Ehsherihioza (Coli infections) - acute, mainly intestinal infections caused by certain serovars bacteria Escherichia coli. Ehsherihioza appear as enteritis and enterocolitis may generalize and proceed with extra-intestinal symptoms. The mode of transmission of E. coli fecal-oral. Most infection occurs when consuming contaminated dairy and meat products. Possible and contact-household transmission path of an intestinal infection. Diagnosis ehsherihioza set the detection of E. coli in the stool and vomit, and at the generalization of infection - in the blood. ehsherihioza Treatment consists of diet, rehydration therapy, the use of antimicrobial agents and eubiotics.
enterocolitis, occurring on the type of dysentery in children older than one year and adults, infection occurs through water and food, there is the summer-autumn season. Mainly prevalent in developing countries. ETKP cause cholera, infection, infected children from two years old and adults, the incidence is high in countries with a hot climate and low sanitary culture. Infection occurs through food and water.
Epidemiological data on infections resulting lesion group EHEC pathogen currently insufficient for detailed characterization. The epidemiology of major importance ehsherihioza play hygienic measures, both general and individual character.
coli sepsis or E. coli lesions of various organs and systems (meningitis, meningoencephalitis, pyelonephritis, and others.). Ehsherihioza may be mild, moderate and severe.
For lesions characteristic for EIKP like dysentery, or shigellosis. The incubation period lasts from one to three days, the beginning of a sharp, indicated moderate intoxication (headache, weakness), fever ranging from subfebrile to high values, chills. Then there are pains in the abdomen (especially around the navel), diarrhea (sometimes streaked with blood, mucus). Palpation of the abdomen noted tenderness along the colon. Often ehsherihioza this species occurs in the light and erased form, there may be a moderate flow. Typically, the disease does not exceed the duration of a few days.
ETKP damage can manifest clinical symptoms similar to those of salmonellosis, food poisoning, or resemble a light form of cholera. The incubation period is 1-2 days, intoxication mild, the temperature usually does not increase, there is repeated vomiting, profuse diarrhea enteritnaya gradually increases dehydration, there is oliguria. There have been a pain in the epigastric region, bearing the cramping in nature.
This infection is often called the "travelers disease" because it often affects people who left on a business trip or on holiday in the country with a tropical climate. The climatic conditions favor the occurrence of severe fever with chills and intoxication symptoms, intense dehydration.
EHEC develops most often in children. Intoxication with moderate, low-grade body temperature. There is nausea and vomiting, loose, watery stools. In severe for 3-4 day, the disease appear severe abdominal pain cramping in nature, diarrhea is enhanced in the faeces graduating fecal character, may mark an admixture of blood and pus. Most often the disease takes a week on their own, but in severe (especially in young children), 7-10 days after the disappearance of diarrhea, there is a chance of developing haemolytic uraemic syndrome (a combination of hemolytic anemia, thrombocytopenia and acute renal failure). Frequent violations of brain regulation: limb convulsions, muscle rigidity, impaired consciousness until sopor and coma. The mortality rate of patients with the development of the symptoms reaches 5%.
feces and vomit in cases of generalization - blood, urine, bile or cerebrospinal fluid. After that is done bacteriological examination, inoculation of nutrient media. Due to the antigenic similarity of pathogens ehsherihioza bacteria that are part of the intestine normotsinoza, serological diagnosis uninformative.
For laboratory diagnosis of infections caused by EHEC, can be applied detection of bacterial toxins in the faeces of patients. Thus in the analysis of a blood ehsherihioza hemolytic anemia signs may be marked increase in the concentration of urea and creatinine. Urinalysis usually shows proteinuria, pyuria and hematuria.
Treatment primarily outpatient, hospital patients are subject to severe and high risk of complications. Patients recommended diet. For the period of acute clinical manifestations (diarrhea) - Desk №4 after termination - table №13. Mild dehydration is corrected fluid intake and rehydration mixture orally, with an increase in the degree of dehydration and severe producing intravenous solutions. Pathogenetic treatment is chosen depending on the type of pathogen.
The drugs nitrofuran series (furazolidone) is usually appointed as antimicrobial therapy, or (in severe infections caused by EIKP), fluoroquinolones (ciprofloxacin). The drug is prescribed for 5-7 days. Treatment ehsherihioza EPKP children advantageously carried out using a combination of sulfamethoxazole and trimethoprim, antibiotic. Generalized forms are treated with cephalosporins second and third generation.
In the combined therapy with prolonged course of the disease for the normalization of digestion and restore intestinal biocenosis include enzymatic preparations and eubiotics. Modern principles of treatment ehsherihioza provoked by bacteria EHEC group, include the use of antitoxic therapeutic measures (serum extracorporeal adsorption of antibodies).
Prediction and prevention ehsherihioza
Forecast for adults and older children - favorable in mild cases of independent marked recovery. Young children may suffer in ehsherihiozom severe that worsens the prognosis. Also noticeable is difficult to recover in the event of generalization and the development of complications. Some particularly severe ehsherihioza are without proper medical care result in death.
Ehsherihioza - diseases associated with low sanitary culture. Personal prevention of these infections is to follow hygienic standards, especially when dealing with children, hand washing, food, toys and household items. Total prevention is aimed at monitoring compliance with the sanitary-hygienic regime in child care, food industry, health care facilities, as well as control over the drain sewage and state sources of water.
Patients after transferring ehsherihioza discharged from hospital after clinical recovery, as well as on the results of bacteriological tests three times. Admission to the Children staff exposed to the sick, is also carried out after the bacteriological diagnosis and confirm the absence of isolation of the pathogen. Those that emit pathogenic Escherichia, subject to isolation for the duration of infectiousness. Workers in the food industry are subject to regular surveys on the subject of abjection, in the case of a positive test - suspended from work.