Nelson - Ch. 200 E. coli Flashcards
E.coli ?aerobic ?gram ?lactose
Facultative anaerobic, G-, lactose fermenter
T/F Most fecal E.coli cause diarrhea
F, do not cause
Most diarrheagenic E.coli except ___ require a large inoculum of organisms to induce disease
STEC
MCC of traveler’s diarrhea
ETEC
Accounts for 10-30% of dehydrating infantile diarrhea
ETEC
Enterotoxin produced by ETEC associated with increased risk of death
ST-ETEC or heat stable enterotoxin
ETEC diarrhea is self-limited and resolves in
3-5 days, occasionally longer than 1 week
ETEC enterotoxin that is structurally, functionally, and immunologically related to cholera toxin produced by V. cholerae
LT or heat labile toxin
ETEC enterotoxin: Large molecule
LT
ETEC enterotoxin: Small molecule
ST
ETEC enterotoxin: Stimulates adenylate cyclase –> increased CAMP
LT
ETEC enterotoxin: Stimulates guanylate cyclase –> increased CGMP
ST
Genes for ST and LT of ETEC are encoded on
Plasmids
E. coli: Explosive, nonmucoid, nonbloody diarrhea, little or no fever
ETEC
E. coli: Resembles bacillary dysentery since it shares virulence genes with Shigella spp
EIEC
E. coli: Cause colonic ulcerations, hemorrhage, mucosal and submucosal edema, and infiltration by PMNs
EIEC
E. coli: Nonmotile and usually non lactose fermenting
EIEC
E. coli: Acute, prolonged (>7d), and persistent diarrhea (>14) in children less than 2
EPEC
E. coli: Outbreaks in daycare centers
EPEC
E. coli: Studies show that breastfeeding is protective against diarrhea caused by
EPEC
E. coli: Duodenum through colon
EPEC
E. coli: Colonization causes blunting of villi, inflammatory changes, and sloughing of superficial mucosal cells
EPEC
E. coli: Characteristic attaching and effacing histopathologic lesion
EPEC
E. coli: Abdominal pain with diarrhea that is initially watery but within a few days become blood-streaked or grossly bloody
STEC
Associated with HUS
STEC
Severe illness with STEC occurs in what age-group
6m-10yrs
STEC-positive young children with ___ early in the course of diarrhea are at high risk for HUS progression
Bloody diarrhea and neutrophilic leukocytosis
Poorly cooked hamburger, apple cider, mayonnaise, spinach, dry fermented sausage, unpasteurized dairy
STEC
STEC affects the ___ most severely
Colon
Attaching-effacing lesions like those seen in EPEC but with production of toxins that kill cells
STEC
Key virulence factors of STEC
Shiga toxins aka VEro toxins aka Shiga like toxins
The ___ family of toxins produced by STEC is associated with a higher risk of causing HUS
Stx2
MC STEC serotype
O157:H7, O111:NM and O26:H11
Most virulent STEC serotype
O157:H7
E coli most frequently associated with HUS
O157:H7
2nd MCC of traveler’s diarrhea
EAEC
Acute and persistent diarrhea in HIV-infected adults and children
EAEC
Associated with growth retardation and malnutrition in infants
EAEC
Form a characteristic biofilm on the intestinal mucosa and induce shortening of the villi
EAEC
Secretory mucoid diarrhea
EAEC
AA fimbriae
EAEC