Intestinal anaerobic infection
Introduction
Introduction to intestinal anaerobic infection Anaerobic bacteria are a major component of the normal flora and can cause infections in any tissue and organ in the body. In recent years, with the continuous improvement of culture technology, anaerobic bacteria have been isolated and identified in time, and reports of anaerobicinfection have gradually increased. The importance of anaerobic bacteria in bacterial infectious diseases has been increasingly recognized by clinicians. Value. Among them, the anaerobic bacteria causing enteritis is mainly Clostridium, which is represented by Clostridium enterocolitis. basic knowledge The proportion of illness: 0.001% - 0.003% Susceptible people: the vast majority of the elderly Mode of infection: fecal-oral route Complications: electrolyte imbalance
Cause
Causes of intestinal anaerobic infection
Clostridium is present in the digestive tract of normal people. After the patient receives antibiotic treatment, the bacteria proliferate abnormally. Therefore, it is endogenous infection, but the bacteria is also present in the hospital environment, and the medical staff can carry the bacteria on hand. Therefore, it can also be caused by contact and transmission through the fecal-oral route, causing an exogenous infection or cross infection. C. difficile enteritis is a multi-line hospital infection, and almost all antibiotics can induce this disease. The incidence rate in the population is extremely low. The majority of the cases are elderly.
Prevention
Intestinal anaerobic infection prevention
Pay attention to food hygiene and avoid contamination of food and drinking water. Refrigerated foods should be heated and boiled before they can be eaten. Avoid contact with patients and sick animals.
Complication
Enteral anaerobic infection complications Complications electrolyte disorder
Severe patients may be associated with electrolyte imbalance, shock, DIC, hypoproteinemia, intestinal bleeding, intestinal perforation and abscess, vascular embolism, toxic megacolon, and occasionally multiple arthritis.
Symptom
Intestinal anaerobic infection symptoms Common symptoms Mucus yellow egg pattern loose stool abdominal pain fever blood in the stool
About 1/2 to 2/3 of patients develop within 4 days of antibiotic treatment. According to the condition, it is light, medium and heavy.
1, light: 3 to 4 times a day loose, yellow-green mucus, large pus cells, occult blood test positive, may be associated with fever and abdominal pain. Colonoscopy showed normal or mild edema of the intestinal mucosa. There was a typical rice-like bulge, which was peeled off and exposed to expose the ulcer. Symptoms are relieved after the antibiotics are stopped for several days.
2, medium (typical): diarrhea more than 10 times a day, the stool is egg-like, with a fake membrane and bloody stool, accompanied by fever and abdominal pain. Peripheral blood neutrophils increased, serum 1-globulin increased, serum potassium, sodium and albumin decreased.
3, heavy: diarrhea more than 20 times a day, the amount of stool is more, strange smell, often bloody stools, the pseudomembrane is large or tubular. Fever and toxemia are more severe and hypoproteinemia occurs in the short term. Often due to dehydration, electrolyte imbalance, shock, DIC, intestinal bleeding or intestinal perforation into a critical state, the prognosis is poor.
Examine
Examination of intestinal anaerobic infections
1, blood: Most patients with elevated white blood cell count, up to 60 × 109 / L, increased neutrophils.
2, white blood cells can be seen in stool smear examination, a large number of positive bacilli can be seen in Gram staining, and Bacillus licheniformis can be isolated from the feces of 85% of patients using CCFA medium, and can be identified by biochemical test or gas-liquid chromatography. .
3. Tissue culture: Cell B toxins as low as 10 pg in feces can be detected. This method requires cell culture equipment.
4. The ELISA method used in recent years can detect A toxin or B toxin at a level of 100 to 1000 pg, which is fast, correct, sensitive and economical.
Diagnosis
Diagnosis and identification of intestinal anaerobic infection
Patients with typical clinical manifestations after taking antibiotics should consider this disease, especially for the elderly. Typical cases with pseudomembrane discharge may be helpful in the diagnosis of this disease if the antibiotics are discontinued or the condition is improved after treatment with vancomycin. For light cases, the best way to confirm the clinical diagnosis is colonoscopy. The mucosa of each part should be carefully observed, because the small yellow patches are brittle and can be covered by congestion, mucus and feces. Pathogen culture and toxin detection have important reference value for diagnosis.
