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bacterial causes of gastroenteritis
GI
126
Medical
08/29/2010

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Term
what things are often found in a pts food consumption hx if subject to a foodborne illness?
Definition
raw/poorly cooked food, unpasteurized milk/juices, or home-canned food
Term
what clinical factors are important to examine in a pt with a hx/symptoms of foodborne illnesses?
Definition
incubation period, duration of illness, predominant symptoms (vomiting/diarrhea/fever?), and pt populations
Term
what social factors are important to examine in a pt with a hx/symptoms of foodborne illnesses?
Definition
pets/visits to a petting farm, daycare, travel, consumption of untreated water, and group picnics
Term
what should vomiting as a primary symptom in gastroenteritis lead a dr to consider?
Definition
enteric viral infection (in a day or so) or food poisoning due to preformed toxins (in a few hrs or so: *staph aureus enterotoxin or *bacillus cereus heat-stable enterotoxin)
Term
what should watery, noninflammatory diarrhea point a physician to in terms of a dx?
Definition
enteric viruses, ETEC (enterotoxigenic E coli), vibrio cholerae, and parasites (except entamoeba histolytica)
Term
what should persistent diarrhea point a physician to in terms of a dx?
Definition
parasitic infection
Term
what should inflammatory diarrhea point a physician to in terms of a dx?
Definition
shigella, campylobacter, salmonella, STEC (EHEC); EIEC, clostridium difficle, yersinia entercolitica, vibrio parahaemolyticus, and entamoeba histolytica (parasite)
Term
what are the most common bacterial causes of gastroenteritis in the US?
Definition
salmonella, campylobacter, and shigella (in order)
Term
what are the most common overall causes of gastroenteritis in the US (in order)?
Definition
calivirus (norovirus), salmonella, STEC, campylobacter, clostridium perfringens (preformed toxin), staph enterotoxin, shigella, and vibrio parahaemolyticus
Term
what characterizes diarrhea due to staph aureus food poisoning?
Definition
food is usually contaminated by a human carrier by *preformed toxin - doesn't taste contaminated, incubation period is 4 hrs, diarrhea is watery (not bloody), pts present with severe vomiting/abdominal pain/nausea/no fever for <24 hrs. often found in ham/poultry/potato or egg salad/mayonnaise/cream pastries - therefore often seen @ picnics
Term
what is the MOA of the staph aureus enterotoxin?
Definition
the staph aureus enterotoxin is a superantigen which *activates T cells, stimulating cytokine release, and *acts on neuronal receptors in the upper GI, stimulating the vomiting center in the brain. the staph aureus enterotoxin is *heat stabile (unlike the organism), and the organism need not be present to cause the disease.
Term
what is bacillus cerus?
Definition
a spore-forming gram positive bacillus (all spore-forming bacteria are gram positive, but the reverse is not always true)
Term
what are the 2 toxins produced by bacillus cereus?
Definition
a heat-stable and a heat-labile toxin
Term
what is the MOA of the *heat-stable enterotoxin produced by bacillus cereus?
Definition
unknown
Term
what is the MOA of the *heat-labile enterotoxin produced by bacillus cereus?
Definition
it resembles the heat-labile toxin of E. coli & vibrio cholerae and stimulates cAMP, resulting in *hypersecretion of water and electrolytes
Term
what characterizes the *heat-stable enterotoxin produced by bacillus cereus?
Definition
implicated food: rice. incubation hrs: ~2. symptoms: n/v, cramps. duration hrs: 8-10.
Term
what characterizes the *heat-labile enterotoxin produced by bacillus cereus?
Definition
implicated food: meat/veggies. incubation hrs: ~9. symptoms: diarrhea, nausea, cramps. duration hrs: 20-36.
Term
what characterizes the clostridium spp?
Definition
clostridium spp are an *anerobic, spore-forming bacillus and associated with many clinical diseases.
Term
what GI diseases are associated with clostridium spp?
Definition
antibx-associated diarrhea (C. difficile), food poisoning (C. perfringens)
Term
what characterizes food poisoning due to C. perfringes?
Definition
outbreaks usually involve *meat, *spores are heat resistant* (withstand initial cooking and revert to vegetative form if food is not refrigerated/rewarmed), and enterotoxin is *heat-labile (released after ingestion of organism/pre-formed in left-overs)
Term
what is the MOA for food poisoning due to C. perfringes? what part of the GI is most affected.
Definition
the enterotoxin alters membrane permeability, resulting in fluid secretion. the ileum is most severely involved.
Term
what characterizes food poisoning due to C. perfringens?
Definition
incubation in 8-24 hrs (longer than staph aureus toxin), nausea, abdominal pain, diarrhea (similar to bacillus cereus heat-labile toxin), no fever/rare vomiting, resolution in <24 hrs
Term
what characterizes vibrio spp?
Definition
gram negative (along w/campylobacter, does not belong to enterobacteriaceae), highly motile curved rods
Term
what do vibrio cholera subgroups O1 and O139 produce?
Definition
cholera toxin, which causes more severe gastroenteritis, however this is uncommon in the US
Term
what are the more common forms of vibrio seen in the US? where are they seen geographically?
Definition
V. parahaemolyticus, V. vulnificus (does not cause gastroenteritis) and nontoxigenic V. cholera. vibrio likes saltwater and therefore is seen mostly in the gulf of mexico and can contaminate shellfish/seafood
Term
is noncholera vibrio illness a notifiable disease?
Definition
no, only cholera
Term
what is gastroenteritis due to vibrio usually due to?
Definition
sewage contaminated water near costal waters - often associated with consumption of raw oysters/other shellfish
Term
how can vibrio parahaemolyticus outbreaks still occur in monitored coastal areas?
Definition
the organism multiplies rapidly and low levels can reach infectious levels if not handled properly.
Term
what characterizes gastroenteritis due specifically to vibrio parahaemolyticus?
Definition
gastroenteritis due specifically to vibrio parahaemolyticus is transmitted by eating undercooked seafood, has a 5-72 hr incubation period and produces watery diarrhea for 1-3 days (less severe than cholera, though bloody in severe cases). pts co-present with nausea, vomiting, low-grade fever, and headache.
Term
does V. parahaemolyticus produce enterotoxins?
Definition
this is unclear
Term
can V. parahaemolyticus infect wounds?
Definition
occasionally, though V. vulnificus (which does not cause GI disease) is usually more responsible for this kind of infection, and lead to systemic/life-threatening disease.
Term
what characterizes gastroenteritis due to nontoxigenic V. cholerae?
Definition
diarrhea due to nontoxigenic V. cholerae ranges from mild to severe watery and does not cause epidemics like V. cholera O1 or O139. nontoxigenic V. cholerae has also not been associated with wound infections.
Term
what is the MOA of the enterotoxin produced by V. cholera O1 or O139?
Definition
it is a typical exotoxin w/A (active) and B (binding) subunits. the toxin binds GM1 cells receptors, the A subunit gets into the cell and *activates adenylyl cylase to generate a lot of cAMP. the *cAMP then activates ion pumps, causing secretion of Na, Cl, K, and carbonate.

(same as the heat-labile enterotoxin produced by bacillus cereus as well as the labile E. coli toxin)
Term
what characterizes the enterobacteriaceae family?
Definition
enterobacteriaceae are a ubiquitous *gram negative bacilli which *ferment glucose and are oxidase negative. they are found as normal intestinal flora in humans/animals and can cause the following clinical diseases: sepsis, UTIs, and GI/pulmonary infections as either primary or opportunistic pathogens
Term
which members of the enterobacteriaceae family are associated with gastroenteritis?
Definition
escherichia, shigella, salmonella, and yersinia
Term
what is the serological classification of the enterobacteriaceae (and other gram negagive bacteria) based on?
Definition
O, H, or K antigens. O antigens are found on the end of LPS (lipopolysaccharide) endotoxins. H antigens have to do with flagella (implies motility). K antigenicity has to do with the capsule.
Term
what characterizes Escherichia coli?
Definition
nonpathogenic E. coli are normal flora of the GI tract and both pathogenic/nonpathogenic forms are lactose fermenters. specific O (somatic) and H (flagellar) antigens are associated with pathogenic E. coli. (O157:H7 is associated with E.coli causing hemolyticuremic syndrome (HUS))
Term
what are the virulence factors associated with E. coli?
Definition
*adhesins which allow organisms to attach to certain cells where they can do damage, examples are fimbriae, colonization factor antigens, intimin, and bundle forming pili. *enterotoxins including heat-labile toxin (LT), heat-stabile toxin (ST), and the shiga toxin (STEC).
Term
what pathogen is the leading cause of traveler's diarrhea?
Definition
enterotoxigenic E. coli
Term
what is the leading mode of transmission of enterotoxigenic E. coli?
Definition
contaminated drinking water, food washed w/contaminated water
Term
what types of enterotoxins are produced by enterotoxigenic E. coli?
Definition
heat-stable (STa & STb) and heat-labile (LT-I & LT-II)
Term
what is the MOA for enterotoxigenic E. coli enterotoxin LT-I?
Definition
ADP-ribosylates adenylate cyclase regulatory protein, increases cAMP, which alters electrolyte channels (same as cholera toxin, causes watery diarrhea)
Term
what is the MOA for enterotoxigenic E. coli enterotoxin STa?
Definition
same as cholera toxin/LT-I - but activates cGMP rather than cAMP. (leads to watery diarrhea)
Term
what is the MOA for enterotoxigenic E. coli enterotoxin STb?
Definition
STb increases intracellular Ca++, increases HCO3- secretion, and induces villous atrophy. (leads to watery diarrhea)
Term
what is the clinical disease associated w/enterotoxigenic E. coli?
Definition
non-inflammatory diarrhea, (watery - no blood/mucus), low-grade fever/nausea/abdominal cramping all of mild to moderate severity for 2-5 days
Term
what is the older name for shiga toxin-producing E. coli (STEC)?
Definition
enterohemorrhagic E. coli (EHEC)
Term
what is the most common subtype of shiga toxin-producing E. coli (STEC) in the US?
Definition
O157:H7 (though some non-O157 subtypes can express the shiga toxin)
Term
what is shiga toxin-producing E. coli (STEC) a common pathogen of?
Definition
livestock - often STEC infections will result from beef contaminated during slaughter or direct contact with animals
Term
what is the primary route of transmission for shiga toxin-producing E. coli (STEC)?
Definition
ground beef, unpasteurized milk/juice, and spinach/lettuce (prob due to contaminated irrigation water)
Term
what forms of the shiga toxin are produced by shiga toxin-producing E. coli (STEC)?
Definition
Stx-1 and Stx-2 (one or both may be produced)
Term
what is the effect of intimin production by shiga toxin-producing E. coli (STEC)?
Definition
intimin is responsible for attachment/effacement lesions and destruction of microvilli (more invasive)
Term
what is the MOA for the shiga toxin as produced by STEC?
Definition
the A subunit enters the cell and A1 cleaves the 28s rRNA in the 60S ribosomal subunit, preventing binding of tRNA to the ribosome - *disrupting protein synthesis. the B subunit binds globotriasosylceramide receptors on intestinal/renal epithelium (*potential hemolytic uremic syndrome*). (1 A and 5 B subunits total).
Term
what characterizes the clinical disease associated with shiga toxin-producing E. coli (STEC)?
Definition
after a 3-4 day incubation period, watery diarrhea starts, initially mimicking ETEC infection. however, w/in 2 days the diarrhea becomes bloody (though not many WBCs unlike shigella) and is accompanied by severe abdominal pain/sometimes vomiting. severity of disease ranges from mild to hemorrhagic colitis and is usually self-limiting between 4-10 days.
Term
what is hemolytic uremic syndrome (HUS)?
Definition
HUS can be caused by STEC, more commonly in younger children and characterized by renal failure/thrombocytopenia/hemolytic anemia and has a mortality rate of 3-5% and a sequelae (renal impairment/HTN) rate of 30%. HUS occurs when STEC toxin enters the bloodstream, attaches to glomerular endothelium (blood vessel cell lining of kidney), causing damage to blood vessels (not just in the kidneys but in all tissues of the body), and initiates a non-inflammatory reaction leading to acute renal failure (ARF) and platelet activation that causes thrombocytopenia (low platelet count).
Term
what is often the mechanism for STEC/HUS outbreaks in petting zoos & raw milk?
Definition
fecal isolates of STEC match those found on animals in zoos and in raw mild, implying inadequate washing
Term
what characterizes enteroinvasive E. coli?
Definition
enteroinvasive E. coli is more invasive, causing inflammatory diarrhea. it is transmitted via contaminated food/water and is less common in the US. enteroinvasive E. coli resembles Shigella in that it is non-motile, ferments lactose slowly (shigella does not ferment lactose), and can cross react with shigella antiserum.
Term
what characterizes clinical disease due to enteroinvasive E. coli?
Definition
enteroinvasive E. coli invades cells and spreads, leading to cell death/sloughing/inflammatory response. it starts as watery diarrhea and becomes dysenteric (mucus in stool/lots of fecal WBCs) and is associated with fever/cramping
Term
what characterizes enteropathogenic E. coli?
Definition
enteropathogenic E. coli often causes infant diarrhea in developing countries which is non-inflammatory, watery, and associated with possible vomiting.
Term
what is the pathogenesis of enteropathogenic E. coli?
Definition
like w/STEC, enteropathogenic E. coli cause attachment/effacement lesions by initially attaching via bundle forming pili and more securely via intimin receptors. enteropathogenic E. coli modify the cytoskeleton to form pedestals and disrupt the microvilli (leading to impaired absorption, though no invasion)
Term
what characterizes enteroaggregative E.coli?
Definition
enteroaggregative E.coli can cause protracted diarrhea in children/infants for >14 days in developing countries. enteroaggregative E.coli attaches via fimbria (no A/E lesions), stimulates mucin production, forms a biofilm, and causes watery to mucoid diarrhea. vomiting is rare.
Term
what characterizes the shigella spp?
Definition
shigella spp are non-motile, non-lactose fermenting bacteria which can either cause dysentery or watery diarrhea. S. sonnei is the most common in the US and causes watery diarrhea (as does S. boydii), while S. dysenteria/S. flexerni cause dysentery, but are not generally found in the US
Term
what is the most common mode of transmission for shigella spp in the US?
Definition
*person-person, as it only requires a low infectious dose and can be spread via contaminated food/water and has no animal reservoir
Term
what is the pathogenesis of gastroenteritis due to shigella?
Definition
shigella spp invade the *intestinal mucosa (M cells) and the bacteria express proteins that then enable *spread to enterocytes via induction of phagocytosis, phagolysosome escape, and mediation of cellular actin rearrangement (formation of actin tails propel bacteria into adjacent cells).
Term
what about shigella spp contributes the most to the severity of the disease they cause?
Definition
the shiga toxin, of which S. dysenteria type I is the most potent producer. the shiga toxin is capable of causing HUS (same as STEC).
Term
can shigella produce enterotoxin along with shiga toxin?
Definition
yes, shigella spp can produce enterotoxins which cause watery diarrhea.
Term
why do shigella spp infection sometimes result in abscesses, ulcer, and inflammatory reactions?
Definition
b/c shigella spp invade enterocytes
Term
how is dysentery typically spread? who does it typically affect?
Definition
dysentery typically spreads person-person via the fecal/oral route, and is less commonly spread via contaminated food. usually children <15 are infected.
Term
after an incubation period of 1-3 days, how does dysentery present initially?
Definition
usually initially as watery diarrhea (prob due to enterotoxin production)
Term
what is the definition of dysentery? how does it present?
Definition
dysentery = inflammatory colitis and bloody diarrhea involving of small stools with mucus and tenesmus (painful straining to pass stools). cramping, fever, and pain in the lower abdomen are common co-presentations and there may be pseudomembrane formation (sloughed off epithelial cells, bacterial, fibrin, and inflammatory cells)
Term
how does the incidence of shigella-induced gastroenteritis compare to that of salmonella or campylobacter?
Definition
shigella-induced gastroenteritis is common, but less so than campylobacter and salmonella
Term
after norovirus, what is the next most common cause of gastroenteritis?
Definition
salmonella
Term
what is the single spp of salmonella called? what is the classification w/in this spp?
Definition
salmonella enterica which is then broken down into serotypes, such as typhimurium and enteritidis, which are the most commonly seen in the US. (for ex. these serotypes are written as S. typhimurium - not in italics)
Term
what is salmonella arizonae?
Definition
a serotype of salmonella associated with reptiles
Term
what are the 2 most common serotypes of enteritis (diarrhea) producing salmonella in the US?
Definition
S. enteritidis and S. typhimurium
Term
what serotypes of salmonella can produce enteric (typhoid) fever, a systemic disease?
Definition
S. typhi and S. paratyphi
Term
what is the most common route of salmonella transmission?
Definition
exposure to undercooked chicken or eggs, as seen in food prepared in advance and poorly refrigerated. exposure to turtle/rodents also possible routes of transmission.
Term
why has it been illegal to sell small turtles as pets since 1975?
Definition
this was done in an attempt to cut down on rate of salmonella transmission via turtle contact, however attempts to treat turtles, their eggs, and breeding grounds w/antibx to eliminate salmonella have not been successful and have resulted in a high prevalence of antibx resistance
Term
what was learned about salmonella in the 2009 outbreak?
Definition
salmonella can persist in high-fat and low water food and withstand temperatures as high as 194 F (90 C) for 50 min – can be very difficult to inactivate
Term
what is significant about the alfalfa salmonella outbreak?
Definition
all alfalfa sprouts infected were traced back to a single seed grower
Term
what is the pathogenesis of salmonella-induced gastroenteritis?
Definition
the enterotoxin activates cAMP, leading to watery diarrhea (like cholera), and its adhesin also disrupts the membrane, "ruffling" it, triggering its own phagocytosis. once salmonella is intracellular, it can travel from cell to cell (apical -> basolateral surface) and cause an inflammatory response, it may even invade the bloodstream and produce a systemic response (enteric/typhoid fever - not all salmonella can do this)
Term
how does gastroenteritis due to salmonella typically present?
Definition
after a 24-48 hr incubation period, n/v, abdominal cramps, and diarrhea (predominant symptom - starts watery, can become hemorrhagic/dysenteric). self-resolution occurs w/in a week.
Term
what characterizes enteric/typhoid fever as caused by salmonella? where are endemic areas for salmonella capable of causing enteric fever?
Definition
the reservoirs are gall bladders of chronic carriers, and from there, salmonella can be transmitted in a water supply contaminated with sewage. endemic areas include latin america, asia, and india.
Term
what characterizes the yersinia spp?
Definition
yersinia are bipolar staining coccobacilli which are animal pathogens presumably transmitted to humans via consumption of contaminated food or water. Y. pestis is the best known as it causes plague, but the enteric spp are *Y. enterocoltica and Y. pseudotuberculosis*
Term
what is the pathogenesis of gastroenteritis due to yersinia spp?
Definition
yersina invade the M cells of peyer's patch and can also replicate within the RES. virulence factors trigger *cytotoxic events and *impair PMN & macrophage activity (damages peyer's patches and mesenteric lymph nodes).
Term
what does gastroenteritis due to yersinia spp mimic? beyond that, what are other presentations of pts w/enteric yersina spp infections?
Definition
yersinia spp infections can mimic appendicitis (fever, abdominal pain, mesenteric lymphadenitis). gastroenteritis due to yersinia also may include diarrhea, and enteric fever - polyarthritic syndrome. the infection is eventually self-limiting.
Term
what is the major cause of inflammatory diarrhea in the US?
Definition
campylobacter spp
Term
how do campylobacter spp appear morphologically?
Definition
curved, gram negative rods (though not a part of enterobacteriaceae) that resemble vibrio
Term
what is the most common campylobacter spp?
Definition
C. jejuni
Term
where are campylobacter spp found? what is the route of transmission?
Definition
campylobacter is normal flora of the GI & GU tracts in animals and is transmitted via contaminated food/water. undercooked chicken is the most common source - also unpasteurized milk.
Term
what characterizes clinical disease due to campylobacter spp?
Definition
dysenteric stools are common (invasive, triggers inflammatory response), fever, lower abdominal pain, all lasting for ~1 week.
Term
what syndrome is campylobacter jejuni infection associated with?
Definition
guillain-barre syndrome, which is an autoimmune acute demyelinating syndrome often preceded by an infection due to the antibody induced by ganglioside-like structures in the campylobacter LPS core
Term
what kind of disease is gastroenteritis due to clostridium difficile?
Definition
gastroenteritis due to clostridium difficile is antibx-associated, as it can be normal intestinal flora/nosocomia - but when pts are on antibx, C. diff can take over the intestine completely.
Term
what characterizes the gastroenteritis due to clostridium difficile?
Definition
gastroenteritis due to C. diff can either be simply self-limited diarrhea or can progress to pseudomembranous colitis (fibrin, mucus, inflammatory cells) in more serious cases.
Term
what are virulence factors for C. diff?
Definition
toxin A - enterotoxin and toxin B - cytotoxin
Term
what characterizes helicobacter spp as a cause of gastroenteritis in humans?
Definition
helicobacter pylori is the human pathogen, and resembles campylobacter (gram negative, curved rods)
Term
what virulence factors does helicobacter possess?
Definition
*urease (allows persistence at low pH, useful in dx of H. pylori), *vacuolating cytotoxin (VacA) which induces apoptosis, and the *Cag protein which reorganizes actin (activates multiple celluar proteins)
Term
what is the presumed route of transmission for H. pylori?
Definition
person-person, fecal-oral
Term
what is the most common bacterial cause of gastritis, gastric ulcers, and duodenal ulcers?
Definition
H. pylori
Term
how does H. pylori colonization change as pts age?
Definition
colonization increases with age and can persist for years, possibly for life
Term
what other diseases are H. pylori linked to?
Definition
gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphomas
Term
how does H. pylori utilize its virulence factors?
Definition
low pH avoidance in the stomach is accomplished via: good motility allowing the organism to get below the mucus layer and urease activity which produces ammonia (*neutralizes microenvironment). surface proteins also mediate adherence to epithelial cells and NAP (neutrophil activating protein), urease, VacA, and Cag protein all have toxic activity.
Term
what characterizes gastritis due to H. pylori?
Definition
the infection is limited to stomach mucosa, an inflammatory response is induced (abcesses & ulcers), and the pt may be asymptomatic for decades. clinically, pts will present with pain in the upper abdoment, n/v.
Term
what are complications associated w/H. pylori mediated gastritis?
Definition
perforation of ulcers - leading to internal bleeding and peritonitis
Term
how are H. pylori infections diagnosed?
Definition
endoscopic examinations can yield a bx/cx of gastric mucosa, upon which urease tests are performed. the urea breath test can also performed, where pts ingest 13C or 14C-urea, and if urease-equipped H. pylori are in the stomach, that labeled CO2 will be exhaled
Term
what is the fecal leukocyte test?
Definition
this is done to test for WBCs to determine if the diarrhea is inflammatory. it consists of a *methylene blue stain and requires a fresh stool sample for wet mount
Term
what is the lactoferrin stool sample test?
Definition
more sensitive than a fecal leukocyte test, this tests for the iron-binding glycoproteins (lactoferrin) present in PMNs to determine whether the diarrhea is inflammatory. it is available commercially as a latex agglutination test for convenience.
Term
what test is appropriate for diagnosing pts with persistent diarrhea?
Definition
ova & parasite (O&P) test - needs to be performed ~3x consecutively
Term
what bacteria are tested for in a routine stool cx?
Definition
C. jejuni, salmonella spp, shigella spp, and perhaps vibrio (along coastal areas) are tested for in routine stool cxs. vibrio cholera and STEC (culture and/or toxin) tests can be requested.
Term
if a pt has been on antibx, what is an important bacteria to look for in their stool?
Definition
C. diff and/or its toxin
Term
what can the macconkey agar be used to differentiate?
Definition
between lactose fermenters and non-lactose fermenters. E. coli is a lactose fermenter, but many other GI pathogens are not.
Term
what is an important application of the sorbitol macconkey agar test?
Definition
screening for E. coli O157, an enterohemorrhagic non sorbitol fermenter, which will appear clear while other fermenters will appear pink.
Term
what is hekton enteric agar (HE agar) selective for?
Definition
shigella or salmonella
Term
what is the cefoperazone-vancomycin-amphotericin B agar (campy CBA) agar selective for?
Definition
campylobacter
Term
what is the thiosulfate-citrate-bile salts-sucrose (TBCS) agar selective for?
Definition
vibrio - likes bile salts
Term
if a sorbitol macconkey test is positive (indicating presence of E. coli 0157), what should also then be tested for?
Definition
the shiga toxin, either stx1 or stx2 via EIA or PCR
Term
what are the CDC recommendations for identifying STEC?
Definition
include STEC O157 in routine enteric bacterial panels, screen stool samples for Stx (via EIA or PCR), cx simultaneously or cx Stx-positive samples, if Stx-positive broth is negative for STEC 0157 - send to public health lab for identification of non-O157 STEC
Term
what route of transmission is rotavirus more associated with?
Definition
person-person
Term
what route of transmission is norovirus more associated with?
Definition
food contamination
Term
what route of transmission is ETEC more associated with?
Definition
travel
Term
what route of transmission is vibrio more associated with?
Definition
coastal areas, shellfish
Term
what route of transmission is C. jejuni more associated with?
Definition
contaminated poultry/water/milke - big in the US
Term
what route of transmission is STEC more associated with?
Definition
undercooked meat, spinach/lettuce
Term
what route of transmission is C. diff more associated with?
Definition
immunocomprimised/heavy antibx load
Term
what route of transmission is salmonella more associated with?
Definition
meat/eggs/dairy/reptiles
Term
what route of transmission is shigella more associated with?
Definition
contaminated food, water, daycare/travel
Term
what route of transmission is yersinia more associated with?
Definition
contaminated pork/tofu/raw milk