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Unit 6: Micro > Enteric Bacterial Infections 3: The Vibrios > Flashcards

Enteric Bacterial Infections 3: The Vibrios Flashcards

1
Q

What are the three vibrios?

A

Vibrio cholerae, parahaemolyticus, vulnificus

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2
Q

Cellular characteristics of V. cholerae?

A
  • Curved
  • Motile
  • Gram - rod
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3
Q

Two reservoirs of V. cholerae?

A

Humans and ocean

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4
Q

What cell wall antigen indicates pathogenicity in V. cholerae?

A

O cell wall antigen

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5
Q

What are the two V. cholerae groups that cause epidemic disease?

A

O1 and O139 groups

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6
Q

V. cholerae transmission?

A

Fecal-oral

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7
Q

What is a major barrier to V. cholerae infection?

A

Stomach acid

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8
Q

What makes a person susceptible to V. cholerae infection?

A

Gastrectomy, antacids, or coincident H. pylori infection

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9
Q

What allows the surviving V. cholerae to reach the small intestine brush border?

A

Secretion of mucinase and toxin-coregulated pilus

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10
Q

What are O1 and O139 markers for?

A

Infection with the CTX bacteriophage

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11
Q

Why is a high infectious dose of V. cholerae needed for infection?

A

Much of the organism is killed by gastric acid

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12
Q

Describe the choleratoxin

A
  • A-B subunit structure
  • B binds
  • A causes percistent activation of adenylate cyclase resulting in loss of water and ions from attached cells
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13
Q

What is the Pavlovian Syx of V. cholerae infection?

A

Massive rice water diarrhea

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14
Q

What is the cause of morbidity and mortality from V. cholerae infection?

A

Dehydration and electrolyte imbalance

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15
Q

What is the typical scenario in which V. cholerae infection occurs?

A

Following travel

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16
Q

What is V. cholerae’s claim to fame in the diarrhea department?

A

Most watery diarrhea of any of the infectious gastroenteritis bugs

17
Q

Typical Syx of V. cholerae infection?

A
  • No fever
  • No pain with diarrhea
  • band hypokalemia from bicarb and K+ loss
  • Hypoglycemia
18
Q

Tx for V. cholerae infection?

A

Primarily rehydration

19
Q

What is a simple test to determine the hydration status of a patient?

A

The longitudinal pinch test to assess skin turgor

20
Q

Although not commonly performed, describe the culture technique for V. cholerae

A
  • Use of bile salt agar
  • Acid reaction on triple-sugar-iron agar
  • Oxidase positive
  • Sucrose (+)
21
Q

What supportive measures are taken in the management of V. cholerae?

A
  • Rehydrate and rebalance electrolytes - IV Lactated Ringer solution
  • Oral Rehydration solution
  • Tetracyclines if necessary
22
Q

V. cholerae preventive methods

A
  • Treat water, cook food
  • Killed and live vaccine but not recommended for routine use in travelers
  • Prophylactic tetracyclines
23
Q

What is the typical scenario of a V. parahaemolyticus infection?

A

Typically gastroenteristis

24
Q

Cellular characteristics of V. parahaemolyticus?

A
  • Oxidase (+) Gram (-), Curved motile rod
  • Halophile (lives in salty areas)
25
Q

Which is more common? V. parahaemolyticus or V. vulnificus? More lethal?

A

V. p. is more common, V. h. is more lethal

26
Q

Typical scenario of a V. vulnificus infection?

A

Lethal cellulitis

27
Q

What is the leading cause of gastroenteritis in those whoe eat undercooked seafood?

A

V. parahaemolyticus

28
Q

What is a very important point to make to a person with immunocompromise?

A

No more shellfish

29
Q

What is the method to culture V. parahaemolyticus?

A
  • Culture in 8% NaCl
  • Culture from stool on thiosulfate-citrate-bile salts-sucrose media
30
Q

Tx for parahaemolyticus?

A

Oral rehydration but if severe (high fever) doxycycline or quinolone

31
Q

Characteristics that are similar b/w the V. cholerae and non-cholerae vibrios?

A
  • Possibility of dehydration
  • Self-limited (generally)
  • Efficacy of doxycyline Tx
32
Q

What is different b/w the V. cholerae and the non-cholerae vibrios?

A
  • Likelihood of dehydration
  • Likelihood of need for doxycycline
33
Q

Cellular characteristics of V. vulnificus

A
  • Oxidase (+)
  • Gram (-)
  • Halophile
34
Q

What are the virulence factors of V. vulnificus?

A
  • Hemolysin
  • Protease exotoxin
  • Siderophores - infection exacerbated by iron overload
35
Q

What are the Pavlovian Hx characteristics?

A

Cellulitis with Hx of handling raw shellfish

36
Q

Which bug has the highest case fatality rate for a foodborne illness?

A

V. vulnificus

37
Q

Tx for V. vulnificus?

A

Early and often debridement; Ceftazidime + Doxycycline (or antipseudomonal penicillin)

38
Q

What is similar in gastroenteritis and cellulitis caused by vibrios?

A

Exotoxin production and patient RFs for complications after infection

Unit 6: Micro (13 decks)

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