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54 Cards in this Set
- Front
- Back
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tell me about shigella, |
HUman only LOW dose required
Cholera was NOT person to person and needs a HIGH dose |
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what is one of the most infectious enteric pathogens
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shigella
occurs in places that are clean and have good sanitation. contrast to cholera which was common when sanitation was poor |
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where do shigella live? what is the incubation time? what is disease presentation?>
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intracellular, lived in large intestine and causes inflammation
72 hours moderate diarrhea to severe dysentary (blood and mucous in poo) |
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when do you have mucous and blood in the stool?
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in shigella that has progressed to a severe dynetary
*recall the bug lives in the large bowel and causes inflammation |
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what is the seasonality of shigells
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ehh, kinda stable
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what does shigella loos like
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gram - rod
non spore anerobe non motile WONT FERMENT LACTOSE, e coli the other gram - rod but it will ferment lactose |
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what seperates shigella from the other gram - rods (e coli for instance)
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shigellea ferment lactose
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what virulence is assoicated with shigella
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enterotoxin, watery disrrhea
O toxin: indice endocytosis into follocal associated M cells Actin Binding: lets shigella move btwn cells Shiga Toxin: disrupts protein synthesis |
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what does surface O AG do in shigella
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induces endocytosis into M cells, the shigella then lyse phagolysosome and escapes into the cytoplasm
**inflammatory response then Actin binding protein lets it move from cell to cell- adheres to actin and forces polymerization |
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what toxin associatd wtih shigella inhibits protein synthesis
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sjiga toxin
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how do we dx shigella
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in any pt with FEVER nad diarrhea
acute onset diarrhea and mucous will see PMN and RBC in poo sample Dont tx with AB be we dont want to lyse the cells and release all of the toxins recall humans are hte only resevoire |
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how do we culture shigella
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wont ferment lactose, seperate from E coli
*plate it fast bc other bugs will over grow it and make acid that kills it **you will have blood tinged mucous Shigella Salmonella Agar- selective agar, are white when they wont ferment lactose humans are the only resevoire, SUPER infectious. |
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how can we ID shigella on culture and tell it apart form e coli
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shigells wont ferment lactose so is white
e coli ferments shigell adn is red humans are hte only resevoir |
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how is shigella treated
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self limited
tx with fluids AB can shorten BUT... can provoke hemolytic urea |
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whats reiter syndrom
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urethritis, polyarthritis, conjunctivitis
**assoicated with shigella **HLA B27 males its common |
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does bacteremia occur with shigella infection
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not really
but can have long term complication- Reiters syndrome (urethra, eye, joint) more common in HLA B27 males |
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what HAL marker is common with Reiters (urethritis, joints, eye )
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HLA B27
Associated with shigella |
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whats hemolytic uremic syndrome, what bug
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shigella, can be provoked by AB use
**S dysteneriae, type I infection with toxin production *acute renal failure with poor prognosis |
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who/what is the SOLE resevoir for shigella
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HUMANS
person to person, small dose required. can be food, water, flies |
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okay so there was a graph with the seasonality of shigella but later it said what...
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increased in summer BUT NOT AS MUCH AS salmonella
*shigella easily penetrates toilet paper adnd is found around the toilet of ppl who are infected **highly infectious, humans are hte only resevoir |
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what are 3 common complications with shigella
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1. Reiters: urethritis, arthritis, eye. HLA B27
2. Hemolytic Uremic Syndrome: shigella toxin production, acute renal failure and poor prognosis 3. Autoimmune Disease: plastid endoded AG with host myosin |
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what disease is SOLE person to person and has a really low infectious dose. Fecal to oral transmission and has a slight increase in summer
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shigella
common in kids 1-4 |
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what are the serotypes of shigella, what are the common ones in IS
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1A B C D
S flexneri (gay males) , S sonneiv(kids) |
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whats the best way to decrease shigella
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well its fecal oral person to person with low dose
**handwashing!!! common in kids 1-4 |
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is salmonella common
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OH YA, normal flora in humans AND animals (shigella was only humans)
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what are the 4 types of shigella infection
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1. Gastroenteritis
2. Bacteremia (NOT seen in shigella) w/o GI sx 3. Enteric Fever: S typhi (recall shigella had a fever) 4. Carrier state |
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whats the onset of salmonella
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12-48 hr incubation
sudden onset! fever, chills, cramps, diarrhea, vomit lasts 2-3 days |
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who gets salmonella anyway (2-3 day infectin, human AND aminal resevoir)
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young old AIDS, DM, Cancer, ppl on AB
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ok so shigella is gram - rod, non spore, aneobe, motile nad a lactose non fermenter. what about salmonella
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the same
**key is to know that shigella and salmonella wont ferment lactose and E coli will |
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ok so the nomenclature of salmonella is wacky, what are hte 3 types
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1. S typhi
2. S typhimurium 3. S Enteridis thses are SEROTYPES, NOT species |
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does shigella or salmonella create H2S
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salmonella
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who has enterotoxin shigella or salmonella
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shigella- causes watery diarrhea that preceeds dysentey
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which virus busts out of the phagolysosome, what about the one that stays in
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busts out- shigella
stays in- salmonella |
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what are the virulence factors with salmonella
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1. Enterotoxin
2. mucosal invasion- can enter BOTH M and epithelium (shigella was just M cells) 3. LPS- endotoxic shock, systemic disease can just hang in the phagolysomeom, wont bust it also Resistance to killing, acid resistant, phoPQ controlled genes for phago survival |
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how is salmonella dx
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lots of macro nad PMN in the pooand leukocytes
will ahve blood if there is a fever also LACTOSE NON FERMENTER, cells will be white do serological tests |
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what is the tx for salmonella
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supportive
maintain fluids/electrolytes AB not rewuired |
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what disease is common in developed countries bc we want fresh fruits and veggies but ppl handle food wring
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salmonella
animal resevoire- chicken and pork and eggs. also pets and now tomatoes bc |
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which needs a high dose, low
shigella salmonella |
shigells0 low
salmonella - HIGH |
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ok so a high dose of salmonella is required and is common in the midhandling of fresh veggies. who needs a smaller inoculum
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babies, higher incidence in kids 6 mo to 5 years
INCREAED IN FALL- can be a carrier for a long time |
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which really spikes in summer, shigella or salmonella
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salmonella- picnic food
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how can salmonella (its on the rise) be prevented
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handle food better
change what we wont (no fruits and veggies!) dont feed animals other dead animals |
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can you give AB just to make pigs frow
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nope
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Demand for fresh fruits and vegetables increases risks of
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salmonella
tomatoe, alfalfa, peppers, frozen foods, frozed rodents (for your pet snake) EGGS- ONE source can infection 500 mil eggs clinical labs |
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were there salmonella outbreaks in labs?
what about in homes |
oh ya
oh ya, pets, foods, etc. no pets for immunocomprimised ppl or old ppl |
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what bug was planted in salad bars by the cult
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salmonella
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what diesase did mary mellen spread
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salmonella thyphi
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whats oxidase +
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vibrio
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what turns pink bc it ferments lacktose, what wont
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E coli- Pink
Shagella/Salmonella- no pink |
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what bug makes H2S
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Salmonella typhi
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what ferments lactose
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shigella salmonella
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what happens to E coli, shigella and salmonella typhi on TSI
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E Coli- yellow, gas shoves agar up
Shigella- pink and yellow S typho- black |
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is proteus mobile
is salmonella is shigella |
YES
YES NO |
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what does urease
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proteus, turn pink
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if you have salmonella with Fe what happnes
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black pigment
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