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:* Role of [[Doxycycline]] or [[Fluoroquinolones]] unclear, does not appear to shorten duration of non-cholera gastroenteritis | :* Role of [[Doxycycline]] or [[Fluoroquinolones]] unclear, does not appear to shorten duration of non-cholera gastroenteritis | ||
==References== | |||
{{reflist|2}} | |||
==Diagnosis== | |||
A nasopharyngeal or an oropharynx swab is sent to the [[bacteriology]] laboratory for [[Gram stain]] (Gram-negative, coccobacilli, diplococci arrangement), growth on [[Bordet-Gengou agar]] or [[Buffered charcoal yeast extract agar|BCYE]] plate with added [[cephalosporin]] to select for the organism, which shows mercury-drop-like colonies. | |||
Several diagnostic tests are available, especially [[ELISA]] kits. These are designed to detect FHA and/or PT antibodies of the following classes: IgG, IgA, IgM. | |||
Some kits use a combination of antigens which will lead to a higher sensitivity, but might also make the interpretation of the results harder since one cannot know which antibody has been detected. Also, a new rapid molecular test is available, real-time PCR, based on the so-called FilmArray technology . This test takes about one hour and detects about 15–17 viruses and bacteria, including ''B. pertussis''. | |||
The organism is [[oxidase test|oxidase]] positive, but [[Rapid urease test|urease]], [[nitrate reductase]], and [[citrate]] negative. It is also nonmotile. | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 19:29, 7 August 2015
Cholera
Antibiotics
- Antibiotic treatments for one to three days shorten the course of the disease and reduce the severity of the symptoms.
- People can recover even without them, if sufficient hydration and electrolyte balance is maintained.
- Doxycycline is typically used first line, although some strains of V. cholerae have shown resistance.
- Doxycycline single dose 300 mg or tetracycline 12,5 mg/kg 4 time/day for 3 days
- Other antibiotics proven to be effective include cotrimoxazole, erythromycin, tetracycline, chloramphenicol, and furazolidone.[1]
- Fluoroquinolones, such as norfloxacin, also may be used, but resistance has been reported.[2]
- Young children: erythromycin 12,5 mg/kg 4 time/day for 3 days
- for children below 6 months of age: 10 mg daily for 10 days add zinc
- for children 6 months to 5 years of age: 20mg daily for 10 days add zinc
- In many areas of the world, antibiotic resistance is increasing. Testing for resistance during an outbreak can help determine appropriate future choices. In Bangladesh, for example, most cases are resistant to tetracycline, trimethoprim-sulfamethoxazole, and erythromycin. Rapid diagnostic assay methods are available for the identification of multiple drug-resistant cases.[3] New generation antimicrobials have been discovered which are effective against in in vitro studies.[4]
References
- ↑ "Cholera treatment". Molson Medical Informatics. 2007. Retrieved 2008-01-03.
- ↑ Krishna BV, Patil AB, Chandrasekhar MR (2006). "Fluoroquinolone-resistant Vibrio cholerae isolated during a cholera outbreak in India". Trans. R. Soc. Trop. Med. Hyg. 100 (3): 224–6. doi:10.1016/j.trstmh.2005.07.007. PMID 16246383. Unknown parameter
|month=ignored (help) - ↑ Mackay IM (editor) (2007). Real-Time PCR in microbiology: From diagnosis to characterization. Caister Academic Press. ISBN 978-1-904455-18-9.
- ↑ Ramamurthy T (2008). "Antibiotic resistance in Vibrio cholerae". Vibrio cholerae: Genomics and molecular biology. Caister Academic Press. ISBN 978-1-904455-33-2.
Vibrio parahaemolyticus
Antibiotic regimen
- 1. Sepsis or Soft Tissue Infection Antibiotic Management [1]
- Preferred regimen: Doxycycline 100 mg IV q12h AND Ceftazidime 2 g IV q8h OR Fluoroquinolone
- Alternative regimen (1): Cefotaxime 2 g IV q6h IV AND Ciprofloxacin 400 mg IV q12h (synergistic in vitro) OR Moxifloxacin 400 mg IV OD OR Levofloxacin 750 mg IV OD
- Alternative regimen (2): Cefotaxime AND Minocycline (synergistic in vitro)
- 2. Gastroenteritis
- Most cases self-limiting
- Maintain hydration: oral or parenteral routes
- Role of Doxycycline or Fluoroquinolones unclear, does not appear to shorten duration of non-cholera gastroenteritis
References
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
Diagnosis
A nasopharyngeal or an oropharynx swab is sent to the bacteriology laboratory for Gram stain (Gram-negative, coccobacilli, diplococci arrangement), growth on Bordet-Gengou agar or BCYE plate with added cephalosporin to select for the organism, which shows mercury-drop-like colonies.
Several diagnostic tests are available, especially ELISA kits. These are designed to detect FHA and/or PT antibodies of the following classes: IgG, IgA, IgM. Some kits use a combination of antigens which will lead to a higher sensitivity, but might also make the interpretation of the results harder since one cannot know which antibody has been detected. Also, a new rapid molecular test is available, real-time PCR, based on the so-called FilmArray technology . This test takes about one hour and detects about 15–17 viruses and bacteria, including B. pertussis.
The organism is oxidase positive, but urease, nitrate reductase, and citrate negative. It is also nonmotile.