Gastrointestinal Infections & Food Poisoning: MLAB 2434 - Microbiology
Gastrointestinal Infections & Food Poisoning: MLAB 2434 - Microbiology
Gastrointestinal Infections & Food Poisoning: MLAB 2434 - Microbiology
General Concepts
Anatomy of GI Tract
Organisms must be able to survive
gastric acids in order to reach the
small bowel
In small bowel, motility (peristalsis)
is major host defense. Organisms
can not adhere to intestinal wall
Generally, a large dose of organisms
is needed to cause disease
Normal GI Flora
produces IgA
Pathogens would have to compete with
normal flora
Risk Factors
Achlorhydria
Inadequate
stomach acidity
of antibiotics
Diagnosing Cause of
Diarrhea
History
Travel to endemic areas of world
Recreational activities
Exposure to ill patients
Food
Detailed history of food eaten 3 days
prior to onset of symptoms
Diagnosing Cause of
Diarrhea
Physical Exam
Dehydration
Toxic megacolon
Increase in heart rate or decrease in blood
pressure after standing upright
Laboratory Diagnosis
CBC
Fecal WBC
Stool Culture
O &P
Electrolyte panel
Enterotoxin-Mediated
Diarrhea
Symptoms
Rapid
onset of diarrhea
fever
Absence of blood or pus
Point to enterotoxin mediated illness
Large
Enterotoxin-Mediated
Diarrhea
Pathogens
ETEC
V.
cholerae
S. aureus
C. perfringens
B. cereus
Other types
Viral and parasitic can be similar but
symptoms longer lasting
Invasive Diarrhea
Campylobacter jejuni
Most
Campylobacter jejuni:
Fast facts
Grows best at 42 degrees C
Microaerophilic conditions
Capnophilic conditions
Campy plate
Gram-negative curved rods, seagull
wings
Salmonella species
Gastroenteritis
Fever
Salmonella species
Fast Facts
Salmonella
Shigella species
Diarrhea
Shigella species
Fast Facts
Requires a low microbial load
Fecal WBC lab test
Observe
Culture
Colorless
colonies(NLF) on MAC
Blue green colonies of HE
Red/colorless on XLD
Shigella
Vibrio species
Requires
Stool
Clostridium difficle
Test
Source of
Contamination
Toxin
Implicated Foods
S. aureus
Nasal passages of
asymptomatic
carriers
Staphylococcal
enterotoxin
Clostridium
botulinum
Botulism
neurotoxin
Mushrooms, salami,
improperly canned foods
Bacillus cereus
Environmental
contaminant
Heat-stable
enterotoxin &
heat-labile
enterotoxin
Parasitic Infections
Giardia lamblia
Entamoeba histolytica
Cryptosporidium
Cyclospora
Microsporidia
Ascaris
Stronglyloides
Trichuris
And many more
Rotavirus
Primarily
old
Spread by fecal-oral route
Peak incidence from December
through June
Calicivirus
Norovirus
Laboratory Diagnosis of
Gastrointestinal Pathogens
Laboratory Diagnosis of
Gastrointestinal Pathogens
Fecal
Leukocytes
Interpretation of Cultures
All media plates work together to
determine the presence of a pathogen.
Routine stool cultures include testing for:
Salmonella species, Shigella species,
Aeromonas species, Plesiomonas species,
and Campylobacter jejuni
Less frequently ordered
Yersinia, Vibrio, E. coli 0157:H7
Treatment of Diarrhea
References