Campylobacteriosis( Vibriosis) - Causes, symptoms and treatment. MF.

Kampilobacteriosis( Vibriosis) - acute zoonotic infection( infection occurs from animals) is a bacterial disease with a predominantly fecal-oral transmission mechanism, characterized by a gastrointestinal lesion and occurs against a background of febrile-intoxication syndrome.

Campylobacteriosis causative agent

Campylobacteria

The causative agent belongs to the genus Compylobacter and is represented by 3 species - C. jejuni, C. coli, C. lari and others, causing OKZ( acute intestinal disease) with a similar clinical course. These are gram-negative spirally bent rods that have specific structural features responsible for the symptoms:

• spores and capsules do not form, but there is a capsule-like shell, which predetermines stability in the external environment and the action of phagocytosis.
• There are flagella, their number reaches 5, this ensures their high mobility with corkscrew / helical / translational movements and as a result - rapid generalization of the infection.

• Energy is derived from amino acids, and this can play a role in the formation of intoxication, because such a competitive method of energy consumption leads to a violation of protein metabolism.
• Prolonged growth on nutrient media makes diagnosis difficult, because the pathogen forms colonies within 2-4 days.
• The ability to form hydrogen sulphide - this contributes to the formation of flatulence.
• Cytotoxin damages the intestinal mucosa.
• Enterotoxin causes diarrhea syndrome( diarrhea).
• Cell wall lipopolysaccharide is an endotoxin that becomes harmful only after the death of bacteria, and this component contributes to intoxication.

Campylobacter resistance:

In the environment, at room temperature, it persists for 1-5 weeks, the same stability periods when the pathogen is found in food, water and sewage, milk, and also in biological waste. At minus temperature, it persists for several months.

High temperatures( 50 ° С), direct UVI and air, drying, high and low pH values, disinfectants in working concentration are harmful. It is sensitive to antibiotics of macrolides, metronidazole, nalidixic acid.

High susceptibility to campylobacteriosis in persons with weakened resistance, immunodeficiency, severe concomitant pathology, after gastrectomy and treatment with immunosuppressants. Also under high risk are people working in the agricultural sector. The prevalence is geographically very high and is found on all continents, which is associated with the intensification of livestock, increased international trade in animal feed and urbanization. Seasonality of the disease is recorded throughout the year, but the maximum incidence in June and August, and the minimum in the winter months.

Causes of infection with campylobacteriosis

Source - agricultural and domestic animals( rabbits, pigs, cows, sheep, ducks, etc.), and this list is completed by rodents and wild animals.

Transmission mechanism: fecal-oral due to alimentary route, i.e. when using infected products - infected milk and dairy products from sick animals, vegetables and fruits( when seeding the soil in which these fruits grow);Transplacental;It is not excluded contact-household and blood transfusion.

Symptoms of campylobacteriosis

The incubation period - the time interval from the onset of the introduction of the pathogen, to the first signs of the disease, lasts 2-11 days, but on average 1-5.During this period, the pathogen penetrates the gastrointestinal tract and adheres to it on enterocytes( intestinal cells), mainly the small intestine, after which the pathogen begins to multiply, colonizing the remaining parts of the intestine and, after reaching a certain concentration of the pathogen, the following period appears: clinical manifestations.

The period of clinical manifestations is characterized by either gastroenteritis, enterotitis, or enterocolitis, but other clinical forms are possible, depending on the amount of the infecting dose, the premorbid background( the presence of aggravating factors on the part of the body), and the state of resistance. Thus, in case of unfavorable circumstances( younger age, imperfect immune system, concomitant pathology - malformations or diseases), bacteraemia may develop with dissemination of the pathogen into various organs and tissues - ie, sepsis occurs, with the formation of secondary bacterial foci in the heart, the central nervous system, lungs, liver and other organs.

At the onset of the clinical period, there are some age-related features:

• Newborns have general toxic symptoms with decompensation: fever, development of SDR( respiratory distress syndrome), diarrhea characterized by a stool with mucus and blood streaks. Sometimes there can be no intoxication, and the intestines are struck isolated.

• In infants, enterocolitis is more commonly seen( ie, defeat of both the small and large intestine), characterized by acute onset of the disease, IHI I and II degree( infectious-toxic shock), fever to 38 ° C for 5 days. The chair is watery at first, after 2-3 days the stool becomes colitic - that is, lean, with a lot of mucus and scarlet blood, abdominal pains are cramped and more often located in the lower parts, possible peritoneal symptoms( Shchetkina-Blyumbiga, a symptom of the shirt ande.g.).The duration of this disease is about 8 days.

• In older children and adults, campylobacteriosis occurs with lesions of the upper gastrointestinal tract - a gastrointestinal form characterized by an acute onset with an influenza-like prodromal period, ie within 1-2 days patients complain of general weakness, headache, myalgia and arthralgia( muscularand joint pain), nausea and vomiting up to 15 times a day, pain in epigastrium and mesogastrium as a result of the formed inflammatory reaction, fever appears on day 2-3 of the disease and persists for 3 days. The chair is at first abundant, liquid, foamy, fetid, then watery up to 10 times a day - it can lead to dehydration and acidosis, the skin turgor decreases, dry skin, muscle cramps and decreased diuresis. Lasts for about 5 days. Regardless of age, a generalized form may arise - bacteremia with dissemination to various organs.

Diagnosis of campylobacteriosis

Diagnosis is often impossible due to multiple and nonspecific symptoms, so if you are suspected of resorting to laboratory methods:

• bacteriological and bacterioscopic - these methods determine the causative agent in feces, blood, CSF( cerebrospinal fluid) and other biological materials.
• Serological methods: RIF( immunofluorescence reaction), RSK( complement fixation reaction), ELISA( immunoferment assay), RPHA.Using these methods, a qualitative and quantitative determination of antigens and antibodies is determined.

Treatment of campylobacteriosis

Etiotropic therapy - is directed to the use of antibiotics, gentamicin and erythromycin are most effective, and kanamycin, levomycitin, and semi-synthetic antibiotics are the least effective.

Symptomatic therapy is determined by clinical manifestations: antipyretic, prescription and probiotics, enzymatic therapy, immunomodulators and immunostimulants under the control of immunograms, etc.

Complications of Campylobacteriosis:

Peritonitis, intestinal bleeding, reactive arthritis, in pregnant women can lead to miscarriages.

Prevention of Campylobacteriosis

Specific prophylaxis is not developed, and non-specific is to comply with the norms for processing and storing food, respecting personal hygiene rules and protecting water from sewage pollution.

Consultation of a doctor

Question: Is there any immunity after a previous illness?
Answer: Post-infectious immunity is poorly understood, but after the transferred disease, bacteria with feces can be released within 2-5 weeks( this period may be less when treated with antibiotics).

Question: Is the sick person dangerous?
Answer: officially there is no, but a potential threat persists.

Therapist doctor Shabanova I.Е.