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Microbiology General e47384fa

A 60 year old female patient complains of diarrhoea and abdominal pain. She was on antibiotic therapy earlier which comprised of Clindamycin. She is a diabetic and is on oral hypoglycemic. Stool culture revealed gram positive motile rods. The colonoscopy is done of this patient and the typical structure is revealed. Which of the following microbe is responsible for this?

A
Clostridium difficile
B
Enteroinvasive E. coli
C
Enteroaggregative E. coli
D
Shiga toxin-producing E. coli
High-Yield Explanation
Enteroinvasive E. coli (EIEC) produce a disease very similar to shigellosis. The disease occurs most commonly in children in developing countries and in travelers to these countries. Similar to Shigella, EIEC strains are nonlactose or late lactose fermenters and are nonmotile. EIEC produce disease by invading intestinal mucosal epithelial cells. Enteroaggregative E. coli (EAEC) causes acute and chronic  diarrhea  (>14  days  in  duration)  in  persons  in developing countries. These organisms also are the cause of  foodborne  illnesses  in  industrialized  countries  and have been associated with traveler’s diarrhea and persistent diarrhea in patients with HIV. They are characterized by  their  specific  patterns  of  adherence  to  human  cells. Shiga toxin-producing E. coli (STEC) are named for the cytotoxic toxins they produce. STEC has been associated with mild  non-bloody  diarrhea,  hemorrhagic  colitis,  a  severe form of diarrhea, and with hemolytic uremic syndrome, a disease resulting in acute renal failure, microangiopathic hemolytic  anemia,  and  thrombocytopenia. C. difficile can be isolated from stool culture in 30% of patients with antibiotic-associated diarrhoea and over 90% of those with pseudomembranous colitis, but also from 5% of healthy adults and up to 20% of elderly patients in residential care. The rectal appearances at sigmoidoscopy may be characteristic, with erythema, white plaques or an adherent pseudomembrane or may resemble ulcerative colitis.

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