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Y1 - Infection > Lecture 17 - Escherichia Coli > Flashcards

Lecture 17 - Escherichia Coli Flashcards

1
Q

How can E.coli be described?

A

Gram-negative rods
Typically lactose fermenting
Often motile

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2
Q

What colour does Escherichia coli stain with gram stain?

What type of bacteria are they?

A

Red/pink

Gram-negative rods

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3
Q

Where are E.coli usually found?

A

In large bowel of animals + humans

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4
Q

What family does E.coli belong to?

A

Enterobacteriaceae

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5
Q

What family does E.coli belong to?

A

Enterobacteriaceae

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6
Q

How can E.coli and other Enterobacteriaceae be differentiated from other bacteria like Pseudomonas aeruginosa?

A

E.coli = can use lactose as an energy source making lactic acid as waste (with pH indicator = pink/red)

Pseudomonas aeruginosa = non lactose fermenting (can use lactose) with pH indicator = yellow

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7
Q

What are the different ways by which different species of E.coli can be identified?

A

Serology (use antibodies to detect different bacterial surface antigens)

Metabolic profiling

Genomic diversity

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8
Q

How is E.coli typically transmitted?

A

Faecal-oral route:
-Faeces used as fertiliser for crops, crops not washed
-from animals to humans

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9
Q

What are the 4 different serological antigens of E.coli which can be identified by serological antibodies?

A

O - LPS (Lipopolysaccharide membrane)
H - Flagella
K - Capsule
F- Fimbriae

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10
Q

Where is E.coli considered normal flora?

A

Large bowel

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11
Q

What is E.coli’s role in the large intestine?

A

Protects against invasion by pathogenic species like Salmonella

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12
Q

What diseases can be caused as a result of E.coli?

A

Intestinal infections (diarrhoea)
Toxin-mediated disease
Extra—intestinal infections

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13
Q

What are some examples of extra-intestinal infections that E.coli can cause

A

UTI
Intra-abdominal
Biliary tract
Bloodstream infection
Neonatal meningitis

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14
Q

How many pathotypes of E.coli are there that cause diarrhoea?

A

6

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15
Q

What are the 6 pathotypes of diarrhoeagenic E.coli?

A

Enterotoxigenic E.coli (ETEC)
Enteropathogenic E.coli (EPEC)
Enteroaggregative E.coli (EAEC)
Enteroinvasive E.coli (EIEC)
Diffusely adherent E.coli (DAEC)
Shiva toxin-producing E.coli (STEC)

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16
Q

How does E.coli generally cause diarrhoea?

A

Adheres to the gut epithelia damaging them causing it to become inflamed, leading to diarrhoea

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17
Q

What does ETEC stand for?

A

Enterotoxigenic E.coli

18
Q

What does STEC stand for?

A

Shiga toxin-producing E.coli

19
Q

Why can STEC be know as Verocytotoxic E.coli (VTEC)?

A

Damages vero cells

20
Q

Why can shiga toxin-producing E.coli be know as Enterohemorrhagic E.coli (EHEC)?

A

Can cause Haemorrhagic colitis (Bloody diarrhoea) and haemolytic uraemia syndrome

21
Q

What is Haemolytic uraemia syndrome (HUS)?

A

Triad of:
-acute renal failure
-haemolytic anaemia
-thrombocytopenia

22
Q

How does Shiga toxin produce symptoms/cause damage?

A

Toxin binds to Gb3 on cell
Toxin endocytosed into cell
Transported to Golgi
Fragments of toxin cleaved
Harmful fragment released into cytosol
Inactivates ribosomes inhibiting protein synthesis

23
Q

How does shiga toxin basically cause cell damage/damage large intestinal lining?

A

Toxin inhibits protein synthesis in cell

24
Q

What treatment does a patient need with Haemolytic Uraemic syndrome and why?

A

Dialysis to treat the acute renal failure

25
Q

What are extra intestinal pathogenic E.coli (ExPEC)?

A

Strains of E.coli capable of causing disease outside the intestinal tract

Have a wide range of virulence factors

26
Q

What is Cystitis?

A

Urinary tract infection often caused by E.coli

27
Q

Why are UTIs more common in women?

A

Anatomical differences
Much shorter journey for women from faeces

28
Q

How does Cystitis lead to Pyelonephritits?

A

Cystitis where the E.coli travels up the ureters to the kidneys

29
Q

What is the most common cause of bacterial bloodstream infection?

A

E.coli

30
Q

What are some causal factors for E.coli bloodstream infections (E.coli bacteraemia)?

A

Age
Hepatobiliary infections
UTIs
Catheterised patients
GI infections

31
Q

How are Diarrhogenic E.coli infections prevented?

A

Avoid foods and drink that could be contaminated

32
Q

How are Diarrhogenic E.coli infections treated?

A

Most infected recover in a few days
Clear liquids (prevent dehydration and loss of electrolytes)
Oral rehydration solutions
Avoid antibiotics (may make illness worse)

33
Q

What needs to be avoided when treating Diarrhogenic E.coli infections?

A

Antibiotics (AVOID)

34
Q

How are UTIs treated?

A

Antibiotics

35
Q

What antibiotics are used to treat Urinary Tract Infections (UTI)?

A

Trimethoprim (treatment can fail if UTI is resistant to this)
Nitrofurantoin

36
Q

What strain of E.coli causes travellers diarrhoea?

A

Enterotoxigenic E.coli (ETEC)
By producing 2 toxins

37
Q

What is febrile neutropenia?

A

Fevers that coincide with low neutrophils

38
Q

What is the first line treatment for febrile neutropenia?

A

IV Tazocin (Piperacillin + Tazobactam) 4.5g TDS

If penicillin allergic - IV meropenem 1g TDS

39
Q

What do you add to treat febrile neutropenia if there evidence of infection of the Hickman line?

A

IV vancomycin

40
Q

What type of organisms does Tazocin (Piperacillin and Tazobactam) target?

A

Gram +ve and -ve

41
Q

What type of organisms. Does vancomycin target?

A

Gram +ve

Y1 - Infection (21 decks)

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