Enteroinvasive Escherichia coli Infection
Introduction
Brief introduction of intestinal invasive Escherichia coli infection Enteroinvasive E. coli (EIEC) was first reported in Japan in 1967 for large children and adults with diarrhea-like diarrhea, often mistaken for bacillary dysentery. Enteric infectious diseases caused by EIEC. Adults and children can be ill. The main symptoms are fever, abdominal pain, diarrhea, urgency, and pus and blood. Treatment of the same bacteria, antibiotic treatment for severe cases. basic knowledge The proportion of illness: 0.002% Susceptible people: good for adults and children Mode of infection: non-infectious Complications: bacteremia, malnutrition, anemia, leukemia, hemolytic anemia
Cause
Intestinal invasive Escherichia coli infection
Causes:
Infectious disease caused by EIEC, EIEC is a group of diarrhea-causing Escherichia coli isolated from the stool of "dysentery" patients in 1967. EIEC has similar biochemical characteristics with Shigella, no power, no fermentation to lactose. Or slow fermentation, there are common antigens, all invasive pathogenic bacteria, also known as dysentery-like Escherichia coli, can invade epithelial cells, and grow and multiply in them, causing inflammatory reactions, pay attention to the identification and identification of the two The medium has a citrate medium, a sodium acetate medium, and the common O serotypes are: O28, O29, O32, O112, O124, O136, O143, O144, O152, O164, O167, etc., EIEC does not produce enterotoxin. It mainly invades the colon and forms an intestinal wall ulcer, which causes strong virality. As long as 10 to 100 bacteria can cause disease, contaminated water and food can cause outbreaks, and can also be spread by contact, forming sporadic cases, adults and children. Onset.
Pathogenesis:
EIEC invades intestinal mucosal epithelial cells. After the death of bacteria, endotoxin is released, which destroys cells to form inflammation and ulcers, causing diarrhea. It is rare in clinical practice, mainly affecting older children and adults, and its clinical manifestations are similar to bacillary dysentery.
Prevention
Intestinal invasive Escherichia coli infection prevention
Intestinal invasive Escherichia coli infection is a self-limiting disease in most cases, and healed more than 1 to 2 weeks. The prognosis is related to the following factors:
1 year old and frail, infants and children with low immune function, more complications, serious prognosis;
2 toxic bacillary dysentery has a high mortality rate, especially respiratory failure;
3 Shigella dysenteriae type I caused more serious symptoms, while Fusarium is prone to chronic, drug-resistant strains affect the efficacy;
4 The use of appropriate antibacterial drugs has an important role in the elimination of infection, improper medication, inadequate treatment, and treatment in a timely manner affect the efficacy.
Complication
Enteroinvasive Escherichia coli infection complications Complications bacteremia, malnutrition, anemia, leukemia, hemolytic anemia
Parenteral complications of intestinal invasive Escherichia coli infection are rare.
1. Bacteremia is mainly seen in children, malnutrition, sickle cell anemia and immunocompromised patients, more than 100 cases abroad, there are a few cases reported in China, the symptoms of bacteremia are more serious, the mortality rate is as high as 46% The bacteremia is more common in 1 to 2 days after the onset of the disease, and antibiotic treatment is effective.
2. Hemolytic uremic syndrome is mainly seen in Shigella infection of dysentery, some cases have leukemia-like reactions at the beginning, followed by hemolytic anemia and DIC, acute renal failure in some cases, thrombosis and renal cortical necrosis in large and small arteries. There are fibrin deposits in the glomeruli and arterial wall. In about half of the cases, the sputum test is positive. In most cases, the immune complex is positive in the serum. Endotoxemia may be related to the pathogenesis, but the endotoxemia caused by other bacteria has no similar performance. The prognosis of this disease is serious.
3. Arthritis occurs more than 2 weeks after the bacillary dysentery, which may be caused by allergic reaction, mainly involving large joints, which can cause knee and ankle joint swelling, exudate, antibodies to agglutinating Shigella in joint fluid, serum resistance The "O" titer is normal, and treatment with hormones can be quickly relieved.
Symptom
Intestinal invasive Escherichia coli infection symptoms Common symptoms Large intestine black diarrhea abdominal pain
For fever, abdominal pain, diarrhea, urgency and heavy, pus and blood, symptoms and dysentery are difficult to identify, the diagnosis must be EIEC serum agglutination test positive, while Escherichia coli obtained from stool culture is also positive for guinea pig corneal test, treatment of the same bacteria, For severe cases, antibacterial treatment is required.
Examine
Examination of intestinal invasive Escherichia coli infection
At the same time, the Escherichia coli obtained from stool culture was also positive for the guinea pig cornea test.
Diagnosis
Diagnosis and identification of intestinal invasive Escherichia coli infection
Determining the diagnosis must be positive for the EIEC serum agglutination test.
Clinical attention is distinguished from bacillary dysentery.
