Campylobacter enteritis

Introduction
Cause
Prevention
Complication
Symptom
Examine
Diagnosis

Introduction

Introduction to Campylobacter enteritis Campylobacter enteritis is an acute intestinal infection caused by Campylobacter. Clinically, it is characterized by more neutrophils and red blood cells in fever, abdominal pain, and bloody feces. Campylobacter was first isolated from bovine and sheep aborted in 1909 and was called vibriofetus. It was first isolated from humans in 1947. basic knowledge The proportion of illness: 0.001%-0.003% Susceptible people: no special people Mode of infection: digestive tract spread Complications: Arthritis Cholecystitis

Cause

Cause of Campylobacter enteritis

(1) Causes of the disease

Campylobacter, which causes human diseases, has C. jejuni, C. coli, C. laridis, and fetal subspecies of C. fetus. And the mucosal subspecies of C. sputorum, the bacterium is Gram-negative, spiral or S-shaped, does not form spores, and has a single flagella at one or both ends of the cell, and the movement is lively, and the microbe needs Oxygen, invasive, contains endotoxin, also secretes exotoxin such as enterotoxin. Campylobacter jejuni has strong viability in vitro, can survive for 160 days in milk at 4 °C, and can survive for more than 2 months at room temperature, but Generally, the disinfectant is sensitive and can be killed in 5 minutes at 58 °C.

(two) pathogenesis

After the oral infection of Campylobacter, it proliferates in the bile and micro-oxygen environment in the upper part of the small intestine. The pathogenesis has not yet been fully understood. It is believed that the pathogenicity in the intestine mainly depends on the direct invasiveness of the strain, the chicken embryo cell invasion test and The chicken inoculation test proved that the bacteria had invasiveness; similarly, the pathological changes of intestinal bloody diarrhea and intestinal mucosa in infected patients, bacteremia and the like also suggested that it has the effect of invading mucosal epithelial cells. In the past, bacterial flagella was studied extensively. It is considered to be a key virulence factor for intestinal lesions, but some authors have different opinions. It is clear that soluble protein PEB1 and chemotactic protein play a role in the adhesion and colonization of the bacteria. PEB1 is directly involved in the adhesion and invasion of bacteria to Hela cells. PEB1 is present on the surface of bacteria and is encoded by the peb1 A gene. In the animal model, the A site of peb1 enhances the adhesion and invasion of the bacteria to intestinal epithelial cells. And promoted, and inactivated peb1 A site can significantly weaken its adhesion; CHY plays a major role in the chemotaxis of the bacteria for its intestine Planting is also extremely important, so it is considered to be the main cause of intestinal pathological changes. In addition, some strains can also produce enterotoxin, similar to cholera enterotoxin, which can cause patients with watery diarrhea; after the bacteria rupture, a large amount of endotoxin is released. Can cause systemic symptoms such as fever.

Pathological changes mainly in the jejunum, ileum and colon, diffuse hemorrhage, edema, exudative lesions in the intestinal mucosa; small intestine villi degeneration under microscopic examination, atrophy, a large number of neutrophils in the lamina propria, mononuclear infiltration, sometimes ulcers And sac abscess, mesenteric lymph nodes, accompanied by inflammatory reactions.

Prevention

Campylobacter enteritis prevention

The preventive measures of this disease are the same as other intestinal infectious diseases. The most important source of infection for jejunal flexion disease is animals. How to control the infection of animals and prevent animal waste from polluting water and food is essential. Pay attention to dietary hygiene and personal hygiene to cut off the route of transmission. Digestive tract isolation is performed on patients. Strengthen the management and treatment of poultry and livestock that have been infected with this strain. Both food and water should be boiled and disinfected. At present, research on live attenuated vaccines and heat-inactivated vaccines are expected to play an important role in eliminating infection sources and preventing infections.

Complication

Campylobacter enteritis complications Complications arthritis cholecystitis

Complicated with aseptic arthritis, cholecystitis and so on.

Symptom

Campylobacter enteritis symptoms Common symptoms Abdominal pain, diarrhea, urgency, nausea, vertigo, fatigue, dysentery, muscle soreness

The incubation period is 2 to 11 days, usually 3 to 4 days. Typical patients have fever, abdominal pain, diarrhea and mucus pus and blood. Frequent fever often occurs, up to 40 ° C, with general malaise, headache, dizziness, muscle aches, sometimes chills and, fever 12 ~ 24h after the start of watery diarrhea, the amount, more than 20 times a day, some patients after 1 to 2 days of dysentery-like feces, blood and mucus, with urgency and heavy, more than 2 / 3 patients have abdominal pain Mainly with spastic pain, abdominal pain often in the umbilical and lower abdomen, a few in the lower right abdomen, similar to acute appendicitis, nearly half of the patients have nausea and vomiting, and the course of the disease is relieved within a week, but a few patients can last for several weeks, sometimes Diarrhea can be repeated, peripheral blood leukocytes and neutrophils are mild to moderately increased, a small number of patients develop aseptic arthritis after enteritis, can also occur Campylobacter cholecystitis, fetal Campylobacter fetus subspecies infection mostly intestine Extra-injection infections, such as sepsis, can cause spasticity in humans.

Examine

Examination of Campylobacter enteritis

Direct smear examination

(1) hanging drop test: take fresh feces on the glass slide, add a little saline to mix, cover the slide to make a hanging drop specimen, observe under the microscope, visible spiral bacteria with characteristic spur motion.

(2) staining examination: taking the feces of patients with acute diarrhea, after smear, Gram staining, microscopic examination showed that Campylobacter showed S-shaped, spiral, Gram-negative bacteria.

2. Bacterial culture is generally carried out in Campy-BAP medium in a 95% nitrogen and 5% carbon dioxide incubator at 42 ° C for 48 h.

3. Serological examination can be performed by tube agglutination, indirect fluorescence, ELISA or passive hemagglutination.

Diagnosis

Diagnosis and identification of Campylobacter enteritis

diagnosis

According to epidemiological data, if you have a history of contact with infected animals or patients, or have a history of suspicious food and clinical manifestations, you can diagnose the disease. The diagnosis depends on the pathogen examination. Serology is also helpful for diagnosis.