Infectious diseases. Diseases caused by Y. enterocolitica and Y. pseudotuberculosis (most important)

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Infectious diseases. Diseases caused by Y. enterocolitica and Y. pseudotuberculosis (most important)

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33. Diseases caused by Y. enterocolitica and Y. pseudotuberculosis

Y enterocolitica and Y pseudotuberculosis resemble the intestinal group and are Gram-negative rods that are motile at 22°C but lose the ability to move at 37°C.

These features help distinguish these Yersinia species from Y pestis and Enterobacteriaceae. It is possible to differentiate these pathogens from each other using biochemical methods, agglutination reactions with specific antiserum, and interaction with a bacteriophage specific for Y. pseudotuberculosis. Serotypes 3, 8 and 9 of Y enterocolitica and serotype 1Y of pseudotuberculosis are most often pathogenic for humans.

Y. enterocolitica has been found in many species of wild and domestic animals, in raw milk, oysters, and water sources. Most often, young children get sick. The disease is characterized by diarrhea, acute inflammation of the mesenteric lymph nodes, pharyngitis, abscesses, arthritis, osteomyelitis, hepatitis, carditis, meningitis, ophthalmitis, hemolytic anemia, Reiter's syndrome, septicemia, and skin rashes up to erythema nodosum. The most severe manifestations of yersiniosis are accompanied by a high mortality rate (up to 50%) even after antibiotic treatment. Abdominal pain in the gastrointestinal form of yersiniosis can be severe enough to suggest acute appendicitis. A common symptom is acute diarrhea for 1-2 weeks. The stools are watery, slimy, or colored with bile, but without blood. A large number of polymorphonuclear leukocytes are found in the feces of patients. Children with severe forms of diarrhea may develop hypoalbuminemia and hypokalemia associated with widespread changes in the mucous membrane of the small intestine. The disease proceeds within 2-3 weeks.

The diagnosis of yersiniosis can be confirmed by isolating the pathogen (Y. enterocolitica) from the faeces of patients. Positive results of the passive hemagglutination reaction also confirm the diagnosis. Antibodies in the blood of patients appear on the 8-10th day after the onset of the disease and can remain in it for several months. In children under the age of 1 year, positive results of serological tests are obtained much less frequently than in older children.

Diarrhea due to Y. enterocolitica usually resolves over time without special treatment.

Most strains of Yersinia are sensitive to streptomycin, tetracycline, chloramphenicol and sulfonamides.

Diseases caused by Y. pseudotuberculosa are accompanied by symptoms of acute mesadenitis and terminal ileitis. Abdominal pain is usually severe, often suggesting acute appendicitis. Septicemia rarely develops. The development of postdiarrheal syndrome of hemolysis and uremia associated with yersinia infection is described. The pathogen is sensitive to ampicillin, kanamycin, tetracycline and chloramphenicol.

Author: Pavlova N.V.

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