Proteus food poisoning
Introduction
Introduction to Proteus Food Poisoning Proteus bacillus is a conditional pathogen, causing food poisoning due to the ingestion of a large amount of food contaminated by Proteus. The main clinical manifestations are gastrointestinal and allergic, which is more common in the past. basic knowledge The proportion of illness: 0.002% Susceptible people: no specific population Mode of infection: non-infectious Complications: dehydration shock
Cause
Proteus food poisoning cause
(1) Causes of the disease
Gram-negative bacilli of the family Enterobacteriaceae of the genus Proteus are pleomorphic, with flagellum, no spores, no capsules, active movement, facultative anaerobic, low nutritional requirements, and can be found on both nutrient agar and blood agar. Growth, suitable growth temperature of 10 ~ 43 ° C, its colonies often have the characteristics of crawling, do not form a single colony, such as increasing the amount of agar to 5%, can get a single colony, hemolysis on the blood agar plate, biochemical characteristics is hydrogen sulfide Positive, phenylalanine deaminase positive, urease strong positive, antigen structure has two kinds of bacteria (O) and flagella (H), according to different antigen and biochemical properties, Proteus is divided into: common Proteus ( P. vulgaris), P. mirabilis, P. myxofaciens and P. penneri, are the first three types of food poisoning.
(two) pathogenesis
The incidence of the disease and the severity of the disease and the number of bacteria ingested (generally considered to be more than 105 / g), the production of toxins and human defense functions and other factors, the pathogenicity of Proteus is mainly the intestinal toxin produced by bacteria Proteus can produce a cell-bound hemolytic factor, which has good adhesion and invasiveness to human transitional cells. Some strains can produce alpha hemolysin with cytotoxic effect, Proteus It can also produce histamine decarboxylase, which can decarboxylate histidine into histamine in meat. Histamine intake exceeding 100 mg causes allergic symptoms similar to histamine poisoning.
Prevention
Proteus food poisoning prevention
The focus of prevention work is to strengthen food management, pay attention to food hygiene, strictly prepare cooking utensils, clean utensils and food, and fast food.
Complication
Proteus food poisoning complications Complications dehydration shock
Severe complications such as severe dehydration and acidosis, and even shock and heart failure can occur.
Symptom
Proteus food poisoning symptoms Common symptoms Abdominal pain with nausea, vomiting, nausea, dehydration, abdominal pain, bloody stool, sticky diarrhea, toxicity
According to the eating of suspicious foods, the collective disease and clinical manifestations of the co-feeders can make a preliminary diagnosis. Proteobacteria food poisoning may have different symptoms due to the different types of bacteria contained in the food, the number and the different metabolites. Gastroenteritis type and allergic type, or both patients.
1. Gastroenteritis type incubation period 3 ~ 20h, rapid onset, nausea, vomiting, abdominal pain, diarrhea, diarrhea is watery, with mucus, foul odor, no pus, several times a day to more than ten times, 1/3 ~ After gastrointestinal symptoms in 1/2 patients, fever accompanied by chills, which decreased after several hours, and severe dehydration or shock.
2. Allergic type incubation period 1/2 ~ 2h, manifested as systemic congestion, facial flushing, drunkenness, itchiness, mild gastrointestinal symptoms, a small number of patients may have urticaria.
Since Proteus can be parasitic in the normal human intestines, food can also be contaminated by Proteus. Therefore, when Prostatus is poisoned, suspicious food, vomit and feces should be taken for bacterial culture, and Proteus can be isolated and isolated. Proteus must be tested for hemagglutination, in order to confirm that the Proteus vulgaris OX19, Proteus mirabilis OXK agglutination titer should be more than 4 times increase, in order to confirm the diagnosis, such as indirect hemagglutination test, sensitivity can be improved 2 ~16 times, in recent years, the biochemical characteristics of urea (urea), phenylalanine and hydrogen sulfide have been established by using Proteus to establish a rapid synchronous qualitative and quantitative detection method-UPS method. The correct identification rate is 100%. The sensitivity is 100 times that of the previous spread growth observation method, and the reporting time is reduced from 4 to 15 days to 4 to 24 hours, and the precision is high and the specificity is strong, which is not affected by the type of the sample and other factors.
Examine
Proteus food poisoning check
Take the serum of the patient in the acute phase and the recovery phase (12-15 days after poisoning), and use the isolated strain to determine the serum agglutination titer. The recovery titer is four times higher than the acute phase titer, which is diagnostic and healthy. As a control, it should be negative.
Taking suspicious food, vomit and feces for bacterial culture, the same type of Proteus can be isolated, and the isolated Proteus must be tested for hemagglutination to confirm that the agglutination titer of OX19 and Proteus mirabilis to OXK should be confirmed. In the case of growth of more than 4 times, the diagnosis can be confirmed. For example, the indirect hemagglutination test can increase the sensitivity by 2 to 16 times. In recent years, the use of Proteus to urea (urea), phenylalanine (hydrogen sulfide), hydrogen sulfide The biochemical characteristics of the rapid synchronization qualitative and quantitative detection method - UPS method, the correct identification rate is 100%.
Diagnosis
Diagnosis and identification of Proteus food poisoning
According to the eating of suspicious food, the collective diagnosis and clinical manifestations of the co-feeders can make a preliminary diagnosis, proteus can be detected in fecal culture, serum agglutination antibodies are helpful for diagnosis, the disease needs to be associated with cholera and paracholera, acute bacterial dysentery, virus Gastroenteritis, non-bacterial food poisoning and other diseases are identified.
