Stomach Infections Flashcards
(29 cards)
Difference between a microbiome and microbiota
Microbiome = refers to all the genome within the gut environment
Microbiota = refers to the organisms within the gut environment
What are some functions of gut microbiota?
- pathogen inhibition
- immune protection
- nutrient metabolism (Vitamins B +K)
- Drug metabolism
- Gut Brain axis
What is the significance of mode of delivery and early life diet on microbiota?
If you are born vaginally = colonises different bacteria e.g. lactobacillus or prevotella
If you are born C-section =
Colonises staphylococcus, corynebacterium
Formula milk also colonises different bacteria e.g. C.difficile
How do you approach taking a history from someone with a GI infection?
Presenting complaint
- Diarrhoea (onset, duration, frequency, consistency )
- Vomiting (onset, frequency)
- Pain (site, does it radiate, intermittent)
PMH
-immunodeficiency?
TRAVEL HISTORY (very important)
- where
- activities
- food and drink
- companions?
Drug history
- laxatives
- PPIs
Social occupation
- occupation (risk of others?)
Different investigations of stool sample
- Stool culture
- use selective anger - prevents normal bacteria growing
—e.g. E.coli, salmonella, shigella - Enzyme immunoassay
- C. Difficile - PCR (only do if need to test for specific bacteria - can only do one at a time)
- norovirus, clostridioiles - Microscopy (only do if travel history)
Difference between watery and inflammatory diarrhoea
Watery
- small bowel origin
- large volume
- accompanied w/ bloating
Inflammatory
- invasive bacterial infections
- smaller volume
- pain when opening bowels
- blood can be present
Salmonella types and features
Broad range of infections
- gastroenteritis, enteric fever, endovascular infections
Divided into typhoidal (enteric fever) or non-typhoidal——
Non
- 8-72 hours incubation period
- faecal-oral, food, animals
Salmonella symptoms, complications and treatment
Symptoms
- Diarrhoea (inflammatory)
- nausea/vomiting
- ab. Cramps
Complications
- abscesses
- septic arthritis
- bacteraemia
Treatment
- Ciprofloxacin
- Ceftriazone
- Azithromycin
Campylobacter general features
- incubation period - 3 days
- transmission = food, water, animals
Campylobacter two types of bacteria that cause infection
Found in GI tract of animals
- campylobacter jejuni
- campylobacter coli
Campylobacter treatment, complications and symptoms
Symptoms
- ab. Cramps
- diarrhoea (inflammatory)
- fever/malaise
- bacteraemia
Treatment (usually self limiting - might need antibiotics if immunocompromised
- macrolides
- fluroquinolones
Complications
- reactive arthritis
- Guillain-Barré syndrome (ascending paralysis)
Shigella general features
Incubation period = 1-7 days
Transmission
- deacon-oral, food water, person to person
General bacteria’s of shigella
Shigella dysenteriae
Shigella flexneri
-can cause bloody diarrhoea
Shigella symptoms, treatment, complications
Symptoms
- fevers, frequent low vol, bloody stools (inflammatory)
- tenesmus
—————NO nausea
Treatment (in immunosuppressive host)
- ciprofloaxin
- ceftriazone
Complications Systemic - seizures (in children) - reactive arthritis - Haemolytic uraemia syndrome
intestinal
- rectal prolapse
- perforation
- obstruction
Type of E.coli causing diarrhoea
STEC - El.coli O157
E.coli features, symptoms, what makes it worse, at risk patients
Incubation period
- 1-10 days
At risk
- children
- Elderly
Symptoms
- painful bloody stools (inflammatory)
- NO fever
- HUS (haemolytic uraemic syndrome)
WORSENED BY ANTIBIOTICS
What is HUS (haemolytic uraemic syndrome)characterised by?
- non-immune mediated haemolytic anaemia
- thrombocytopenia
- acute kidney injury (RBC lysed by toxin, tiny clots form, blocks renal vessels)
C. Difficile general features
Anaerobes -ve
Faecal-oral route
- ANTIBIOTICS disrupt normal flora of gut
Produces spores - very resistance - remain in environment for long time (to killed with hand gel)
C. Difficile risk factors, complications, treatments, what is it the main cause of?
Main cause of antibiotics associated colitis
Risk factors
- old
- antibiotic therapy
- PPI
- hospitalisation
Complications
- toxic mega colon colitis
- perforation
Treatment
- oral vancomycin (stays in gut)
- metronidazole
Norovirus
Symptoms
- diarrhoea (watery) - vomiting
Faeco-oral, direct contact, aerosols
Incubation = 12-48 hrs
Self limiting - resolve in 1-2 days
Highly infectious - causes outbreaks
Rotavirus
Decreased incidence since vaccine
Incubation period = <48hrs
- diarrhoea (watery)
- vomiting
- fever
Supportive treatment
Complications
- seizures
- encephalopathy
What is an important cause of gastroenteritis in young children?
Rotavirus
Cryptosporidium bacteria and type of parasite
I.C. Protozoan parasite
Cryptosporidium parvum
Cryptosporidium
Water associated outbreaks (can last for months and not killed by chlorine)
Cattle transmission
Self limiting
- chronic illness in immunocompromised patients
Incubation period = 7-10 days
Treatment
- nitazoxanide
