Enterobacteriaceae, Legionella, Diarrheal Diseases, Hepatitis Flashcards
(316 cards)
1
Q
Where are Enterobacteriaceae natural inhabitants?
A
GI tract
2
Q
This gram-negative bacterial family is ubiquitous in environment and in gut
A
Enterobacteriacaeae
3
Q
Enterobacteriaceae cause ____ of bacteremias
A
1/3
4
Q
Enterobacteriaceae cause more than ____% of UTIs
A
80%
5
Q
Basic description of enterobacteriaceae
A
Gram negative rods
Non-spore forming
facultative anaerobes
6
Q
What agar is used to differentiate enterobacteriaceae?
A
MacConkey agar
7
Q
Do all enterbacteriaceae ferment lactose?
A
No, both lactose fermenters or non-lactose fermenters
8
Q
What common antigen do all enterbacteriaceae have
A
Enterobacterial common antigen (ECA)
9
Q
selective and differential medium that inhibits gram + organism and differentiates between lactose fermenting gram negatives
A
MacConkey Agar
10
Q
Enterobacteriaceae- lactose fermenter that is motile
A
E. coli
11
Q
Enterobacteriaceae- non-motile lactose fermenter
A
Klebsiella pneumoniae
12
Q
Enterobacteriaceae- motile non-lactose fermenters
A
Salmonella
Proteus
13
Q
Enterobacteriaceae- Non-motile non-lactose fermenters
A
Shigella
Yersinia
14
Q
What types of HAIs are associated most often with Enterobacteracieae?
A
Pneumonias
SSIs
Bacteremia
UTIs
15
Q
What are the most familiar species of Enterobacteriaceae recovered from extraintestinal diseases?
A
E. coli
Enterobacter cloacae
Klebsiella penumoniae
Serratia marcesens
Proteus mirabilis
16
Q
Most common Enterobacteriaceae agents of gastroenteritis and colitis?
A
Salmonella
Shigella
E. coli
17
Q
Two species of Salmonella for which humans are the only reservoir
A
Salmonella typhi
Salmonella paratyphi
18
Q
How often to patients become chronic carriers of salmonella?
A
1-5%
19
Q
Which virulence factor is associated with Enterobacteriaceae and septic shock and Disseminated intravascular coagulation (DIC)
A
LPS polysaccharides and Lipid A endotoxin
20
Q
Common to all aerobic and some anaerobic, gram, negative bacteria, released upon death. Activates the macrophages, white blood cells, releases cytokines, and causes septic shock, necrosis, DIC, and death
A
LPS-polysaccharides and Lipid A endotoxin
21
Q
What do LPS polysaccharides and Lipid A endotoxins cause?
A
- Septic Shock
- Necrosis
- DIC
- Death
22
Q
Structure that facilitates motility and adherence to GI, and urinary epithelial cells. Also assists in invasion of mucosa
A
Flagellar H antigens
23
Q
Structure that prevents phagocytosis, evades immune mechanisms
A
Capsule K antigen
24
Q
Provides resistance to antibiotics, production of toxins, hemolysins, may be chromosomal or plasmid mediated
A
Pathogenic islands
25
Antigen that provides resistance to antibiotics, production of toxins, hemolysins, may be chromosomal or plasmid mediated
Pathogenic islands
26
Enterobacteriaceae with a symptom of red currant jelly sputum and penumonia
Klebsiella pneumoniae
27
Two most common HAIs caused by Klebisella, Enterbacter, and serratia
Pneumonia and UTIs
28
Concern with HAIs from Klebsiella, Enterobacter, and Serratia
Multi-drug resistance
29
What antibiotic for klebsiella, enterobacter, and serratia?
carbapenem
30
Do Klebsiella, enterobacter and serratia ferment lactose?
Yes
31
Motility for enterobacter?
motile
32
motility serratia?
motile
33
motility klebsiella?
not motile
34
what color are lactose fermenters on MacConkey agar?
Pink
35
What pigment does Serratia have on MacConkey agar?
Bright red
36
3 As of klebsiella
Alcoholics (common risk)
Abscesses (what they cause)
Aspiration (How it starts)
37
Enterobacteriaceae HAI that has a capsule
Klebsiella
38
Enterobacteriaceae that causes cavitation in chest imaging and may be mixed up with TB
Klebsiella
39
Which HAI most commonly produces urease?
Protease
40
What is the microbial resistance concern with Klebsiella?
Carbapenemase- producing strains
41
What is the most frequently isolated carbepenemase producing enterobacterales?
Carbapenem- resistant Klebsiella pneumoniae (CRKP)
42
Which enterobactericaeae is most often associated with blood stream infections?
Klebsiella
43
Enterobacteriaceae most often associated with CAUTIs
E Coli
44
What family was the leading cause of CAUTIs?
Enterobacteriaceae
45
What was the top pathogen recovered from CAUTIs?
E. Coli
46
Basic description of legionella
aerobic
Gram negative
Fastidious bacteria
47
Tests for legionella
Urinary antigen detection
48
Clinical manifestations legionella
Pneumonia (Legionnaires disease)
Flu-like illness (Pontiac fever)
49
CDC estimates that less than ___% of the legionella cases are dx'd and reported to the CDC
5%
50
Incubation periods Legionnaire's disease
2-10 days
51
Associated symptoms Legionairre's Disease
Nonproductive cough
fever (usually above 104)
shortness of breath
Malaise
Anorexia
Headache
Confusion
Watery diarrhea
Nausea
Vomiting
Abdominal pain
52
What will a legionnaire's disease chest radiograph look like
infiltrates in the lungs
53
What is common lab result for legionnaire's disease
Hyponatermia
54
low concentration of sodium in blood
Hyponatermia
55
Incubation for Pontiac fever
24-48 hours
56
Pontiac fever symptoms
High fevers
Chills
Myalgia
Headache
57
Symptom resolution with Pontiac fever
Typically resolve in 2-5 days without treatment
58
Risk factors for legionella
advanced age
male gender
cigarette smoking
alcohol abuse
chronic pulmonary disease
immunosuppressed hosts
renal failure
corticosteroid use
59
natural habitat of legionella
Water
60
Mode of transmission legionella
Direct inhalation or aspiration
61
does person to person transmission happen for legionella?
no
62
How can legionella be transmitted in healthcare settings?
Aerosolization by use of respiratory tract devices (humidifiers, nebulizers)
63
Legionella infections can be traced to ...
Multi-species biofilms
64
What is the gold standard definitive test for legionella?
Culture
65
What is the limitation of urinary antigen tests for legionella?
only able to detect serotype 1
66
Treatment for legionella
Quinolones or macrolides
67
Prevention of Legionella
-Water safety plan
- Disinfection
68
What are the disinfection methods for legionella?
- Super heat and flush, hyperchlorination
- Copper silver ionization systems
- Chlorine dioxide
- Monochloramine
- Point of use water filters
69
Two organisms that are the waterborne pathogens that are most associated with outbreaks related to contaminated equipment. Tap water that is used to rinse instruments after disinfection and as a water source for medical instruments may be a source of these infections.
Pseudomonas and non-tuberculosis mycobacteria
70
What are the virulence factors for Klebsiella spp?
capsule
Endotoxins
71
What are common infections caused by Klebsiella spp?
CAP (alcoholics)
HAP (ventilator)
UTIs (indwelling catheters)
72
Incubation periods for ETEC
1-2 days
73
Symptoms of ETEC
Water diarrhea
Cramps
Nausea
Vomiting
Dehydration
74
Common name for ETEC
Traveler's diarrhea
75
Transmission ETEC
fecal/ oral
76
Symptoms EIEC
Bloody/ mucoid stool
fever
cramps
watery diarrhea
77
Transmission EIEC
Travel
Contaminated H2O
78
Who is at risk for EPEC?
infants
Young children
Developing nations
79
Symptoms of EPEC
Watery diarrhea
Fever
Nausea
Vom
Muccoous in stool
80
Enteroaggressive E. Coli- where it's a concern
Developing nations
81
Shigella virulence factors
neurotoxin
cytotoxin (B)
enterotoxin (A)
82
symptoms Shigella
cramps
diarrhea
fever
bloody stools
Can be asymptomatic
83
Transmission shigella
person to person
fecal oral
84
this organism cases 15-20% of pediatric cases of diarrhea in the U.S.
Shigella
85
Infective dose shigella (low/ medium/ high)
Low
86
How salmonella is transmitted
fecal oral or animal to person
87
Infective dose salmonella (low/ medium/ high)?
High infective dose
88
Who is at risk for salmonella?
kids under 5
>65
AIDS patients
Sickle cell
MSM
89
4 clinical manifestations of salmonella
Enteritis
Septicemia
Enteric Fever
Asymptomatic
90
Incubation for salmonella - GI
6-48 hours
91
Symptoms salmonella GI
nausea
vom
diarrhea
fever
ab cramps
myalgia
92
Treatment salmonella enteritidis
No treatment
93
Who is impacted by salmonella septicemia?
advanced age
HIV
94
Infections related to Salmonella septicemia (bloodstream infection)
osteomylitis
endocarditis
arthritis
95
Incubation period for salmonella enteric fever
10-14 days, lasts for weeks
96
What salmonella species cause asymptomatic Salmonella infections?
S. typhi
S. paratyphi
97
Where does salmonella live in the body during asymptomatic infections?
Gallbladder
98
Incubation period yersinia
3-7 days
99
Symptoms yersinia
fever
diarrhea
enterocolitis
acute mesenteric lymphadenitis
100
Source of nonenteric yersina bloodstream infections occur?
blood product
101
What are the two type of plague caused by yersinia pestis?
bobonic plague (most common)
pneumonic plague
102
Symptoms of bubonic plague
Buboes
Fever
Chills
sepsis
gangrene
103
What antigens are used on Enterobacteriaceae classification?
O antigen
K antigen (capsule)
H antigen (Flagella)
104
What increases the risk level for enterobacteriaceae?
medical intervention
disruption to normal GI microbiome
Exposed to contaminated H2O
Very young, old, debilitated
105
Resistance mechanisms for enterobacteriaceae
most common is beta lactamase- ESBLS
106
Enterobacteraceae most common MDROs
Enterobacter
Klebsiella
Serratia
107
Plasmid carrying
KPC
VIM
IMP
NDM
OXA-48
are resistant to what antibiotic?
Carbepenem
108
Most common carbapenem resistant bacteria
Klebsiella
109
Most common organism isolated from CAUTIs
E. coli
110
Most common organism isolated from SSIs
Enterobacter
111
Most common species isolated from bacteremias
Klebsiella spp
112
Common pathophysiology of enterbacteriaceae bloodstream infection
spreads from UTI, lungs, or GI tract to blood
Releases endotoxins
113
Enterobacteriaceae in top 10 CLABSI list
Klebsiella
Enterobacter
E. Coli
114
What enterobacteriaceae cause HAP?
Enterobacter
Klebsiella
E. Coli
115
What Enterobacteraceae organism most commonly casess VAP?
Klebsiella
116
What are the top 5 organisms for CAUTIs?
1) e. coli
2) Kelbsiella
3) Proteus
4) enterobacter
5) seratia
117
What is a risk for an SSI infection with enterbacteriaceae, esp e. coli
Antibiotic PEP with a 3rd gen cephalosporin
118
Who is at risk for a CNS infection with enterobacteriaceae?
premature babies
low birth weight in infants
119
What 2 Enterobacteriaceae organisms typically cause CNS infections?
E. coli
Klebsiella pneumonia
120
E. Coli is in the Top 10 organism list for which HAIs?
#1 CAUTI
#3 SSI
#6 VAP
#9CLABSI
121
E. coli is not a common ________ pneumonia but is a common ________ pneumonia
community acquired pneumonia
healthcare acquired pneumonia
122
Enterobacteriaceae that cause oppurtunistic infections in immunocompromised patients, especially those on ventilators, and prolonged antimicrobials.
enterobacter
123
Enterobacter can cause the following infections
lower resp infections
UTI
wounds infections
septecemia
124
MDRO concern for enterobacter
carbapenemase + EBSL producer
125
126
127
Most dangerous type of EHEC that can cause HUS
O157: H7
128
Incubation period for EHEC
1-9 days
129
Incubation period for ETEC
3-14 days
130
Incubation period for EPEC
3-6 days
131
Epi of EPEC
Diarrhea for >2 weeks in children
132
Precautions for E. coli
Contact
133
Clinical symptoms for EHEC
Ab pain
Myalgia
headache
vom
hemorrhagic colitis
134
Key difference between ETEC and EHEC
No leukocytes in stool of ETEC, just watery diarrhea
135
Systemic complications of EHECt
HUS
136
Culture for EHEC
macConkey agar (lactose fermenter)
137
Is EIEC common in the U.S.
no, very rare
138
How many serotypes of Salmonella enterica are there? based on what?
2400
O, Vi, and H antigen
139
Where are Salmonella Typhi and Salmonella paratyphi prevalent
India and Asia
140
Incubation period Salmonella typhi
5-21 days
141
Symptoms Salmonella typhi
diarrhea
headache
anorexia
myalgia
general weakness
rose spots
hepatosplenomegaly
142
Antibiotic for salmonella typhi
Fluloroquinolones
143
Who is at highest risk for non-typhoid Salmonella
HIV
Infants
144
Season for non-typhoid salmonella
summer, early fall
145
Most common cause of salmonella outbreaks
Salmonella enteritidis
146
Transmission non-typhoid salmonella
Ingestion of undercooked meat (esp poultry, eggs, dairy products)
Exotic pets
147
Incubation of non-typhoid salmonella
6-48 hours
148
Symptoms non-typhoid salmonella
Diarrhea
ab cramps
bacteremia (infants, elderly, immunocompromised, sickle cell)
149
Extraintestinal infections Salmonella
UTI
Osteomyelitis
Joint infections
150
Dx for salmonella
Stool culture
151
Very virulent form of EnterobacteriaceaeEnterobacteriaceae with only humans as the host
shigella
152
Are non-typhoid salmonella patients typically treated?
No, not unless high risk
153
Epi- risk factors for shigella
daycare
migrant workers
international travel
custodial institution
MSM
154
Can you have shigella twice?
no, infection confers immunity
155
Clinical symptoms shigella
FEVER
Bloody diarrhea (20+ stools per day)
severe abdominal cramps
tenesmus
156
Pathogenicity shigella
multiply and cause cell death and inflammation
157
Treatment for shigella
Rehydration therapy
Antimicrobials
158
Gram negative cocobacillus enterbacteriaceae that is invasive and cases disease in humans
Yersinia
159
Where is yersinia common?
Europe
160
What is a common source of yersinia?
chitterlings
161
High risk populations yersinia
infants
African americans
iron chealtor
receive blood
162
What animal is yersinia associated with?
pigs
163
What is the incubation period for yersinia?
1-4 days
164
Symptoms yersinia
- enterocolitis
-mesenteric adenitis (right lower quadrant pain)
- terminalilitis
- septicemia
- reactive arthritis
165
What antibiotics is yersinia resistant to?
macrolides
166
Infection control for yersinia
-safe food handling, esp pork
- Test blood products
-treat H2O
167
Very common enteric- gram negative, non spore forming rod, but not in enterobacteriaceae family
Campylobacter
168
Reservoir for campy
intestines of cows and poultry animals
169
Transmission of campylobacter
Undercooked meat
Unpasteurized dairy
Unchlorinated water
contact with sick pet
170
Incubation campylobacter
1-7 days
171
symptoms of campylobacter
Prodome- fever, headache, malaise, myalgia
1-2 days later- tenesmus, diarrhea, ab pain, lower right quadrant pain
172
Is campylobacter common in healthcare?
No, very rare in healthcare\
173
Gram negative bacteria that are transmitted via fish (aquarium to wounds, fishers, eating fish)
Edwardsiella tarda
Aeromonas speicies
Pleisiomonas Shigelloides
174
Aeromonas species are rare except in ___ therapy
leech therapy
175
Spore forming, gram+ enteric
Bacillus cereus
176
Most common foods bacillus cereus
Rice, noodles, pastries
177
Incubation period Bacillus cereus
8-12 hours
178
What are the caliciviruses?
Norovirus and Sapprolike viruses
179
Transmission
of caliciviruses
Fecal/oral
aersolized vom
Person to person
180
Season for calciviruses
winter
181
Where caliciviruses are the biggest risk
**nursing homes**
*cruise ships
*Schools
*camp
*military
*restaurants
*airplanes
182
Incubation period for caliciviruses
12-48 hours
183
Symptoms calicivirus
**vomit**
ab cramps
diarrhea
184
How long can a patient shed norovirus?
3 weeks
185
incubation 24-48 hours
illness 12-60 hours
more than 50% vom
no bacteria in stool
Kaplan criteria for noro
186
Control norovirus
Wash hands soap and water
Exclude sick staff
No new admits
Disinfect
187
Most common viral GI infenction
Rotavirus
188
Transmission rotavirus
Fecal oral
P2P close contact within household
189
How long can rotavirus survive on the hands?
60 minutes
190
What age group most commonly is infected with rotavirus?
children
191
Symptoms rotavirus
may have cough/ coryza
followed by fever and vomitting
followed by bloody diarrhea 2-3 days later
192
Are there protective antibodies for rotavirus?
No
193
Describe diarrhea for rotavirus
20x per day
non bloody diarrhea
194
Treatment for rotavirus
Oral rehydration
195
Prevention rotavirus
Vaccinate babies
196
Virus that causes watery diarrhea from shell fish, H2O and fomites
astroviruses
197
Describe symptoms of astroviruses
Watery diarrhea
nausea
headache
malaise
low-grade fever
**asymptomatic (most common)
198
Which is more mild, rotavirus or astrovirus?
rotavirus
199
Age effected by astroviruses
<9 years
200
how long astroviral shedding last in stool
up to 35 days
201
High risk age for enteric adenoviruses
Children <4
202
transmission enteric adenoviruses
fecal/ oral
droplet
transplant
*NOT FOOD*
203
Incubation period for enteric adenoviruses
8-10 days
204
Does infection with enteric adenoviruses confer immunity?
Yes, lifelong
205
symptoms adenoviruses
Protracted diarrhea
asymptomatic
206
What organism causes amoebiasis?
Entamoeba histolytica
207
Transmission amoebiasis
fecal oral
208
High risks for amoebiasis transmission
Travel
Nursing homes
Immigrants
Institutionalized
MSM with HIV
209
Symptoms amoebiasis
90% asymptomatic
otherwise- blood diarrhea, fever, dehydration, weight loss
210
More severe symptoms of amoebiasis
Colon ulcers
invasive hepatic abcesses
211
Dx amoebiasis
wet mount or serology
212
This parasetic diarrheal diseases causes diarrhea, stomach pain, flatulence, and anoerexia, or asymptomatic colonization. It is unclear how it is transmitted.
Blastocytis heminis
213
This is the most common parasite in the U.S.
Giardia (lamblia) deodenalis
214
Transmission giardia
contaminated H2O
animals
diapers
MSM
fecal oral
215
Size of inoculum giardia
low
216
Most common clinical presentation giardia
asymptomatic
217
When symptoms are present for giardia, what are the symptoms
foul smelling, profuse watery diarrhea
218
Dx giardia
wet mountw
219
treatment giardia
Metronidazole
Tridazole
220
Transmission of cryptosporidum parvum
contaminated H2O (drinking and recreational)
P2P *handwashing MSM
221
What is unique about crytosporidium parvum?
resistant to chlorine
222
What type of organism is cryptosporidium parvum?
parasite
223
incubation period cryptosporidium
5-28 days
224
symptoms cryptosporidium
profuse, watery diarrhea
ab pain
fever
fatigue
225
Type of agent of cyclospora cayetanesis
parasite
226
Transmission of cyclospora cayetanesis
tropical climates
foodborne
227
Incubation time cyclospora
1-7 days
228
Symptoms cyclospora
Profuse, watery diarrhea
nausea
vom
appetite loss
229
Dx cyclospora
modified acid fast stain
230
Treatment cyclospora
TMP-SMP
231
What are the most common legionella pneumophila serogroups?
1*, 4, and 6
232
Virulence factors of legionella
LPS
Flagella
Pili
Exoproteases
cytotoxins
Outter membrane proteins
233
Mortality rate legionella
1/10
234
Risk for legionella
Advanced age
male gender
smoking
alcohol abuse
COPD
235
Who is at biggest risk for HAI legionella
organ transplants
236
Where do people typically get legionella CAP?
hotel
fountain
cruise ship
spas
237
4th leading cause of CAP
legionella
238
What makes a probable case of legionella healthcare acquired pneumo?
in setting <10 days before onset
239
What makes a definite case of HC acquired pneumo due to legionella?
in hc setting for 10+ days b4 onset
240
When to investigate legionella
2+ cases
241
Where does legionella grow?
Drinking water dist systems
whirlpools and spas
decorative fountains
industrial equip
242
Transmission of legionella
1) aersolization
2) aspiration
3) direct deposit from medical procedure
243
Incubation period of legionairre's disease
2-10 days
244
Incubation period pontaic fever
24-48 hours
245
what mental change is common in legionairre's disease patients?
confusion
246
Does legionella grow easily in culture?
No, fastidious
247
Antibiotics for legionella
quinolones and macrolides
248
Water safety plan steps
1) Describe the water system
2) Assess risk
3) control risk
4) Audit
249
When do you need to culture the water system for legionella?
1 case- where patient was, high risk patient areas
2 cases- facility wide
250
is superheating a flushing a long term solution for legionella?
No, will grow back
251
Non-toxic chemical method to kill legionella
Chlorine dioxide
252
Kills legionella and biofilm
monochloromine
253
Where to use point of use filters for legionella
high-risk units
254
Concerns with hyperchlorination for legionella
short term
carcinogens
255
To prevent legionella use ___ water to rinse respiratory equipment, naso/ oro trach probes, CPAPS
sterile
256
To prevent legionella, clean and disinfect these machines
ice machines
baths
257
Should portable humidfyers be allowed in the room?
No, allow for legionella to grow
258
Who should drink bottled water during a legionella outbreak?
immunocompromised patients
259
What are the CAP- core quality measures?
-oxygen assessment within 24 hours or hosp arrival
- pts over 65 screened for pneumo vax
- blood cultures in ED b4 abx administered
- abx timing (within 6 hrs of arrival)
- Abx selection
- adult smoking cessation advise
-influenza vax
260
What type of virus is Hep A
RNA
261
transmission route Hep A
Fecal/ oral
262
Primary modes of transmission for Hep A
Intimate contact
Poor hygiene
unsanitary conditions
contaminated food and water
263
People at risk for Hep A
Children
MSM
IV Drug users
Occupation (sewage)
travel
264
incubation for Hep A
15-50 days
265
typically hep a symptom for children under 6
asymptomatic
266
Typical symptom for adults and older children in prodromal phase
Fever
Ab discomfort
arthralgia
malaise
fatigue
nausea/ vomit
267
Hep A symptoms iciteric phase
jaundice
dark urine
pale stool
pruritis
268
Infection control for Hep A
Vax PEP within 2 weeks <40 years old
-IG within 2 weeks >40
- standard precautions
269
Best prevention Hep A
Childhood vax
Vax high risk adults
270
Type of virus Hep B
DNA virus
271
Transmission of Hep B
blood
sexual
perinatal
272
These fluids contain which type of Hep?
Blood
semen
vag secretions
saliva
tears
csf
ascites
serous fluids
Hep B
273
Incubation period for Hep B
60-150 days
274
How long before symptoms of hep B does the HbsAg, HBeAg, and HBV DNA start to convert to positive?
2-7 weeks
275
Symptoms of Hep B in young children
asymptomatic
276
Symptoms for adult prodromal acute infection with Hep B
uticarical rash
arthritis
fever
277
Symptoms acute HBV
Fever
fatigue
loss of appetite
nausea
vom
ab pain
dark urine
jaundice
278
How long does acute HBV last?
6 months
279
What labs are elevated during acute Hep B?
IgM
ALT/ AST
Bilirubin
280
What percentage of children with acute Hep B will develop chronic Hep B?
90%
281
What percentage of adults with acute Hep B will develop chronic Hep B?
5%
282
Outcomes chronic HBV
liver damage
cirrhosis
hepatocellular carcinoma
283
When does HBsAg appear? test results mean?
1-10 weeks after exposure
Pt has Hep B
284
What doe HBeAg test results mean?
patient is infectious
285
What does a positive HBV test mean?
patient is infectious
286
What does it mean if the HBsAg stays positive for 6+ months
Chronic case
287
What does it mean if the HBsAg is positive and the DNA and HBeAg are negative
The person is a carrier
288
What to do after HBV exposure
Test anti-HBC
if <10 miu/mL, single dose of HBIG + booster vax within 7 days
289
What to do for HBsAg+
check viral loads
>1000, no non-emergency exposure prone surgeries until viral loads decrease
290
Prevention hemodialysis hep b
Test patients total anti-HBC annually and revax if needed
- do not share med equip
- cleaning and disinfection
291
Partners and infants of HBV patient
should get HBIG
292
Most common Hepatits
Hep C
293
who is at highest risk for Hep C?
-Born 1945-1965
- IV drug users
- multiple sex partners
- HIV
- hemophiliacs with blood before 1987
- blood products before 1992
294
Transmission of Hep C
-Blood injection
- organ transplant
- transfusion HCV blood/ blood products
- sex (much less efficient)
295
How long is the incubation period for Hep C for blood products?
4 weeks
296
How long is the incubation period for Hep C
15-160 days
297
Acute symptoms of Hep C
Asymptomatic*
Fatigue
Ab Pain
Hepatomegaly
jaundice (25%)
298
How many individuals with acute Hep C will continue to have a chronic infcetion?
85%
299
Outcomes of chronic Hep C
Cirrhosis
Hepatic carcinoma
300
How long after exposure does anti-HCV become positive?
6-8 weeks
301
How long after exposure can the PCR for HCV show an infection?
1-2 weeks
302
Treatment for HCV
pegylated interferon +ribdavarin (PR)
protease inhibitors
303
Infection prevention for HCV
-Screen blood, organs and tissue
- counsel patients with HCV
- Needle exchange
304
What can inactivate HCV in blood products?
Heat
305
This is an RNA virus that requires a Hep B infection
Hep D
306
Where is Hep D prevalent?
Mediterranean- Italy
hemophiliacs
IV drug users
307
Transmission of Hep D
Percutaneous only
Not sex or perinatal
308
incubation period Hep D
30-180 days
309
Acute symptoms Hep D
Fever
Fatigue
Loss of appetite
Nausea
vom
ab pain
dark urine
jaundice
310
This is when Hep D infection occurs at the same time as a Hep B infection, which causes a slower moving pathogenesis
Coinfection
311
This is when a Hep D infection occurs after a Hep B infection, and causes a quickly moving infections with chronic symptoms in 1-2 years
Superinfection
312
Chronic symptoms Hep D
Cirrhosis
Hepatic carcinoma
313
This hepatitis causes high mortality in pregnant women
Hep E
314
This hepatitis is spread by the fecal oral route, but is not common in the US
Hep E
315
Which is more severe in the Iceteric phase- Hep A or Hep E?
Hep E
316
Precautions for Hep E
Standard precautions
