L13- GI Infections V (inflam. diarrhea, bacteria) Flashcards
define acute inflammatory diarrhea
- Sxs
- infected site
- main cause
- *key feature in comparison to non-inflam. diarrhea
- <2 wk duration
- blood, pus diarrhea (may progress from watery diarrhea)
- fever
- mainly colon
- mainly invasive bacteria, toxin-producing bacteria
- *mucosal invasion => inflammation (also more common in immuno-compromised)
list the general complication of acute inflammatory diarrhea (not specific to any bacteria)
- *dehydration (main target Sx for Tx)
- electrolyte disturbances
- acidosis
- malnutrition
- dissemination (–> osteomyelitis, meningitis, pneumonia, peritonitis, septicemia)
Listeria: describe microbial features
Gram(+) coccobacilli (short rods) facultative intracellular motile (at <30C = tumbling motility) non-spore forming halophilic β-hemolytic (β-hemolysin)
Grows in 1C-45C (survive refrigeration), pH 4-9.6 (survives stomach acid)
Listeria grows in (1) temperature range and (2) pH range- indicate the significance of each
1- 1C-45C, survives refrigeration
2- pH 4-9.6, survives stomach acid
Listeria clinical manifestations (general disorders)
- febrile gastroenteritis
- endocarditis
- CNS infections
- sepsis
- perinatal infections
- miscarriages
- still birth
list the high risk groups for Listeria infections
- pregnancy, newborns
- elderly
- transplant patients + other immuno-compromised
Listeria:
- unique Gram(+) feature
- (2) found in environment
1- only one with an endotoxin although it is not a true endotoxin
2- soil, water, vegetation, feces (some animals) //// contaminates food (dairy, raw meat, salads) during processing / distribution / in retail environments
Listeria pathogenesis:
- entry occurs via (1) proteins, within vacuole
- vacuole lysis occurs via (2) proteins
- (3) follows lysis, then (4) protein initiates aggregation / polymerization
- viral exiting occurs through (5) process
1- (epithelial cell binding) Internalin A/B = InlA, InlB
2- listeriolysin O (pore-forming) + phospholipase A/B (LLO + PlcA, PlcB)
3- replication
4- ActA (actin polymerization)
5- actin-based motility (–> to other cell, now in double membrane vacuole)
discuss mortality in relation to Listeria
~20%
-~25% of pregnancy cases result in death of fetus or newborn
describe diagnosis of Listeria
Direct microscopy: Gram(+) rods
Culture: 2-3 day incubation / enrichment at 4C
PCR
list the bacterial agents of inflammatory diarrhea
YES PECKSS
Y- yersina
E- *escherichia (EIEC)
S- Serratia
P- proteus E- enterobacter C- citrobacter K- klebsiella S- *shigella
Enterobacteriae spp.:
- (1) important species (for enteric system)
- (2) microbial features
1- Shigella, Klebsiella
2- Gram(-) rods
motile except for (1) species
Shigella:
- (1) microbial features
- (2) transmission
- serotyping is based on (3)
- (4) is rare effect
1- Gram(-) rod, non-motile, non-encapsulated
2- (low-infectious dose) fecal-oral (no animal reservoirs)
3- O-Ag (group A-D)
4- dissemination into blood
list the shigella spp.
Group: A- S. dysenteriae B- S. flexneri C- S. boydii D- S. sonnei
list the main Shigellosis Sxs:
- (1) S. sonnei
- (2) S. flexneri
1- watery diarrhea (75%), vomiting (60%), mucus in stool (50%), abdominal pain (50%)
2- (more severe) mucus in stool (75%), abdominal pain (70%), bloody stool (50%)