Enterotoxic Escherichia coli infection
Introduction
Brief introduction of enterotoxic Escherichia coli infection Enterotoxic Escherichia coli infection of enteric infectious diseases caused by Enterotoxigenic Escherichia colienteritis (ETEC). ETEC is a newly discovered group of diarrhea-producing Escherichia coli in human cholera-like patients. It is one of the main pathogens of tourist diarrhea in developed countries; it is a common cause of adult cholera syndrome and is also a diarrhea in children. The main pathogen is second only to rotavirus. In Bangladesh, ETEC-induced diarrhea accounts for 30% to 60% of all diarrhea, forming a regional epidemic. 302 Hospital first discovered this disease in China in 1982. basic knowledge The proportion of illness: 20% Susceptible people: no specific people Mode of infection: non-infectious Complications: dehydration
Cause
Enterotoxic Escherichia coli infection cause
Enterotoxin (20%):
ETEC settles on the surface of the small intestine, does not damage or invade intestinal mucosal epithelial cells, and produces secretory diarrhea by producing enterotoxin. There are more than 10 common serotypes, such as O6, O8, O15, O25, O27, O42, O63, O87. , O148, O159 and so on.
Protein (10%):
Enterotoxin is divided into two types: heat-labile enterotoxin (LT) and heat-resistant enterotoxin (ST). One strain of Escherichia coli can produce both LT and ST, or only one type. LT is a protein. It consists of A subunit and 5 B subunits with a molecular weight of 85000. It can be inactivated at 60 °C for 10 min. Its antigenicity and toxicity are similar to cholera toxin. The mechanism of diarrhea is also the same as that of cholera toxin. Increased (cAMP), causing excessive secretion of the small intestine and diarrhea.
Low molecular weight (10%):
ST is a low molecular weight (5000) polypeptide hapten. It has no loss of activity at 100 °C for 30 min. There are two subtypes of STa and STb, which bind to the ganglioside receptor on the intestinal epithelial cell membrane and stimulate the cell cyclic guanosine monophosphate. Increased (cGMP) causes short-term excessive secretion of small intestine to cause diarrhea. It is the same as the secretory fluid caused by ST and is similar to isotonic. The concentration of bicarbonate is about twice that of plasma, and potassium ion is 5-6 times that of plasma. .
Prevention
Enterotoxic Escherichia coli infection prevention
1. Prevent cross-infection in hospitals.
2. It should be treated with doxycycline to shorten the time of sterilization.
Complication
Enterotoxic Escherichia coli infection complications Complications dehydration
Concurrent dehydration, acidosis, etc.
Symptom
Enterotoxic Escherichia coli infection symptoms Common symptoms Nasal cold war dehydration water-like muscle pain secretory diarrhea nausea
1. Latency: generally 0.5 to 7 days.
2. Symptoms: manifested as secretory diarrhea, watery stool, accompanied by abdominal cramps, nausea, vomiting, chills, headache, myalgia, rarely fever, 4 to 7 days of disease, ranging from mild to severe, can only be mild Diarrhea can also be severe cholera-like, severe dehydration, acidosis, and even death. Adults often infect ST and LT strains. Children with ST-producing strains are more common, so adult diarrhea is heavier and lasts longer. 302 hospitals are admitted. One adult ETEC enteritis patient had up to 9000 ml of water per day for up to 38 days.
Examine
Examination of enterotoxic Escherichia coli infection
The diagnosis must be done in stool to culture Escherichia coli and detect ST, LT positive.
Diagnosis
Diagnosis and identification of enterotoxic Escherichia coli infection
The diagnosis can be made based on clinical and epidemiological characteristics.
Mainly should be identified with cholera, followed by identification of viral enteritis, salmonella enteritis and so on.
