Duration
c) Symptoms (2)

A

Incubation period: 30 mins - 6 hours
Duration: 12-24 hours

Symptoms:

  • Profuse vomiting
  • Abdominal cramps
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4
Q

Describe the microbiology and epidemiology of bacillus cereus infection. Consider:

MICROBIOLOGY
Structure
Growth conditions

EPIDEMIOLOGY:
Transmission
Types of B. cereus disease

A 
MICROBIOLOGY
Structure: gram positive bacilli
Growth conditions:
-Aerobic
-Spore forming
EPIDEMIOLOGY
Transmission:
-Contaminated food
Types of disease:
-Emetic disease
-Diarrhoeal disease
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5
Q

Describe the pathogenesis of emetic disease caused by bacillus cereus infection. Consider:

a) Which toxin causes this?
b) Which food is this commonly associated with?
c) Pathogenesis of disease?

A

Caused by: heat stabile toxin
Associated with: fried rice

Process:

  1. Spores survive intial boiling of rice
  2. Spores germinate, multiply and re-sporulate
  3. Sporulation produces heat stable enterotoxin (which survives frying)
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6
Q

Describe the pathogenesis of diarrhoeal disease caused by bacillus cereus infection. Consider:

a) Which toxin causes this?
b) Which food is this commonly associated with?
c) Pathogenesis of disease?

A

Caused by: heat labile toxin
Associated with: improperly heated food

Process:

  1. Spores survive cooking of food
  2. Spores germinate and multiply
  3. B. cereus is then ingested, and then produces heat labile toxin
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7
Q

Describe the clinical features of emetic disease caused by bacillus cereus infection. Consider:

a) Incubation period
b) Duration
c) Symptoms (3)

A

Incubation period: 30 mins - 6 hours
Duration: 12-24 hours

Symptoms:

  • Profuse vomiting
  • Abdominal cramps
  • Watery diarrhoea
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8
Q

Describe the clinical features of diarrhoeal disease caused by bacillus cereus infection. Consider:

a) Incubation period
b) Duration
c) Symptoms (2)

A

Incubation period: 8-12 hours
Duration: 12-24 hours

Symptoms:

  • Watery diarrhoea
  • Cramping abdominal pain
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9
Q

Describe the microbiology and epidemiology of clostridium perfringens infection. Consider:

MICROBIOLOGY
Structure
Growth conditions

EPIDEMIOLOGY:
Transmission

A 
MICROBIOLOGY
Structure:
-Spore forming
-Gram positive bacilli
Growth conditions:
-Anaerobic

EPIDEMIOLOGY
Transmission:
-Contaminated food

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10
Q

Describe the pathogenesis of clostridium perfringens infection. (4)

A
  1. Spores survive cooking, then germinate and multiply in cooling food
  2. Food is inadequately reheated, so that organisms aren’t killed
  3. Ingested organisms sporulate in the large intestines
  4. Bacteria then produce enterotoxins
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11
Q

Describe the clinical features of clostridium perfringens infection. Consider:

a) Incubation period
b) Duration
c) Symptoms (2)

A

Incubation period: 6-24 hours
Duration: 12-24 hours

Symptoms:

  • Watery diarrhoea
  • Abdominal cramps
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12
Q

Describe the microbiology and epidemiology of clostridium botulinum infection. Consider:

MICROBIOLOGY
Structure
Growth conditions

EPIDEMIOLOGY:
Transmission

A 
MICROBIOLOGY
Structure:
-Spore forming
-Gram positive bacilli
Growth conditions:
-Anaerobic

EPIDEMIOLOGY
Transmission:
-Contaminated soil/animal bites

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13
Q

List the 3 types of botulism.

Describe the pathogenesis of botulism.

A

Foodborne botulism
Infant botulism
Wound botulism

  1. Bacteria produce heat labile neurotoxins (types A, B, E)
  2. Origin of toxin depends on type of botulism:
    - Foodborne: preformed toxins in food
    - Infant: germinating organisms in baby’s gut
    - Wound: organisms enter wound (e.g. through soil)
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14
Q

Describe the clinical features of botulism. Consider:

a) Incubation period
b) Symptoms (2)

A

Incubation period: 12-36 hours

Symptoms:

  • Neuromuscular blockade (flaccid paralysis; muscle weakness)
  • Respiratory failure
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15
Q

Describe the diagnosis of clostridium difficile infection. (2)

A

Initial test:

  • GDH test
  • Toxin B gene PCR

Confirmation test:

  • Toxin immunoassay
  • Cell-culture cytotoxicity assay
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16
Q

Describe the pathogenesis of clostridium difficile infection. (2)

A
  1. Infection requires prior disruption of normal gut microflora, e.g. due to antibiotic therapy/cytotoxic therapy/PPIs
  2. Bacteria produce potent toxins (types A and B)
17
Q

Describe the clinical features of C. diff infection. Consider:

a) Incubation period
b) Duration
c) Symptoms
d) Complications of severe C. diff infection

A

Incubation period: 0-7 days
Duration: up to weeks

Symptoms:
-Abdominal pain

Complications:

  • Pseudomembranous colitis
  • Bowel perforation
18
Q

What are the 5 severity criteria which indicate severe C. diff infection?

A 
Colonic dilatation: 6+ cm
WCC: 15+
Creatinine: 1.5x increase
Temp: 38.5C
Immunosuppression
19
Q

Describe the treatment of C. diff infection. Consider:

a) Mild-moderate C. diff
b) Severe C. diff

A

MILD-MODERATE C. DIFF:

  1. Strop precipitating antibiotics
  2. Oral metronidazole (5 days)

SEVERE C. DIFFF:

  1. Stop precipitating antibiotics
  2. Oral vancomycin
  3. Faecal transplant
20
Q

What are the 4 high risk antibiotics which may cause C. diff infection?

A

Cephalosporins
Ciprofloxacin
Clindamycin
Co-amoxiclav

21
Q

Describe the microbiology and epidemiology of listeria monocytogenes infection. Consider:

MICROBIOLOGY
Structure

EPIDEMIOLOGY:
Transmission
At risk populations

A

MICROBIOLOGY
Structure: gram positive coccobacilli

EPIDEMIOLOGY
Transmission:
-Contaminated food
At risk populations:
-Pregnant women
-Elderly
-Immunocompromised
22
Q

Describe the pathogenesis of listeria monocytogenes infection. (1)

A
  1. Can cause invasive and metastatic infection
23
Q

Describe the clinical features of listeria monocytogenes infection. Consider:

a) Incubation period
b) Duration
c) Symptoms (3)
d) Complications (2)

A

Incubation period: 3 weeks
Duration: 1-2 weeks

Symptoms:

  • Flu-like illness
  • With/without diarrhoea
  • Severe systemic infection

Complications:

  • Septicaemia
  • Meningitis

7. Microbiology II (12 decks)

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