unique1
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Which of the following organisms would be most likely to cause an outbreak of enteritis in a day care center in the United States?
<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
A. Helicobacter jejuni
B. Salmonella typhi
C. Shigella species
D. Vibrio cholerae
E. Yersinia enterocolitica
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| new_n_lost
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C. Shigella species
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| tompat
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what is helicobactor jejuni
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| tompat
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if u mean to say campylobactor jejuni then i wud go for it as it is very common in US and spreads thru feco oral route
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| unique1
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Campylobactor jejuni is not among the answer choices . I mean Helicobecter jejuni , which is one of the causes of hospital acquired diarrhoea.
BTW , Campylobacter jejuni is not a common cause of diarrhoea in the day cares.
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| tompat
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ur right , i had never heard of helicobactor jejuni,thanx any ways
then i will go for shiga
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| unique1
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<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
The correct answer is E.Yersinia enterocolitica is an important cause of “mini-epidemics” of
pediatric diarrhea. Adults can also be affected, but less commonly than children. Some diarrheal cases are
severe (and occasionally fatal) and may be complicated by severe dysentery, appendicitis, or chronic relapsing
ileocolitis that may require antibiotics to shorten the course.
Helicobacter jejuni(choice A) is an important cause of hospital-acquired diarrhea.
Salmonella typhi(choice B) causes typhoid fever.
Shigella species (choice C) causes epidemics of dysentery in military camps.
Vibrio cholerae(choice D) causes cholera.
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| bactitech
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I looked for Helicobacter jejuni in Google and came up with H. pylori and C. jejuni. In 30+ years in microbiology I have never heard of H. jejuni.
C. jejuni is very common in raw chicken - fully 70-80% of raw chicken harbors this organism.
I always thought Shigella was a day care problem. We have seen a couple of kids over the course of the last couple of years have Y. enterocolitica in their stool. Yersinia is NOT a common finding in stool cultures.
http://www.webmd.com/news/20070412/some-food-born...
According to this list Yersinia is WAY down the list. Salmonella, Campylobacter, and Shigella lead the way in 2006. Our findings in our lab mimic these.
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| unique1
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Bactitech, thanks for your kind opinion. I admire the way you help us. Thank you for that.
Please check this list of gram -ve rods which mentions Helicobacter jejuni .
http://education.med.nyu.edu/courses/old/microbio...
and
http://www.mednet.gr/pim/hp4.htm
As far as the most common causes of different disease are concerned , we have to rely on the popular resources . As you know in the step one forum, most of us are without any clinical experience . Kaplan is the source of this question.
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| bactitech
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I could not access the NYU site, as it requires a username and password :-(.
I will admit that, after working in clinical micro for nearly 30 years, I sometimes wonder where Kaplan gets some of these questions. I try to post updated information for you when possible. You are the docs who will be ordering cultures in a couple of years. You will find that the real world of clinical microbiology is probably very different than the world Kaplan seems to live in. There are always the questions of the horses vs. the zebras. Obviously you all have to be aware that the zebras are out there and the horses are more common. I do not have the luxury of seeing the patient whose culture I am working on, and I virtually never get to talk to the physician about their patient's culture, unless they happen to call on one to either ask a question or order additional testing of some kind. We techs in microbiology have to make judgement calls on what we see growing on the plates in many instances.
Your generation will see the dawning of molecular testing. This type of testing was virtually nonexistent in 2000. I was just trained to perform molecular testing which has already morphed into a little cassette that we just pipette samples into, break a vial and put the reagent into, and then put it in a machine for a couple of hours. With this methodology we can report out the presence/absence of DNA for a number of bacteria and viruses so far, and this is just the beginning. Our lab (a large lab - don't expect this in small labs yet) is doing Enterovirus PCR on CSF, MRSA screening on presurgical patients, Group B strep screening on pregnant women, Herpes PCR on CSF, along with the common DNA amplification testing for GC and Chlamydia. My prediction is that, if the methodology gets cheaper (it will take a LONG time for this to happen), traditional culturing will start to fall by the wayside. Screening for MRSA is top priority, as hospitals soon will NOT be reimbursed by Medicare for hospital acquired infections. Hospitals will be cracking down on EVERYONE to wash their hands at every opportunity which will include you docs. The future viability of reimbursements and hospitals will depend on stringent infection control measures. MRSA screening will probably occur on everyone walking in the door. Molecular screening is a very sensitive, but expensive, methodology. However, infection costs big bucks also.
Read up on molecular testing, because this is the way of the future in microbiology.
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| po
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first aid 141;yersinia enterocolitica-daycare outbreaks,pseudoappendicitis
whats the final opinion?
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| SmokyWaters
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I agree...with the micro bio guy...
never heard of H. jejuni....
what statistics show is ROTA virus to be the most common in day care outbreaks
then is adeno, then is campylo, then salm0nella, then shigella
thats what I remember 
all the best
dear po...pseudoappendicitis isnt ENTERITIS...
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| SmokyWaters
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its mesenteric adenitis that mimicks appendicitis
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