Microbiology Flashcards
What is the commonest cause of gastroenteritis worldwide?
Campylobacter jejuni
Incubation period of campylobacter
16-48 hours
Microbiology of campylobacter
Gram -ve
bacillus
curved
Cause of campylobacter infection
Undercooked poultry
Unpasteurised milk
Clinical presentation of campylobacter
Diarrhoea
- +/- blood
Fever
Abdominal pain
Management of campylobacter
Self limiting
Immunocompromised - macrolides
Investigations of campylobacter
Stool culture
Salmonella enterica - incubation period
12-48 hours
Salmonella enterica - microbiology
Gram -ve bacillus
Salmonella enterica - cause
Undercooked poultry
Meat
Raw eggs
Reptiles
Salmonella enterica - clinical presentation
Diarrhoea - +/- blood Fever Vomiting Abdominal pain
Salmonella enterica - investigations
Stool culture
Salmonella enterica - management
Mainly self limiting
Severe - ciprofloxacin
Shigella - incidence
Outbreaks common in children
Shigella - incubation period
1-9 days
Shigella - microbiology
Gram -ve bacillus
Shigella - cause
Person-to-person spread
Shigella - clinical presentation
Diarrhoea + blood
Pus
Abdominal pain
Shigella - investigations
Stool culture
Shigella - management
Mainly self limiting
Severe - ciprofloxacin
E. Coli O157 - incidence
Children
elderly
E. Coli O157 - incubation period
1-14 days
E. Coli O157 - microbiology
Gram -ve bacillus
E. Coli O157 - cause
Petting animals at farms
Minced beef - burgers
Water
Unpasteurised milk
E. Coli O157 - Clinical presentation
Diarrhoea + blood
Abdominal pain
Fever
E. COli O157 - investigations
Stool culture - if -ve despite blood in stool then test for VTEC (toxin test)
Blood test - check for HUS, increased WCC, decreased Hb
E. Coli O157 - management
Mainly self limiting
Antibiotics are NOT advised (as this may increase toxin release, making HUS more likely)
O157
O antigens
Strain produces VTEC
E. Coli O157 - Toxins
Produces shiga like toxins (new name for VTEC)
E. Coli O157 - complications
HUS
- common cause of renal failure
Salmonella typhia/paratyphia - incidence
Travel related
SE asia
India
Salmonella typhia/paratyphia - incubation period
14-21 days
Salmonella typhia/paratyphia - cause
Person-to-person spread
Eating contaminated food
Drinking contaminated water
Hand hygeine
Salmonella typhia/paratyphia - clinical presentation
Headache Fever Dry cough Rash Constipation or diarrhoea
Salmonella typhia/paratyphia - investigations
Blood culture
Stool culture
Salmonella typhia/paratyphia - management
Mainly self limiting
Severe - ceftriaxone
Salmonella typhia/paratyphia - complications
GI bleeding
Perforation
Encephalopathy
Salmonella typhia/paratyphia - vaccinations
Protect against typhoid
No protection against paratyphoid
Vibrio cholera - incubation period
1-9 days
Vibrio cholera - microbiology
gram -ve bacillus
Vibrio cholera - cause
Person to person spread
Drinking contaminated water
Outbreaks in refugee camps
Vibrio cholera - clinical presentation
Watery diarrhoea
Dehydration
Vibrio cholera - investigations
Stool culture
Vibrio cholera - management
Re hydration
Staph aureus - incubation period
1-6 hours
Staph aureus - cause
Eating a cream bun
Due to pre-formed toxins in food (enterotoxin)
Staph aureus - clinical presentation
Vomiting
Abdominal pain
Staph aureus - Management
Flucloxacillin
Bacillus cerus - incubations period
1-6 hours
Bacillus cerus - cause
Reheated rice
Pre-formed toxin
Bacillus cerus - clinical presentation
Vomiting
Bacillus cerus - management
Self limiting
Rotavirus - incidence
Young children
Outbreaks
Rotavirus - cause
Person to person spread
Faecal oral spread
Rotavirus - clinical presentation
Diarrhoea
Vomiting
Dehydration
Rotavirus - investigations
PCR stool
Rotavirus - management
Self limiting
Rotavirus - vaccination
Oral
Live attenuated
Norovirus - incidence
Outbreaks
Common in schools, hospitals, cruise ship
Norovirus - cause
Person to person spread
Droplet
Faecal oral route
Shellfish
Norovirus - clinical presentation
Diarrhoea
Vomiting
Cramps
Norovirus - investigations
PCR stool
Norovirus - management
Self limiting
Amoebiasis - microbiology
Protozoal infection
Amoebiasis - cause
Faecal oral spread
Poor sanitation
Travel related
Amoebiasis - clinical presentation
Bloody diarrhoea
Fever
Abdominal pain
Amoebiasis - investigations
Stool microscopy
AXR
Endoscopy
Serology
Amoebiasis - management
Metronidazole
Giradiasis - microbiology
Protozoal infection
Happy faces
Giardiasis - cause
Faecal oral spread
Travel related
Spores can exist on salad
Giardia - clinical presentation
Watery diarrhoea Bloating Flatulence Abdominal pain Weight loss
Giardia - investigations
Stool microscopy
OGD biopsy
Giardiasis - management
Metronidazole
C. diff - incidence
Common in the healthcare setting
C. diff - microbiology
Gram +ve bacillus
Anaerobic
C. diff - spores
Survive adverse conditions
Alcohol gel doesn’t work
C. diff - cause
Antibiotics - 4 C’s
C. diff - mechanism of action
Produces 2 toxins
- toxin A (enterotoxin)
- toxin B (cytotoxin)
C. diff - clinical presentation
Diarrhoea
Abdominal pain
C. diff - investigations
Stool sample - screen for GDH
If GDH +ve then test for presence of toxin A or B (PCR)
- screening test -ve then -ve result
- screening test +ve and toxin test -ve then intermittent
- screening test +ve and toxin test +ve then +ve result
C. diff - Management
Mild - oral metronidazole
Severe - oral vancomycin
C. diff - complications
Toxic megacolon
Perforation
Peritonitis
C. diff - recurrence (1st relapse)
Fidaxomicin
C. diff - recurrence (subsequent relapse)
Faecal transplant (through NG tube)
Enterotoxigenic E. Coli - cause
Most common cause of travellers diarrhoea
Enterotoxigenic E. Coli - clinical presentation
Diarrhoea
Enterotoxigenic E. Coli - management
Self limiting
Single dose of ciprofloxacin
Cryptosporidium - incidence
Outbreaks
Cryptosporidium - microbiology
Protozoal infection
Cryptosporidium - cause
Travel related
Contact with animals
Contaminated water
Swimming pools
Cryptosporidium - clinical presentation
Diarrhoea
Cryptosporidium - investigations
Stool
Duodenal aspirate
Cryptosporidium - management
Self limiting