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Transcript
Gastrointestinal Infectious Diseases Staphylococcus aureus- (G+ cocci) Many strains are drug resistant (MRSA), most common nosocomial infection Disease: most common bacterial “food poisoning” Cramping, vomiting, diarrhea, nausea- 2 to 6 hour onset, 24 hour recovery Caused by heat-stable enterotoxins…(implications???) Transmission: typically meats, chicken, custards, cream pies (human nose/hands reservoir to oral entry) S. aureus can also causes: Localized skin infections- folliculitis, boils, carbuncles Systemic infections of organs- osteomyelitis Kidney, liver, spleen abscesses Endocarditis ETC… Clostridium perfringens- (G+ spore-forming bacilli) Disease: mild food poisoning symptoms (very common) 8-16 hours after ingestion Caused by an enterotoxin Transmission: oral entry of spore-contaminated meats and vegetables Clostridium botulinum- (human GI disease caused by 4 of 8 strains) Disease: double vision, dizziness, muscle paralysis, respiratory distress Cause- botulinum toxin (botox) interferes with neuromuscular junctions 70% mortality without supportive care, 10% with care Transmission: oral entry of spores on veggies, fruits, occasionally meats and fish and dairy Clostridium difficile- (normal flora of ~5% population) Disease: watery, foul diarrhea, sometimes bloody due to hemorrhaging of GI Caused by toxin release Overpopulation of C. difficile and toxin release occurs when enterics are destroyed by course of antibiotics (often in hospital patients) Transmission: oral-fecal, or normal flora Listeria monocytogenes- (G+ bacilli) Non-fastidious, resistant to heat, cold, pH extremes, salt Disease: mild food poisoning symptoms, sore throat Most harmful to pregnant women- spontaneous abortions Fetus- meningitis, CNS damage Transmission: typically dairy products, meats, poultry Salmonella enteritidis- (G- bacilli) several strains known to cause disease High quantity of inoculum Disease: 6-24 hour onset of vomiting, diarrhea, fluid loss lasting for 2-5 days Transmission: fecal contaminated food or water, primarily from reptiles and chickens (but found in most animals) Shigella sp.- (G- bacilli, several different species) Low quantity of inoculum Disease: Shigellosis- 2-3 day onset of watery or bloody diarrhea, Shiga toxin Transmission: human reservoir, fecal contaminated food or water (or anything else) Escherichia coli- (G- bacilli, over 150 known strains, most are normal flora of mammals) Only few strains pathogenic Disease: mild to severe hemorrhagic GI disease (leading cause of infantile diarrhea) Caused by variety of heat-stable and heat-labile toxins, attachment proteins for colonization. Over-stimulation of fluid secretion in to GI lumen Transmission: undercooked meats, unpasteurized milk, water (fecal-oral) Campylobacter jejuni- (G- vibrio) Becoming a very common GI pathogen Disease: mild to severe diarrhea, fever, abdominal pain…bloody stool due to intestinal perforation. 1 week to recovery. Caused by a heat-labile toxin Transmission: fecal material or contamination of water by cattle, chickens, turkey Rotavirus- (RNA naked virus) (most common gastroenteritis in infants and children worldwide) Disease: infects epithelia of small intestine to cause watery diarrhea…dehydration! Kills ~2 million children each year worldwide. Transmission: fecal contamination of water (virus pretty stable) Vaccine pulled from market in 1998, new vaccine re-introduced in 2005. Norovirus (aka Norwalk virus)- (RNA naked virus) (may cause as much as ½ the gastroenteritis cases in U.S.) Disease: 1-2 days nausea, vomiting, diarrhea Transmission: fecal contamination of water and food (particularly seafood) Giardia lamblia- (protozoan) Low quantity of inoculum, chlorine resistant Disease: 1-4 week incubation, 50% asymptomatic Sudden-onset of watery, smelly diarrhea, cramps, foul-smelling flatulence Transmission: fecal contaminated water (humans and other animals) Raw veggies and fruits Prevention and treatment: boil or filter water, quinacrine, metronidazole Cryptosporidium sp.- (protozoan) Low quantity of inoculum, chlorine resistant Disease: often asymptomatic, mild watery diarrhea Transmission: fecal contaminated water (various animals)