Campylobacteriosis – the sharp zoonozny infection caused by enterobakteriya of Campylobacter and proceeding with primary damage of a digestive tract. The localized campylobacteriosis form in most cases proceeds as a gastroenteritis or a gastroenterokolit; the generalized form is followed by development of a septitsemiya or septikopiyemiya. The diagnosis of campylobacteriosis is confirmed by means of bacteriological crops a calla, blood; serological reactions, endoscopy of intestines. Specific etiotropny therapy of campylobacteriosis is performed by antimicrobic medicines (metronidazole, antibiotics of a tetracycline row, groups of macroleads or ftorkhinolon, etc.).
Campylobacteriosis – sharp intestinal infection which causative agents are bacteria kampilobakter. In structure of diarrheal diseases 5-15% fall to the share of campylobacteriosis that speaks about its prevalence and the epidemiological importance. Campylobacteriosis is registered worldwide, including in Russia; higher incidence is noted in tropic latitudes. Representatives of various age groups have campylobacteriosis, however more often the infection is diagnosed for children preschool children. Emergence of both sporadic, and group cases of intestinal infection is possible. The peak of incidence of campylobacteriosis falls on aestivo-autumnal months, from June to September.
Campylobacteriosis is caused by the pathogenic species of intestinal bacteria belonging to the Enterobacteriaceae family, the sort Campylobacter. Now there are more than 14 types of the kampilobakter allocated from people and animals. The greatest importance in an etiology and pathogenesis of campylobacteriosis of the person have C.coli, C.jejuni, C.laridis, C.fetus: from them the first two look causes the majority of cases of diarrheal forms of an infection, and the last - hematogenic disease forms.
Kampilobaktera are the gramotritsatelny, not forming a dispute bacteria having the small sizes (length of 0,5-0,8 microns, width of 0,2-0,5 microns), a curved or helicoid form. Mobility of bacteria is provided with one or two zhgutika located polarly. Optimum conditions for growth of kampilobakter is the mikroaerofilny environment with concentration of oxygen no more than 5-10% and with the temperature of 37-42 °C, however bacteria are steady also against low temperatures.
Farm animals and birds, and in the leading way of transfer of activators – the alimentary way realized at the use of the polluted meat products, milk, water are the main source of infection of the person with campylobacteriosis. Less often penetration of microorganisms through the injured skin is possible, for example, at stings of the infected animals. Infection of newborns can occur transplatsentarno or at the time of delivery. In risk group on developing of campylobacteriosis there are villagers, employees of livestock and poultry-farming farms, and also the tourists visiting developing countries. More incidences of campylobacteriosis are subject the persons having immunodeficiency, children and pregnant women.
At hit in an organism kampilobakter reach a small intestine where take root into her mucous membrane and lymphoid educations, causing development of inflammatory process of various expressiveness. On lymphatic ways kampilobakter get into bryzheechny lymph nodes, a worm-shaped shoot, a large intestine. In the course of the activity kampilobakter produce entero-and cytotoxins, and at destruction emit the endotoxins causing development of diarrheal, painful and intoksikatsionny syndromes. Upon transition of campylobacteriosis to a generalized form the septitsemiya and a septikopiyemiya leading to polyorgan defeat with developing of abscesses in a liver and a spleen, polyarthritis, lymphadenitis, meningitis, nephrite, etc. develops.
Classification of campylobacteriosis
On the basis of kliniko-pathogenetic features distinguish localized (gastrointestinalny) and generalized a campylobacteriosis form. Treat the localized options of a course of an infection a gastroenteritis, gastroenterokolit, enteritis, enterokolit, mezadenit, appendicitis. The generalized form is followed by development of a kampilobakteriozny septitsemiya and septikopiyemiya.
Campylobacteriosis can have a manifest or asymptomatic current. Clinically expressed forms include easy, medium-weight and heavy degrees. Asymptomatic forms are presented subclinical and rekonvalestsentny by campylobacteriosis options. Depending on duration of an infection distinguish sharp (up to 3 months), chronic (more than 3 months) and a residual phase of campylobacteriosis.
In most cases campylobacteriosis proceeds in the localized form, accepting the nature of enteritis, an enterokolit, gastroenterokolit or colitis. The diseased often has associated diseases of a GIT: gastritises, duodenita, stomach ulcer of a stomach and 12-perstny gut, dyskinesia of biliary tract, cholecystitises.
The incubatory period proceeds from several hours to 10 days (on average 2-5 days). The beginning of campylobacteriosis sharp - from a fever, fever (38-39 °C), perspiration, a mialgiya, an artralgiya, a headache. At the same time or in several hours diarrhea with a frequency of chair up to 5-10 times a day joins. Excrements have watery character, a fetid smell, quite often contain impurity of bile, slime and blood. Nausea and vomiting are not an obligatory symptom of campylobacteriosis and occur only at a quarter of patients. Skhvatkoobrazny belly-aches are the most constant sign. At a good-quality current the disease is allowed in 3-9 days.
At the heavy course of campylobacteriosis profuzny mucous or bloody diarrhea, the expressed dehydration can develop; children have a convulsive syndrome or the phenomena of a meningizm. Less often the localized forms of campylobacteriosis proceed in the form of a sharp mezadenit, catarrhal or flegmonozny appendicitis. Serous peritonitis, jet arthritis, toxic megacolon, intestinal bleeding, infectious and toxic shock can serve as complications of the localized form of campylobacteriosis. There are messages on connection of the postponed campylobacteriosis with development of a syndrome to Giyena-Barra.
Development of generalized forms of campylobacteriosis is noted at persons with the adverse accompanying background: a kakheksiya, cirrhosis, diabetes, tuberculosis, system diseases, malignant tumors, HIV infection, and also children of the first months have lives. The clinical symptomatology includes persistent fever (to 40 °C and above), profuzny sweats, oznoba, exhaustion, the dispepsichesky phenomena, a gepatosplenomegaliya, an anemization. In certain cases tranzitorny bacteremia can progress in septic process, causing development of the purulent metastatic centers in various bodies in the form of arthritis, micropolylymphadenitis, peritonitis, an endocarditis, myocarditis, pleurisy, pneumonia, meningitis, encephalitis, etc. The current of a generalized form of campylobacteriosis heavy, is quite often noted a lethal outcome.
Chronic campylobacteriosis is usually connected with immunosuppressive states, including HIV infection. Disturbs patients subfebrilitt, an unstable chair, pains in mezogastriya, a loss of appetite, weight loss. Often symptoms of conjunctivitis, a keratit, pharyngitis come to light; women have recidivous vaginita or vulvovaginita, abortions. The organ defeats characteristic of a generalized form can develop in the periods of an exacerbation of campylobacteriosis.
Diagnosis of campylobacteriosis
(contact with animals, trips, etc.), characteristic symptoms can form the bases for suspicion of campylobacteriosis. At a koprogramma research in excrements inflammatory exudate, leukocytes, erythrocytes is found. Rektoromanoskopiya or a kolonoskopiya at the height of a disease reveals a picture of a catarrhal, catarrhal and hemorrhagic, erosive and ulcer proktosigmoidit or colitis.
The most exact confirmation of campylobacteriosis is the bacteriological research a calla. Sometimes as material for a cultural research serves blood, pus of abscesses, a likvor, amniotic waters. Also serological diagnostics by means of the RA, RNGA, RSK, IFA methods, an immunoelectrophoresis, latex agglutination, etc. is carried out.
The Gastrointestinalny form of campylobacteriosis demands differentiation from others OKA, first of all dysentery and salmonellosis, and also a mezadenit and appendicitis of other etiology. The endoscopic biopsy of intestines allows to exclude nonspecific ulcer colitis and a disease Krone. The generalized form of campylobacteriosis needs to be distinguished from the sepsis caused by other activator; a chronic form – from toxoplasmosis, a brucellosis, iyersinioz and other chronic infectious diseases.
Treatment and prevention of campylobacteriosis
The volume of medical actions at campylobacteriosis depends on a form and weight of an infection. At easy degree of the localized campylobacteriosis forms etiotropny therapy is not carried out: in this case are limited to purpose of a diet, oral regidratation, spazmolitik, enzymes, biological bakteriyny medicines for correction of an intestinal dysbiosis. At a medium-weight and heavy current of gastrointestinalny forms of campylobacteriosis, and also at generalization of an infection use of antibacterial medicines to which kampilobakter are sensitive is shown (erythromycin, , doxycycline, chloramphenicol, , ftorkhinolona, aminoglycosides, macroleads, metronidazole, furasolidone, etc.) course of 7-14 days. Pathogenetic therapy of campylobacteriosis assumes infusional introduction of glyukozo-electrolytic and polyionic solutions, purpose of the desensibilizing means. The persons who had campylobacteriosis are on dispensary observation at the infectiologist within 1 month and are subject to double bacteriological inspection.
At the localized campylobacteriosis forms the forecast favorable. Complications are possible only at the heavy course of a disease and among persons with the burdened accompanying background. At the generalized forms developing at children, pregnant women, weakened patients, the lethality can reach 25-30%. Prevention of campylobacteriosis has to be directed to the prevention of contamination of pets and birds; sanitary inspection behind water supply, the mode of storage and technology of processing of foodstuff; training of the population in standards of personal hygiene and to rules of cooking.