Campylobacter infection
Introduction
Introduction to Campylobacter infection Campylobacter is a mobile, curved microaerobic Gram-negative bacillus that causes septic thrombophlebitis, bacteremia, endocarditis, osteomyelitis, prosthetic septic arthritis, and diarrhea . basic knowledge The proportion of illness: 5% - 14% Susceptible people: no specific population Mode of infection: digestive tract spread Complications: cholecystitis, pancreatitis, peritonitis, endocarditis, arthritis, osteomyelitis, curvular enteritis, bacteremia
Cause
Cause of Campylobacter infection
It is believed that three species of Campylobacter have a pathogenic effect on humans, and Campylobacter fetus can typically cause adult bacteremia, which often occurs in patients with concomitant diseases such as diabetes, cirrhosis or malignant tumors. It can cause recurrent infections, which are difficult to treat if the patient's immunoglobulin is defective. Campylobacter jejuni can cause meningitis in infants, and Campylobacter jejuni and Campylobacter can cause diarrhea in people of any age. Campylobacter is a bacterial pathogen that is generally isolated and can be isolated from >90% of infected diarrhea patients. Contact with wild or domestic infected animals. Ingestion of contaminated foods (especially uncooked poultry foods) and water can cause outbreaks, but the source of infection in sporadic cases is often unclear. There is a correlation between the outbreak of Campylobacter diarrhea in summer and the subsequent Guillain-Barré syndrome (up to 30% of cases).
Prevention
Campylobacter infection prevention
Pay attention to food management and drinking water hygiene, prevent poultry and livestock manure pollution, do a good job of milk disinfection, and strictly disinfect patient waste.
Complication
Campylobacter infection complications Complications cholecystitis pancreatitis peritonitis endocarditis arthritis osteomyelitis curvitic enteritis bacteremia
The local complication of Campylobacter infection is caused by the direct spread of the bacteria in the gastrointestinal tract, including cholecystitis, pancreatitis, peritonitis and massive gastrointestinal bleeding. The extraintestinal manifestation of Campylobacter jejuni infection is very rare, with brain Inflammation, endocarditis, septic arthritis, osteomyelitis and neonatal sepsis, less than 1% of patients with Campycolitis can develop bacteremia, most likely in patients with low immune function, young children and In the elderly, patients with jejunal enteritis who have low immune function often have transient bacteremia, but most of the strains are quickly cleared by the normal human defense function, and patients with acute gastroenteritis are not routinely tested for blood culture. The mortality rate of Campylobacter jejuni infection is 0.05/1000. In general, the complications of Campylobacter infection are rare, most of them do not require antibiotic treatment. The most serious complication after Campylobacter infection is Guillain-Barre syndrome (GBS). ), is an acute demyelinating disease of the peripheral nervous system. The annual incidence rate in the United States is 1 to 2/100,000. Some Campylobacter serotypes are associated with a greater risk of GBS infection. Country, the most common being Penner serotype O :19; in South Africa, the most common being Penner serotype O :41.
Symptom
Campylobacter infection symptoms common symptoms diarrhea meningitis unexplained fever bacterial endocarditis abdominal pain hepatomegaly
The most common manifestation is enteritis, similar to salmonellosis and shigellosis. Enteritis can occur in all age groups, but 1 to 5 years old is the peak age of onset. Diarrhea is watery and sometimes bloody. White blood cells can be seen after staining the stool smear. Although abdominal pain and hepatomegaly are also common, fever after recurrence or intermittent episodes (body temperature 38 to 40 ° C) is the only symptom of systemic Campylobacter infection. This infection can also manifest as subacute bacterial endocarditis, septic arthritis, meningitis or painless unexplained fever (FUO).
Microbiological examination is required to make a diagnosis, especially in the case of ulcerative colitis. Campylobacter can be isolated from blood and various body fluids using standard media, but selective media is required for isolation from stool samples: 7% dissolved horse serum agar plus vancomycin, polymyxin B And Schirrow medium of trimethoprim (TMP).
Examine
Examination of Campylobacter infection
1, routine examination of stool examination can be watery stool or mucus, microscopic examination showed a small amount of white blood cells and red blood cells, pus cells, etc., blood common species can be seen with a total number of cells and a slight increase in neutrophils.
2, pathogen inspection:
(1) Direct inspection of fecal soils by Gram staining or Wright's staining. Under the microscope, a slender S-shaped, spiral-shaped, comma or seagull can be seen. It can also be used to observe the dynamics of bacteria by using a fecal hanging drop. .
(2) Fecal culture The feces were inoculated on a selective medium, and the pathogenic bacteria were obtained by culturing in a micro-oxygen atmosphere at 42 °C.
3, serological examination should use serum for agglutination test, check O, H k antibodies, recovery period serum antibody sales have more than 4 times the increase in the diagnosis.
Diagnosis
Diagnosis and identification of Campylobacter infection
1, bacterial dysentery, typical sputum sputum has high fever, abdominal pain, diarrhea, diarrhea, bloody stool, abdominal pain in the lower abdomen or left lower abdomen, left lower abdomen is obviously tender, and there are intestinal cords, accompanied by obvious urgency and heavy, fecal examination has more pus cells, phagocytic cells, The heavy ones are often dehydrated, which is beneficial to distinguish from this disease.
2, other bacteria caused by diarrhea, such as typhoid fever, pathogenic Escherichia coli, Yersinia, Aeromonas hydrophila, other anaerobic bacteria, etc., sometimes difficult to identify from the clinical, suspected should rely on etiology and Serology to confirm the diagnosis.
3. Intestinal infections must be differentiated from salmonellosis and brucellosis.
