Proteas - Causes, symptoms and treatment. MF.

The infections caused by the prosthesis are now becoming more common due to improved detection methods, as well as the growing alertness of doctors to this problem.

Proteus is a microorganism from the group of conditionally pathogenic, belonging to the family of Enterobacteria( Enterobacteriaceae), a class of gamma proteobacteria, a type of proteobacteria( Proteobacteria).The main habitat of the proteus is the intestine, in which this microorganism is part of the normal microflora. Normally, the amount of protea in the stool should not exceed 104 cfu in 1 gram of stool. Proteus - Gram-negative( Gram stain does not stain) bacterium, is an optional anaerob( primary life in the absence of oxygen, but the presence of oxygen is not fatal), the dispute does not form. Proteus - a small microorganism up to 3 microns, has the appearance of filaments or threadlike sticks, which are highly mobile. Proteus possess certain biochemical activity( for example, their lecithinase activity was revealed).

There are several types of proteas: Proteus mirabilis, Proteus vulgaris, Proteus myxofaciens, Proteus hauseri, Proteus penneri. Some species of the proteus - P. morganii, P. rettgeri - are referred to other groups. The main properties of the pathogenicity of the protein is the ability to produce endotoxin( toxigenic properties), as well as hemolytic properties. Proteus, like many representatives of the Enterobacteria family, has O-, N-, K-antigens, according to which they are subdivided into serological variants, of which there are about 110. They reproduce on special nutrient media( for example, protein nutrient medium, meat-peptone agar, Mekopeptonian broth, Ploskirev's medium), the optimal growth temperature is 370. Proteus is relatively stable in the external environment, it tolerates freezing well, high temperatures suffer worse - at 600 dies within 1 hour, at 800-5 minutes. To disinfecting solutions is fairly stable.
In microbiology protheus is considered a bacterium with sanitary-indicative properties. When P. mirabilis is detected, a conclusion is made about the degree of fecal contamination of the material under study, and when P. vulgaris is detected, the degree of contamination with organic substances.

Causes of infections caused by the

protein Not all types of protea are pathogenic to humans. Proteins that can cause infection include P. mirabilis( up to 85-90% of all diseases caused by the prosthesis), P. vulgaris, P. penneri.

The source of infection of for pathogenic species of the proteus is a sick person and an animal, with excrements of which the proteus enters the external environment( soil, water, sewage, organic fertilizers in the decomposition stage), where it can remain viable for a long time.

The infection mechanism is alimentary, and the pathway is water( bathing in doubtful in terms of their cleanliness of reservoirs, ingestion of infected water) and food( eating meat products, dairy products, fish, sausages, various semi-finished products).Less often, the infection can be transmitted by contact-household way( through contaminated hands, contamination of the umbilical wound of newborns, infection through urological catheters).

Risk groups for infection are individuals with reduced immunity or age( newborns and young children, elderly people) or with concomitant chronic diseases of the intestine, lungs, abdominal organs. Also at risk are those who take antibacterial drugs uncontrollably, that is, self-medics.

Symptoms and signs of infection caused by the

protein The incubation period of the ( the period from the moment of infection until the first symptoms appear) from several hours( usually 2-6 hours) to 3 days.

1. Lesion of the gastrointestinal tract is the most frequent manifestation of a protein infection. It appears in the form of gastroenteritis, enterocolitis, sometimes gastritis. As with acute intestinal infections, the onset may be acute: there are symptoms of intoxication - weakness and headaches, a decrease in appetite, sometimes the temperature rises to 37.5-39 ° depending on the severity of the process, with gastritis and gastroenteritis. A frequent symptom is vomiting, nausea, almost immediately there are disorders of the stool in the form of a watery stool with an unpleasant odor odor, abdominal pains are unstable, often cramping, patients are disturbed by increased gas formation( flatulence), "rumbling" of the intestine. Duration of the disease 4-5 days.
Severe forms of protein intestinal infection can lead to the development of anemia, hemolytic-uremic syndrome, acute renal failure.

2. Dysbacteriosis of the intestine - is recorded when the threshold of the normal content of protae in the bowel movement is exceeded( more than 104KOE / g).Symptoms of a dysbacteriosis can be various from a small indulgence of a chair to a watery stool after a meal up to 2 times a day.

3. The urinary tract infection caused by the prostate is manifested in the form of pyelonephritis, cystitis, and prostatitis. Symptoms of these diseases do not differ from them, caused by another infection.

4. Wound infections of caused by P. mirabilis. At the risk of wound infection - patients with trophic ulcers, patients burn hospitals, patients traumatology departments.

5. Intrahospital infections of caused by a prostate can be different. These are otitis, cholecystitis, urinary tract infection, infection in newborns with the development of severe forms in the form of meningitis, sepsis.

Diagnosis of Protease Infections

Primary diagnosis is based on the identification of clinical symptoms of a particular form of infection, identification of risk groups for prostate infection, after which a laboratory confirmation of a preliminary diagnosis is required.

Laboratory diagnostics:

1) Bacteriological analysis of feces and other materials( urine, separable wounds, burn surfaces, purulent discharge and others).Sowing is carried out on differential diagnostic environments( Ploskireva), enrichment medium. When sowing, the proteus grows in the form of a flattening thin film in the form of a veil of bluish color. In feces, P. vulgaris is more common, present in about 2% of healthy people, but in a small amount - up to 104 cfu / g. Excess of this amount indicates intestinal dysbacteriosis, which is most often associated with the detection of other opportunistic bacteria( klebsiella, citrobacter and others).
When sowing urine, the detection of a proteus is called bacteriuria and indicates a lesion of the urinary tract. True bacteriuria( in the absence of symptoms in the patient) is diagnosed in the presence of a proteus in an amount of not less than 105 microbial bodies of the protein in 1 ml of urine( a lesser amount is regarded as contamination with the fence).Bacteriuria( in the presence of patient complaints), as well as under the condition of urine collection from the catheter, is diagnosed when 104 microbial bodies of the proteus are detected in 1 ml of urine.

Proteus on nutrient medium

2) Serological tests - determination of antibodies in blood( rarely used, mainly for retrospective diagnosis).
3) Auxiliary studies of ( general blood test, urine, biochemical blood tests, coprogram and others) to determine the severity of the patient's condition.

Treatment of infections caused by the prostate

Organizational-regime measures are reduced to semi-bed and bed rest, depending on the severity of manifestations, compliance with the water regime to restore fluid loss, a sparing diet with limited fatty and spicy food.

Medication for infections caused by the

1) Specific bacteriophages are assigned with excessive growth of the protea. Recommended phages include "Bacteriophage Protein Liquid", "Bacteriophage coliprotein liquid", "Intesti-bacteriophage liquid", "Piobacteriophage combined liquid", "Piobacteriophage polyvalent purified liquid".Bacteriophages are prescribed for an hour and a half before meals. Single doses are calculated depending on the age and are: up to 6 months - 10 ml, 6-12 months - 10-15 ml, 1-3 years - 15-20 ml, 3-12 years and over 30 ml. Multiplicity of admission and treatment is determined only by the attending physician. Before drinking a bacteriophage, you need to drink alkaline mineral water.

2) Probiotics and symbiotics for restoration of normal intestinal flora( acipol, acylact, bifidumbacterin, bifiform, linex, normoflorin, biovestin, primadofilus and others).Assigned on an empty stomach, the course of at least 10-14 days.

3) With pronounced growth of the protein in adults, antibacterial drugs ( amoxicillin, nifuroxazide, 3-4 generation cephalosporins, fluoroquinolones, streptomycin) are prescribed. Before the appointment of an antibacterial drug it is necessary to conduct a special study - an antibioticogram of the material to avoid treatment errors. To the group of tetracyclines, certain strains of the protein are stable. Antibiotics are prescribed only by the attending physician!

4) Symptomatic treatment of - treatment of specific symptoms of the disease( antipyretic drugs, enterosorbents, analgesics, anti-inflammatory drugs, normalizing water-electrolyte balance and others).

Prophylaxis of Protein Infections

1) Careful adherence to sanitation in health care facilities( especially children's care).
2) Compliance with hygiene in everyday life.
3) Eating fresh and quality foods, removing suspicious foods from the diet in terms of quality.
4) Caution when swimming in unfamiliar waters, excluding swallowing water when bathing.
5) Exceptions to contact with sick children and adults.

Doctor infectious diseases Bykova N.I.