GI Grand Rounds: A Brief Discussion of E coli 0157:H7
•
2 gefällt mir•854 views
A brief talk highlighting a case of food poisoning from E. Coli 0157 given to medical students, residents, and gastroenterology fellows. This is not an exhaustive review and was meant to stimulate discussion.
Empfohlen
Empfohlen
Weitere ähnliche Inhalte
Was ist angesagt?
Was ist angesagt? (20)
Ähnlich wie GI Grand Rounds: A Brief Discussion of E coli 0157:H7
Ähnlich wie GI Grand Rounds: A Brief Discussion of E coli 0157:H7 (20)
Kürzlich hochgeladen
Kürzlich hochgeladen (20)
GI Grand Rounds: A Brief Discussion of E coli 0157:H7
- 10. Severe colitis w/ rectal sparing
- 14. Salmonella 0.9% Shigella 0.6% Campylobacter 1.4% E. Coli O157 0.3% 1996: 233,212 stools tested Overall 1.5%-2.9% Clin Infect Dis. (2001) 32 (3): 331-351
- 17. Diffusely Adhering (DAEC) Enteroaggregative (EAEC) Enteroinvasive (EIEC) Pathogenic Strains of Ecoli Enterohemorrhagic (EHEC) Enteropathogenic (EPEC) Enterotoxigenic (ETEC)
- 18. Cows are a natural habitat a role for vaccination and probiotics
- 19. Hamburger meat is the leading vehicle of infection
- 20. CDC: 2012 Incidence Rate per 100,000 people 16.4214.30 E. coli 1.12 Vibrio 0.41 SalmonellaCampylobacter
- 21. Isolation rate of STEC O157 by age United States 2009 (n=1,947) National Enteric Disease Surveillance: Shiga toxin- producing Escherichia coli (STEC) Annual Summary, 2009
- 22. result in colitis that resembles ischemic colitis
- 23. Would you treat this patient?
- 25. 159 cases of E. coli O157: H7 in children who attended a fair in Canada in 1999 BMC Public Health. 2013; 13: 799
- 26. Cipro- increases Shiga production in mice models Hemolytic Uremic Syndrome No effect on duration of symptoms Is concern about giving antibiotics legitimate? Proulx F, Turgeon JP, Delage G, et al: Randomized, controlled trial of antibiotic therapy for Escherichia coli O157:H7 enteritis.
- 27. Non-immune Hemolytic Anemia Thrombocytopenia Renal Impairment NHS-0583-3DC-3N HUS Hemolytic Uremic Syndrome (HUS) *Most common cause of renal failure in children
- 28. Micrographs of Samples from Patients with Hemolytic–Uremic Syndrome. Noris M, Remuzzi G. N Engl J Med 2009;361:1676-1687.
- 29. 1997 – 2009: 981 Cases of HUS National Enteric Disease Surveillance: Shiga toxin- producing Escherichia coli (STEC) Annual Summar Median 4.5 yrs Deaths 52 (5%) Summer 569 (58%) E. Coli O157:H7 95%
- 30. Antibiotics and HUS Systemic Reviews Safdar 2002 • 9 Studies • Neither protection nor increased risk • Pooled OR 1.15 (95% CI 0.79-1.68) Panos 2006 • 19 Studies • Inconclusive Safdar N. JAMA 2002; 288:996-1001
- 31. Other Treatment and HUS Synsorb • an agent that binds to ST to prevent its absorption from the gut. Antibodies • Monoclonal Ab against Shiga 1 and 2
- 32. •Antibiotics were stopped by ID •Hgb 11.7 9.1 •Schistocytes on Smear •Normal Renal Function