Gastrointestinal Infections Flashcards
What toxins can affect the GI tract?
- Chemical
- Bacteria
- Viruses
- Protozoa
- Roundworms (nematodes)
- Tapeworm (cestodes)
- Flukes (tremtodes)
What defences does the GI system have against toxins?
- sight, smell, memory
- saliva: antibacterial enzymes
- gastric acid
- commensal bacteria
- colonic mucous
- bile in duodenum
- anaerobic environment: small bowel + colon
Benefits of gut micro biome
- outcompete harmful bacteria for nutrients
- produces antimicrobial substances
- helps develop newborn immune system
- produce certain nutrients e.g. vitamin K
What do bacteria in colon produce?
Short chain fatty acids
e.g. acetate, propionate, butyrate
Function of the SCFAs produced by the bacteria in colon
- Butyrate: energy source of coloncytes + helps regulate gut environment
- Acetate: helps reduce satiety
- propionate: reduces serum cholesterol
CHECK may not be right
What health conditions can decrease the diversity of the gut microbiome?
Obesity
Inflammatory bowel disease
What is faecal microbiota transplant?
Therapeutic procedure in which you transfer healthy donor fences into GI tract of another to restore a balanced gut microbiome.
Route of administration in faecal microbiota transplant
- nasoduodenal tubes
- upper GI endoscopy
- colonoscopy
- caecum >distributed throughout length of colon
What condition has been treated with faecal microbiota transplant effectively?
Clostridioides difficile infection
What is the criteria for selecting donors for faecal microbiota transplantation?
- 10-25 year olds
- not used antibiotics, laxatives or diet pills in last 3 months
- have no GI disease
- screen for hepatitis, HIV, inflammatory markers
What is dysbiosis?
Imbalanced gut microbiome
How can different diet choices affect gut microbiota?
- high fibre: increases health
- gluten free diet in those without coeliac disease: lowers number of key species
- sweeteners: disrupt diversity
- prebiotics: food for microbiota (good)
Name bacterial infections of the gut + their gram stain
gram negative bacilli:
- salmonella
- campylobacter
- shigella
- enterotoxigenic E. coli
gram positive
- Clostridioides difficile
Gram stain of salmonella bacteria
Gram negative bacilli
Symptoms of salmonella
- Nausea
- Vomiting
- Non bloody diarrhoea
- Fever
- Abdominal cramping
How is salmonella spread?
Ingesting contaminated food + water
Outline a salmonella infection inside the gut
- salmonella endocytosed into enterocytes
- move to submucosa > taken up by macrophages
- macrophages transfer salmonella to reticuloendothelial system
- multiple inside cells
- causes lymphoid hyperplasia + hypertrophy
- re enter gut from liver
Gram stain of campylobacter
Gram negative bacilli
S shaped
How is campylobacter spread?
Via faeco-oral route
Eating poultry
Treatment of salmonella
Self limiting in 2-3 days
Fluids
Symptoms of campylobacter infection
- fever
- abdominal cramping
- profuse diarrhoea (can be bloody)
Treatment of campylobacter infection
- Self limiting (few days - weeks)
- Fluid/electrolyte replacement
- antibiotics if bloody diarrhoea
What infection is associated with eating poultry?
Campylobacter
(Salmonella)
Why do you get profuse diarrhoea in campylobacter infection?
Releases a cytotoxin
(Similar to cholera)
What does a shigella infection cause?
Shigellosis
Gram stain of shigella
Gram negative bacilli
How is shigella spread?
From infected stools
Person to person
Often spread between family members
Symptoms of shigella infection
Bloody diarrhoea with mucous
Abdominal cramping