Spade
Compare the composition of healthy colonic microbiota to that of one after broad spectrum antibiotics.
Healthy will have diverse
After it will look depleted, can lead to overgrowth of opportunistic pathogens
What is the first-line antibiotic treatment for initial C. difficile infection?
Oral vancomycin or fidaxomicin
List the four essential elements for a valid informed consent
Disclosure, Understanding, Voluntariness, Capacity
Which pathogen is associated with toxic megacolon?
C. diff
Which pathogen talked about today can be diagnosed through stool culture?
Salmonella or Shigella
What pathogen is notorious for outbreaks on cruise ships?
Norovirus
Which toxin blocks the 60S ribosomal subunit?
Shiga toxin
What are the two non-antibiotic treatments for C. difficile and how do they work?
bezlotoxumab binds Toxin B reucing reccurance
fecal microbiota transplants reestablishes the microbiota
C. diff spores are resistant to heat, acid, antibiotics, and alcohol based hand sanitizers
What pathogen should you expect in a sickle cell patient with diarrhea and osteomyelitis?
Salmonella (mostly the non-typhoidal)
What are three differences between infectious and non-infectious diarrhea?
Timeframe acute vs chronic
Fever in infectious
Self-limited in infectious many times
What is the most common cause of infective diarrhea in the U.S.?
Norovirus
Contrast clinical features that would differentiate viral gastroenteritis due to Norovirus from C. diff.
Norovirus, non-inflammatory diarrhea
C. diff is an inflammatory diarrhea with leukocytosis and recent antibiotics
What is first line treatment for infective diarrhea in both norovirus and adenovirus?
Oral fluid and electrolyte replacement
Name at least two bacteria covered today that vancomycin would not cover.
Salmonella
Shigella
Which stool test is most specific for C. difficile?
PCR for toxin genes
(or combined EIA for toxins A/B plus glutamate dehydrogenase antigen)