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watery, no inflammatory cells, blood
Clinical features of travelers enteric condition
thrombocytopenia
result of untreated hemolytic uremic syndrome characteerrized by low platelet levels
poor sanitation (fecal-oral trransmission)
key risk factor for Salmonella enterica serovar
Typhi
should not be treated with antibiotics due to release of toxins
what is important to note in the treatment of hemolytic urea syndrome
pseudomembrane colitis
caused by C. difficile enterotoxin, can occur after antibiotics, yellow pseudomembrane in the colon, symptoms include diarrhea, fever, and pain
abrasions, mucous membranes, or across placenta
how does syphilis spread
ETEC, EPEC, EAEC, vibrio cholerae, rotavirus, norovirus, adenovirus, giardia, cryptosporidium
Causative agents of travelers enteric condition
bloody stools mucousy from pus, hemolytic uremic syndrome
Clinical features of inflammatory enteric condition
H . pylori
strongest risk factor for gastric cancer if left untreated, second to smoking as defined cause of cancer
syphilis
what disease is gumma necrosis associated with
H. Pylori
what bacterial. species has been associated with chronic gastritis
EHEC, EIEC, shigella, campylobacter jejuni, non-typhi salmonella, entamoeba histolytica
Causative agents of inflammatory enteric condition
watery, inflammatory if due to C. difficile
Clinical features of abx-associated enteric condition
C. difficile
Causative agents of abs associated enteric condition
food poisoning, not contagious, short duration
Clinical features of intoxication enteric condition
S. aureus, B. cereus
Causative agents of intoxication enteric condition:
C. difficle
The main cause of healthcare-associated infections
intoxication (toxin-mediated)
Which enteric condition would antibiotics not be effective:
typhoid fever/enteric fever
Humans are the only reservoir for which disease:
enteric fever/ typhoid fever
prolonged fever, bowel perforation, meningitis osteomyelitis, septic arthritic, chronic carriage
fecal-oral route
How is typhoid fever transmitted
salmonella enterica typhi and para-typhi
Causative agents of typhoid fever/enteric fever
urease, vacA, cagA, modified LPS, mutated flagella
Virulence factors of H pylori
gastric-oral,oral-oral, and oral-fecal
Transmission modes of H, pylori
elevate gastric pH
Function of H. pylori urease
triggers reorganization of actin cytoskeleton in epithelial cells
Function of H. pylori CagA
apoptosis of gastric epithelial cells and induces inflammatory cytokines
Function of H pylori VacA
stool ag test, urea breath test, stool pcr, culturing biopsy
Diagnostic test for H. pylori
Haemophilus influenzae
normal flora of nasopharynx, associated with meningitis, pneumonia, and epiglottitis
Bordetella pertussis
Causative agent of whooping cough
Bordetella pertussis
pertussis toxin, inhibits ciliary function, disrupts cytokine production and neutrophil recruitment
Legionella pneumophilia
transmitted through water supply, legionnaires disease (atypical pneumonia), pontiac fever, no human-to-human transmission
Chlamydia pneumoniae
atypical pneumonia, most common in school age children
Mycoplasma pneumoniae
atypical pneumonia, mild illness, “walking pneumonia”
Typical pneumonia
pneumonia responsive to cell wall antibiotics, causative agents streptococcus pneumoniae and Haemophilus influenza, presents with severe acute infection
Atypical pneumonia
not responsive to penicillin, mild symptoms, causative agents mycoplasma pneumonia, legionella pneumophilia, chlamydia pneumoniae, subacute
mycoplasma pneumonia, legionella pneumophilia, chlamydia pneumoniae
Causative agents of atypical pneumonia
streptococcus pneumoniae and Haemophilus influenza
Causative agents of typical pneumonia
B-lactams
bactericidal cell wall membrane disruption agent
penecilins and cephalosporins
Examples of B lactams
macrolides, tetracyclines, clindamycin
Bactriostatic protein synthesis inhibition agents
trimethoprim/sulfamethoxazole, metronidazole
Bacteriocidal DNA/RNA function disruption agents
disrupt bacterial cell walls
What is the mechanism of action of cephalosporins
tetracyclines
What drug class does doxycycline belong to
lysis of bacterial cell walls
MOA of penicillin
penicillin
Drug of choice for strep pharyngitis, adverse drug reactions rare
lysis of bacterial cell walls
MOA of amoxicillin
amoxicillin
More stable than penicillin against b-lactamases, diarrhea most common ADR (adverse drug reaction)
binds bacterial 50s ribosomal subunit and inhibits protein synthesis
MOA of clindamycin
clindamycin
Most commonly used as an alternative to penicillin, C. diff associated diarrhea common ADR, serum conc. can be altered by other drugs,
destabilizes anaerobic cell DNA
MOA of metronidazole
metronidazole
reactions when taken with alcohol, ADR metallic taste, furry tongue, nausea, can use in tandem with other abx with strep and staph coverage
diarrhea
What is the most common adverse reaction for amoxicillin-clavulanates
stabilizes amoxicillin against b-lactamases
What does clavulanate do in amoxicillin-claculanate
limit uptake, inactivate drug, modify target, efflux pump
Mechanisms bacteria develop resistance
Limit uptake
bacterial resistance mechanism characterized by high lipid content restricts hydrophilic drug access, thickened cell wall limits access, reducing the number of membrane porin channels
inactivation
mechanism of bacterial resistance in which B-lactamases produced by gram-negative bacteria inactivate drug
Modifying drug target
mechanism of bacterial resistance characterized by alteration in structure or function of penicillin-binding proteins (PBPs), ribosomal mutation or subunit methylation, mutation in enzymes involved in folate biosynthesis
without clavulanate amoxicillin can be cleaeved by penicillinases
What is the benefit of adding clavulanate to amoxicillin
Intrinsic resistance
mechanism of antibiotic restistant in which mycoplasma do not have cell wall so are not inactivated by antibiotic that target cell wall
Acquired resistance
bacteria mutate or can transfer resistance between one another
mycobacteria,staph aureus, enterobacteriaceae
Examples of bacteria that limit uptake of an antibiotic
Type I drug hypersensitivity/Anaphylactic
IgE associated, decreased BP or difficulty breaething, hives, angioedema
Type II drug hypersensitivty/cytotoxic
IgM associated, decrease number of affected cells
Type III drug hypersensitivity/immune complex
IgG associated, Fever, arthrralgias, fatigue, rarsh in 25% of cases
Type IV drug hypersensitivity/cell-mediated
no atb, contact dermatitis, masculopapula rash, SCARs
Viral infection masquerading as allergic reaction to drug
Why are people often misdiagnosed as allergic to antibiotics
Chlamydia trachomatis
#1 sexually transmitted bacterial disease in north america
C. trachomatis, C. pneumoniae, C. psittaci
Important bacteria related to chlamydial diseases in humans
mucous membrane disease
Chlamydial disease caused by C. trachomatis
respiratory
Chlamydial disease caused by C. pneumoniae
psittacosis
Chlamydial disease from birds caused by C psittaci
Gonococcal stomatitis
usually asymptomatic infection that can spread by kissing an infected pearson as well as genital contact
pharyngitis, tonsillitis, fever,and swollen lymph nodes
Symptoms of gonococcal stomatitis
treponema pallidum
Causative agent of syphilis
stage of syphilis characteized by chancre lesion on male or female genitalia
Primary syphilis
Secondary syphilis
stage of sphilis with skin rash in palms and soles, mucous patches, condylomata lata
Tertiary syphilis
stage of syphilis characterized by gummatous lesions (gummas), cardiovascular syphilis, neurosyphilis
1-30 years
Latency time of syphilis
Gumma, luetic glossitis, painless swelling of parotid gland
Clinical manifestations of tertiary syphilis
hutchinson triad, rhagades, frontal bossing, short maxilla, perforated palate, saddle nose, mucous patches
Orofacial features of congenital syphilis
Deaf, Blind, malformed teeth
Hutchinsons triad
bartonella henselae
Causative agent of Cat Scratch Disease
Klebs-loeffler bacterium/corynebacterium
Causative agent of diphtheria
Diphtheria
heart develops conduction problems, palate can become paralyzed, diptheric membrane in throat can suffocate the patient
diarrhea caused by clostridiodes difficle
what is. a potential. concerning advrse reaction for a pateeint taking clindamycin
inhibits bacterial protein synthesis
what is the mechanism of action for clindamycin
penicillins
to which drug class does amoxicillin belong
sanford guide
which resource on the care provider toolkit would give information solely about infectious diseases and agents used to treat them
haemophilus influenzae
causative agent of otitis media (ear infection) among young children
EHEC, EIEC, shigella ect.
infection by which type of bacteria would lead to hemolytic uremic syndrome
purple ecchymosis,petechiae, gingivial hemorrhage
oral manifestations of hemolytic uremic syndrome (HUS) thrombocytopenia
legionella pneumophila, chlamydia pneumoniae, mycoplasma pneumonae
causitive agents of atypical pneumonia