Diphtheria is an acute infectious disease characterized by inflammation of the tonsils, general intoxication and toxic damage to the cardiovascular and nervous systems.
Diphtheria is caused by corynobacteria (diphtheria bacillus, Leffler's bacillus). Corynebacterium diphtheriae is a Gram-positive, rod-shaped bacterium of the genus Corynebacterium that causes diphtheria.
First described by German microbiologist Edwin Klebs. Large, straight, slightly curved, polymorphic, rod-shaped bacteria. Metachromatic grains of volutin (Babesh-Ernst grains) are localized at the poles of the cells, giving the cells a characteristic “mace” shape. Volutin grains are stained with methylene blue or Neisser. On micropreparations, they are located singly or, due to the peculiarities of cell division, are arranged in the form of the Latin letter V or Y. In many strains, microcapsules are isolated. Facultative anaerobe. They grow on complex nutrient media containing whey, for example, clotted horse serum according to Roux, a mixture of bovine whey with sugar broth according to Loeffler. On blood agar with tellurite (Klauber's medium), the colonies turn black due to the reduction of tellurite.
The cause of the disease can be both toxigenic and non-toxigenic strains of diphtheria bacillus, but only the first of them cause complications such as myocarditis and neuritis. The pathogen is resistant to high and low temperatures, drying. It quickly dies when boiled and exposed to disinfectants. In the process of reproduction, it produces a toxin that plays a major role in the pathogenesis of the disease. C. diphtheriae can cause not only throat diphtheria, but also skin lesions.
The source of the disease is a sick person or a bacteriocarrier.
The patient is contagious from the last day of the incubation period until the complete sanitation of the body, which can occur at different times.
Diphtheria is transmitted mainly by airborne droplets, but contact and food transmission of the infection are possible.
The incubation period lasts 1 - 6 days. Clinically, diphtheria is divided into several types depending on the localization of the virus:
throat disease (90% of cases),
larynx,
Respiratory tract (trachea, bronchi).
More rare localizations: eyes, skin, wounds, genitals. By the nature of the course, typical (membranous) and atypical (catarrhal, hypertoxic, hemorrhagic) diphtheria are distinguished. According to the degree of severity, mild, moderate and severe forms are distinguished.
Possible complications of diphtheria: in young children, due to the closure of the lumen of the larynx or trachea with an exfoliated film, sudden death may occur. A complication of the disease is myocarditis, which can develop both after severe and after mild forms of diphtheria, but more often with widespread lesions and delayed diagnosis. Neurological complications are expressed by motor disorders, usually disappear after recovery. The most characteristic complication is paralysis of the soft palate, which develops on the 3rd week of the disease. The voice becomes nasal, when swallowing liquid food pours out through the nose. Sometimes there is paralysis of the oculomotor nerve. Tendon reflexes decrease, muscle weakness, coordination disorder appear. With damage to the muscles of the neck and torso, the patient cannot walk, hold his head. Gastritis, nephritis, hepatitis may develop.
Prevention of diphtheria mainly consists in immunization, as well as in the isolation of patients and the suppression of the spread of infection. A patient is considered contagious as long as the pathogen is found at the site of infection. Isolation is terminated after receiving three negative results of bacteriological examination.
The medical worker should conduct a conversation with the relatives of the patient about infectious safety. He must tell them that they must allocate a separate dish to the patient and disinfect it, the dishes should not come into contact with the general one. Also, people in contact with the sick person should wear a hygienic mask, carry out daily wet cleaning with a disinfectant solution in the house, regularly ventilate the room, and observe personal hygiene.
WHOOPING COUGH
Whooping cough is an acute infectious disease of children with a cyclic course and characteristic attacks of whooping cough.
The causative agent of whooping cough - Bordetella pertussis - small coccoid gram-negative rods with rounded ends (0.2-0.5 x 0.5-2 microns), bipolar stained. Motionless. Dispute does not form. They have a microcapsule and drank. obligate aerobes. They have O-antigen, capsular antigens.
The infection is transmitted by airborne droplets. Pertussis, which is in droplets of sputum and mucus of the patient, when coughing, enters the air and then penetrates through the respiratory tract into the body of a healthy person. Infection is possible only when communicating with patients, since Bordetella pertussis quickly dies outside the body. The risk of infection through surrounding objects is practically eliminated.
Most often, children from 1 to 5 years old get sick, sometimes children under 1 year old. In adults, the disease is rare. Whooping cough leaves a strong immunity, recurrence is very rare.
The incubation period lasts from 2 to 15 days (average 5-9 days).
Clinic. Initially, there is a slight cough, intensifying every day. The temperature rises, the child becomes irritable, sleep and appetite worsen, this period is called catarrhal, lasts up to 2 weeks. All manifestations of the disease continue to grow; gradually the child's health worsens, the cough becomes longer and more severe, and at the end of the second - the beginning of the third week it becomes paroxysmal in nature: the disease passes into the third period - spasmodic, which lasts 1-5 weeks. Bouts of convulsive coughing are the main and constant symptom of the disease. The cough begins with two or three deep coughing shocks, followed by a series of short shocks, they follow one another and end with a deep wheezing due to convulsive constriction of the larynx. Then the coughing starts again. The severity of the disease depends on the duration and frequency of attacks. In young children, coughing attacks are long (up to 2-3 minutes), consist of short expiratory shocks without wheezing. During an attack, the patient's face turns red, then acquires a bluish tint. Tears appear in the eyes, sometimes hemorrhages form in the white of the eyes, the tongue is protruded from the mouth, the jugular veins swell, involuntary separation of feces and urine is possible. The attack ends with the discharge of viscous sputum and often vomiting. Cough attacks are repeated from 5 to 30 or more times a day. The face becomes puffy, the eyelids swell, and hemorrhages may appear on the skin of the face. In the intervals between attacks of coughing, children feel quite satisfactory. Gradually, the cough weakens, attacks become less frequent - a recovery period begins, which lasts an average of 1-3 weeks.
The total duration of the disease is from 5 to 12 weeks. A child is considered contagious within 30 days from the onset of the disease. Mass vaccinations have led to the appearance of the so-called erased forms of whooping cough, when the spasmodic period can be very mild or completely absent.
Pathogenesis. Bordetella pertussis breeds mainly on the mucous membrane of the respiratory tract. Their epithelium undergoes dystrophic changes and exfoliates, signs of catarrhal inflammation are revealed. The decay products of the pathogen (endotoxins) cause irritation of the nerve receptors of the larynx, there are impulses that go to the brain and lead to the formation of a persistent focus of irritation in it. Due to the lowering of the threshold of excitation of the nerve centers and receptors, an insignificant non-specific irritation is enough to cause an attack of spasmodic cough. “Neurosis of the respiratory tract” develops, which is clinically manifested by jerky exhalations following one after another, followed by convulsive deep breaths, repeated many times and ending in secretions of viscous sputum or vomiting. Whooping cough in infants is especially severe, they do not have spasmodic coughing fits, their equivalent is apnea attacks with loss of consciousness and asphyxia.
At present, thanks to seroprophylaxis and mass vaccination, the severity of the course and morbidity have significantly decreased, mortality does not exceed tenths of a percent.
Complications: pneumonia (especially in children from 1 to 3 years old), nosebleeds, respiratory arrest. In infants and debilitated children, whooping cough can be very difficult: the catarrhal period is short, sometimes a spasmodic period immediately sets in, often coughing fits lead to respiratory arrest.
Fatal outcome is now rare, mainly in infants from asphyxia, pneumonia, in rare cases - from spontaneous pneumothorax.
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BACTERIAL INFECTIONS A group of infectious diseases Infections included in the group Intestinal infections Typhoid fever, paratyphoid fever A and B, salmonellosis, dysentery, cholera, escherichiosis, botulism Respiratory tract infections (respiratory infections) Diphtheria, scarlet fever, whooping cough, tonsillitis, meningococcal infection, tuberculosis, ornithosis, respiratory chlamydia , Mycoplasmosis Blood infections Typhoid fever, relapsing fever, plague, tularemia, Integument infections Anthrax, tetanus, gas gangrene, syphilis, gonorrhea, urogenital chlamydia, trachoma
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Intestinal infections Causative agents of diseases of the respiratory tract (respiratory infections)
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Intestinal infections Mechanism of infection - fecal-oral or oral Ways of transmission - water, food, household contact
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Causative agents of intestinal diseases Salmonella - salmonellosis Salmonella (bacillus) typhoid fever - typhoid fever Salmonella paratyphoid A - paratyphoid A Dysentery bacillus - dysentery Escherichia coli (E. coli) - escherichiosis Vibrio cholerae - cholera Clostridium botulism - botulism
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Typhoid fever, paratyphoid (A, B) and salmonellosis pathogens - bacteria of the genus Salmonella (family - enterobacteria) Sources of infection: - typhoid - a sick person, a bacteriocarrier; - salmonellosis - domestic animals and birds; sick person. The transmission mechanism is fecal-oral. The route of transmission is alimentary (food), water, contact-household (household items, dirty hands). Prior to the identification of pathogens, typhoid included all diseases that occur with impaired consciousness and fever. Typhus - smoke, fog, turbidity, gloom. Currently, typhus is divided into: - typhoid, paratyphoid A and B; - rash (rickettsiae), - recurrent (spirochetes). A common feature of these diseases is typhoid status - impaired consciousness, memory, orientation.
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Salmonellosis causative agent - bacteria of the genus Salmonella The main source of infection are animals, sometimes patients and bacteria carriers. Zooanthroponotic infection. Clinic: intoxication, damage to the digestive tract. Amer. scientist Daniel Salmon. Salmonella are movable rods, secrete endotoxin, gram "-", do not form spores and capsules, facultative anaerobes. Stability: - at room temperature - up to 3 months; - in water up to 5 months, - in meat and dairy products up to 6 months, - on eggshells up to 24 days; - die at 100°C, (in meat products they die after 2.5 hours) Salting and smoking have no effect. - maintain low temperatures, up to - 80 °C; - UV resistant. There is no specific prevention. The main measures for the prevention of toxic infections are the prevention of the sale of infected products and the establishment of sanitary supervision.
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Typhoid fever and paratyphoid a and b The causative agent is Salmonella typhi bacteria. Typhoid fever is an acute infectious disease. anthroponotic infection. The bacteria of typhoid fever, paratyphoid-rods are similar in size and shape to intestinal ones, do not form spores and capsules, are well mobile, gram "-", grow on simple nutrient media under aerobic conditions. Produce endotoxin. Typhoid bacteria are stable in the external environment: at low temperatures - 1-3 months, in fresh water of reservoirs - up to 1 month, in dairy products they can multiply and accumulate. They die when boiled. Diagnosis - bacteriological method (blood for hemoculture, feces, urine, contents of roseol.); serological (Vidal's reactions). After the transferred disease, a stable lifelong immunity is formed.
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The incubation period is from 7 to 25 days. Diagnosis: 1. Bacteriological method. Examine sputum, pus, feces, urine, scraping with roseol, bone marrow punctate. 2. Serological method. 3. Express diagnostics of typhoid fever and bacteriocarrier. From the first days of illness, antigen is detected in feces, urine and other substrates. Clinic Severe intoxication (headache, weakness) High temperature The tongue is thickened and lined with white coating, there are imprints of the teeth on the lateral surfaces (the tip of the tongue and the lateral surfaces without plaque) Bloating. Enlargement of the liver and spleen Insufficient roseolous rash on the skin of the back and extremities (8-10 days) CCC: lowering blood pressure, bradycardia, deafness of heart tones Prevention .. All patients who have had typhoid fever are subject to mandatory dispensary observation. Systematic monitoring of chronic carriers. Current disinfection in the foci of infection. According to epid. indications are vaccinated.
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Prevention of intestinal infections The main measures for the prevention of acute intestinal infections: 1. Personal hygiene, 2. Drink only boiled or bottled water for drinking 3. Before use, fresh vegetables should be thoroughly washed and doused with boiling water. 4. For nutrition, choose foods that have been heat-treated. Thoroughly fry (boil) foods, especially meat, poultry, eggs and seafood. Do not store food for a long time, even in the refrigerator. 5. Store perishable food only in cold conditions. Do not leave cooked food at room temperature for more than 2 hours. Do not consume food that has expired and has not been refrigerated (perishable food). 6. Use separate kitchen utensils and utensils such as knives and cutting boards to handle raw foods. Keep raw foods separate from cooked foods. 7. Swim only in places designated for this purpose. When swimming in ponds and pools, do not allow water to enter your mouth. If symptoms of an acute intestinal infection occur (fever, vomiting, upset stool, abdominal pain), you should immediately seek medical help! Prevention of salmonellosis 1. Drink only boiled water from open sources; 2. Follow the rules of personal hygiene 3. Do not "take samples" in the market from the counter, do not "treat" unwashed fruits or vegetables to children; wash fruits, vegetables, berries thoroughly under running water, then pour over with boiling water; 4. Put purchased vegetables, fruits, meat, fish, eggs in a bag separately from products that are not subjected to heat treatment (bread, sausage, cottage cheese, confectionery, etc.); 5. When buying food products, pay attention to their shelf life; 6. Strictly observe the "commodity neighborhood" when storing products: separate storage of raw and finished products, especially in the refrigerator; 7. Have separate cutting equipment (knives, cutting boards) for raw and finished products, thorough washing of equipment; 8. Dishes from minced meat, poultry subjected to sufficient heat treatment.
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Bacterial dysentery (shigellosis) causative agent - dysentery bacillus Shigella genus. Sh. disenteriae Shigella are small Gram-negative rods, non-motile (have no flagella), do not form spores, facultative anaerobes. Japanese scientist Shig. Dysentery is an acute or chronic infectious disease characterized by diarrhea, damage to the mucous membrane of the colon and intoxication of the body. The habitat of Shigella is the cells of the human colon. Source - a sick person Ways of transmission - alimentary (milk), water, contact-household. It proceeds hard: an increase in t (up to 38-39) is characterized by bloody diarrhea with blood, symptoms of CNS damage. Diagnosis: 1) bacteriological examination (scatological research) 2) serodiagnosis. Prevention - dysenteric bacteriophage. With dysentery, local and general immunity develops.
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Prevention of dysentery A complex of sanitary and hygienic measures aimed at identifying patients, breaking the mechanism of infection transmission and increasing the body's resistance. -- In order to identify unrecognized cases of the disease, bacteriological examination of feces is carried out for persons in contact with patients. -- It is also necessary to conduct a survey of applicants for work related to public catering, water supply, and child care. --Control over the sanitary condition of water supply, sewerage facilities, sewage collection sites and their neutralization. -- Strict sanitary control in the food industry and public catering, especially those engaged in the processing of milk and dairy products. -- Sanitary-educational work among the population plays an important role in the fight against dysentery.
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Cholera (Greek Cholē- bile, rheō- flow, expire) Pathogen - Vibrio cholerae Vibrio cholerae asiaticae Pathogen - Vibrio cholerae, in the form of a "comma", mobile (has a flagellum), spores and capsules do not form, gram "-", aerob . In pure culture, the microbe was isolated during expeditions to Egypt (1883-1884) by Robert Koch ("Koch's comma") It tolerates freezing well (up to 4 months). Boiling kills within 1 minute. In food products - 2-5 days, in dairy products - up to 2 weeks. Sensitive to acidic environment. In order to disinfect a bucket of water, just drop one drop of acetic acid.
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Cholera is an acute anthroponotic intestinal infection characterized by watery diarrhea followed by vomiting. Cholera belongs to the group of especially dangerous (quarantine) infectious diseases (plague, cholera, yellow fever, smallpox). Highly virulent pathogen, high mortality, severe course of the disease. Capable of spreading rapidly. The source of infection is a person with a typical or erased form or a vibrio carrier. The mechanism is fecal-oral, the leading route of transmission is water, food and household contact. They speak of a cholera epidemic already if the number of cases is 7-10 people. Hospitalization required. Cases require reporting to WHO. Localization and elimination of the focus of cholera is carried out under the leadership of the emergency anti-epidemic commission.
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Pathogenesis Action occurs in the small intestine. Cholera - exotoxin, causes hypersecretion of water and chlorides (diarrhea, dehydration); - endotoxin, has an immunogenic effect. Normally, up to 8 liters of fluid per day are secreted into the human intestine. 200 ml of 8 liters is excreted in the feces, and the rest is reabsorbed. The toxin acts on the intestinal wall and disrupts the absorption of fluid. The fluid accumulates in the intestines and stomach, stretching them, there is rumbling, anxiety - irreversible vomiting and diarrhea develop. As a result, it leads to dehydration. As a result of a massive loss of fluid with vomit and feces, its content in the intercellular space, in the cells, decreases; the volume of circulating blood decreases. At autopsy, in patients who died from cholera, the blood resembles "currant jelly" - only uniform elements. Clinic Increasing t to 38-39, vomiting, diarrhea, convulsions, impaired S.-S.S., breathing.
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COUNTER-EPIDEMIC MEASURES WHEN THE PATIENT OR CARRIER IS DETECTED Immediate isolation of the patient Discharge of those who have been ill with negative results of three bacterial tests after treatment Daily rounds of all residents of a disadvantaged settlement Identification and hospitalization of persons suspected of cholera Identification and isolation for 5 days in the isolation room of all contacts, emergency prophylaxis with antibiotics Laboratory examination of the population for cholera
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FOOD TOXIC INFECTIONS Toxic infections are acute, often massive diseases that occur when eating food containing a large number of live conditionally pathogenic microorganisms (hundreds of millions per 1 g of product) and their toxins released during the reproduction and death of microbes. Unlike causative agents of intestinal infections, the causative agents of toxicoinfections are characterized by moderate pathogenicity for humans. A prerequisite for their occurrence is the consumption of foods richly contaminated with microorganisms. Toxic infections are not caused by pathogens themselves, but by toxins that accumulate in foods. Therefore, the incubation period is extremely short - from 10 minutes to 1 hour. Diarrhea, vomiting, abdominal pain, disruption of the nervous system (disorder and loss of consciousness, especially in children) develop. Food poisoning is caused by various pathogens: staphylococci, E. coli, enterococci, fecal streptococcus, Proteus.
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Staphylococcus aureus - Staphylococcus aureus Staphylococcus aureus is common in the environment and multiplies well in food. Sources and reservoirs of infection: farm animals (dairy cattle with mastitis), poultry; sick people and bacteria carriers. Ways of transmission: airborne, contact-household, alimentary. Possessing increased resistance to antibiotics, it causes nosocomial infections (HAIs). According to the World Health Association (WHO), Staphylococcus aureus, as the causative agent of nosocomial infections, is given the first place.
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Staphylococcus aureus causes diseases of the skin and subcutaneous tissue: pyoderma, abscess, panaritiums, boils. Respiratory diseases: tonsillitis, pneumonia, pleurisy. Diseases of the nervous system and sensory organs: otitis media, conjunctivitis, meningitis. Diseases of the digestive system: enteritis, enterocolitis, stomatitis, acute food intoxication. Diseases of the musculoskeletal system and connective tissue: arthritis, osteomyelitis. Diseases of the genitourinary system: cystitis, urethritis, mastitis, endometritis. Diseases of the cardiovascular system: endocarditis, pericarditis, phlebitis.
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Botulism The causative agent is the botulism bacillus, genus Clistridium, species Cl. botulinum. (from lat. botulus - sausage) Clostridium botulism - gram-negative anaerobic spore-forming bacteria Clostridium botulinum. The botulinum toxin they secrete is the most potent toxin known in nature. The toxin disrupts neuromuscular impulse transmission, as a result of which paresis and paralysis of various localizations develop in patients.
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Clinic and diagnostics The incubation period is short (since the products contain the pathogen and its toxin) - up to 12 hours on average. Symptoms: nausea, vomiting, loose watery stools up to 15 times / day. Temperature - 38-40 °. Pallor, tachycardia, decreased blood pressure. With dehydration - convulsions, anuria, collapse, shock. Lethal outcomes up to 60%. (acute respiratory failure) Diagnosis - clinical and epidemiological data and laboratory tests. Material - vomit, gastric lavage, feces, blood. Treatment. Antitoxic anti-botulinum serum is introduced according to the Bezredko method. There is no post-infectious immunity Prevention - careful heat treatment of food, strict adherence to sanitary standards for the preparation, storage and consumption of food.
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Causative agents of diseases of the respiratory tract (respiratory infections) Staphylococci, streptococci - tonsillitis Koch's bacillus (tuberculosis) - tuberculosis Diphtheria bacillus - diphtheria Streptococcus - scarlet fever Bordetella (whooping cough) - whooping cough Meningococcal infection - meningococcus Chlamydia - respiratory chlamydia, ornithosis Mycoplasma - mycoplasmosis
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Angina Acute infectious-allergic disease, in which inflammatory changes are expressed mainly in the palatine tonsils. The main pathogens are pathogenic and opportunistic pyogenic cocci: staphylococci, streptococci. The source of infection is often purulent diseases of the nose and paranasal sinuses, dental caries, etc. Clinic. The disease usually begins acutely, accompanied by a feeling of sore throat, general malaise, headache, aching joints, sore throat when swallowing. The temperature rises to 38-39°, sometimes up to 40°. Prevention of angina Sanitation of the upper respiratory tract
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Tuberculosis (consumption) is one of the oldest infectious diseases. The causative agent is Mycobacterium tuberculosis, tubercle bacillus, Koch's bacillus - thin, straight or curved acid-resistant sticks. There are giant forms with branching, filamentous, club-shaped forms. Sometimes they are chains or individual clusters of coccoid grains. Non-motile, gram "+", do not form spores, obligate aerobes, facultative intracellular parasites
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Distinctive properties of mycobacterium tuberculosis Resistance to acids and alcohol Remain viable when exposed to various physical and chemical agents. In dry sputum (under certain conditions), Koch's bacteria can remain viable for up to six months. In dried sputum on various objects (furniture, books, dishes, bed linen, towels, floors, walls, etc.), they can retain their properties for several months. Koch's wand dies in sunlight within 1.5 hours. Ultraviolet rays kill mycobacteria in 2-3 minutes.
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After the initial infection, no clinical manifestations of the disease may occur. The disease will not develop, however, Mycobacterium tuberculosis (MBT) can be in the body for a long time (years decades) without harming it. This state of relative equilibrium can be disturbed in favor of the pathogen with a decrease in the body's defenses (deterioration of social living conditions, malnutrition, stressful situations, aging Ways of infection 1. Aerogenic: (by inhalation of air) airborne (during sneezing and coughing); dust (in dusty rooms where the patient was) 2. Contact (through household items) 3. Food (when eating contaminated food).
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SPIT IN THE URNE A disgusting phenomenon, what will it be? People are spitting in all directions. Spit clean, spit dirty, spit healthy, spit contagious. The spit will dry up, become light, and the spit will fly with the dust. Consumption is carried into the lungs, into the throat. Spitting kills more people through our fault than in war. Be cultured: don't spit on the ground, but spit in the bins!", Vladimir Mayakovsky. "Comrade people! COMRADES PEOPLE, BE CULTURAL! DON'T SPIT ON THE FLOOR, BUT SPIT IN THE URNS.
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CLINICAL FORMS Eye tuberculosis. Extrapulmonary tuberculosis Tuberculosis of the digestive system Tuberculosis of the genitourinary system Tuberculosis of the central nervous system and meninges Tuberculosis of the bones and joints Tuberculosis of the skin
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Diagnosis fluorographic examination (FLG) The reaction to the Mantoux test is considered positive when an infiltrate (papules) with a diameter of 5 mm or more is formed.
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The quantiferon test is an immunological test that determines the level of specific interferon gamma (IFN-γ) in the patient's blood. Gamma-interferon in the blood is detected only in infected people (positive result). The quantiferon test has no contraindications and complications, as it is carried out outside the body (in vitro), in test tubes with the patient's blood.
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According to the recommendations of the World Health Organization (WHO), immunization with the BCG vaccine is considered one of the most important measures to prevent tuberculosis.
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BCG (Bacielle Calmette - Guerin) The BCG vaccine was created by French scientists A. Calmette and C. Guerin from a virulent strain of bovine Mycobacterium tuberculosis (MBT) by long subculture (230 consecutive passages) on a potato medium unfavorable for MBT growth with the addition of glycerin and bovine bile. The authors began passages of the strain in 1908, and 13 years later (after the 230th generation) the strain lost its virulence for animals (rabbit, monkey). At the same time, the experimental animals became resistant to subsequent MBT infection. The first child was vaccinated orally in July 1921 in France.
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Whooping cough (French cock's cry) Pathogen BORDETELLA PERTUSSIS The causative agent of whooping cough was first isolated from a sick child by J. Borde and O. Zhangu in 1900. Small, ovoid, gram "-" stick with rounded ends Motionless. There is no dispute. There are no flagella. Forms a capsule. Obligate aerobes Whooping cough is a highly contagious disease to which children are very susceptible (in adults it causes prolonged bronchitis). - bacteriological method (before the start of microbial therapy) - serological method Routine prophylaxis Combined DTP vaccine (adsorbed pertussis-diphtheria-tetanus vaccine) includes diphtheria and tetanus toxoids, killed whole microorganisms - whooping cough pathogens Appearance of a child with whooping cough during a spasmodic attack
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Scarlet fever In 1675, the disease was called purple fever - scarlet fever (English) Pathogen - (Streptococcus pyogenes) pyogenic streptococcus. Gram-positive hemolytic facultative aerobic group A streptococcus. It lives in the nasopharynx or on the skin of adults, can cause purulent processes - tonsillitis, erysipelas, in children with primary infection it develops scarlet fever. The main routes of infection are: - airborne (for example, when coughing, talking and sneezing); - household (through linen, toys, dishes, household items); - food (through food). Clinic: a rapid increase in temperature; hyperemia of the posterior pharyngeal wall, tonsils, tachycardia, vomiting; enlargement of the lymph nodes; redness of the tongue and hypertrophy of its papillae. (crimson tongue)
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the founder of antiseptics (the science of fighting infection) - the Hungarian obstetrician Ignaz Philip Semmelweis The young doctor Semmelweis, after graduating from the University of Vienna, remained working in Vienna and soon wondered why the death rate during childbirth in the hospital reached 30-40% and even 50%, far exceeding mortality in home births. In 1847, Semmelweis suggested that this phenomenon was somehow connected with the transfer of infection ("cadaveric poison") from the pathological and infectious diseases departments of the hospital. In those years, doctors often practiced in morgues (“anatomical theaters”) and often resorted to delivering directly from a corpse, wiping their hands with new handkerchiefs. Semmelweis ordered hospital staff to first dip their hands in a bleach solution and only then approach a woman in labor or a pregnant woman. Soon, mortality among women and newborns decreased by 7 times (from 18% to 2.5%).
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However, Semmelweis's idea was not accepted. Other doctors openly laughed at his discovery and at himself. The head physician of the clinic where Semmelweis worked forbade him to publish mortality reduction statistics, threatening that he would “consider such a publication a denunciation,” and soon fired Semmelweis from work altogether. Hounded and misunderstood during his lifetime by his contemporaries, Semmelweis went mad and spent the rest of his days in a psychiatric hospital, where in 1865 he died of the same sepsis from which women in childbirth died before its discovery. It wasn't until 1865, 18 years after Semmelweis's discovery and, coincidentally, in the year of his death, that the English physician Joseph Lister suggested fighting the infection with phenol (carbolic acid). It was Lister who became the founder of modern antiseptics.
Pathogentuberculosis
The causative agents of tuberculosis are mycobacteria (Mycobacterium tuberculosis, Mucobacteriuin bovis) - Gr + thin curved rods without spores, capsules and flagella, due to the characteristics of the chemical composition (high lipid content), the tubercle bacillus is stained like spores (according to Ziehl-Neelsen, it is stained burgundy , background - blue). On simple media, the pathogen does not grow; it is grown, for example, on an egg medium with starch, glycerin and malachite green to suppress the growth of concomitant microflora (Levenshtein-Jensen medium).
Two types of mycobacteria are pathogenic for humans:
M. tuberculosis - thin, slightly curved rods that grow better on media with glycerin; guinea pigs are more sensitive to them; source of infection- human, infection- airborne or airborne dust; pulmonary tuberculosis develops more often;
M-bovis - thick short sticks; rabbits are more sensitive to them; source of infection- farm animals; infection- more often in the alimentary (food) way; observed tuberculosis of the mesenteric lymph nodes.
The virulence of mycobacteria is associated with endotoxin and cord factor (cell wall glycolipids); allergenic properties are associated with cellular proteins. The incubation period is from several weeks to several years.
Disease occurs in various forms and can be generalized with damage to the organs of the genitourinary system, bones, meninges, eyes, skin. Features of immunity in tuberculosis:
marked natural predisposition l people to tuberculosis, due to the genotype;
immunity non-sterile(to superinfection) - while there are tubercle bacilli in the body, newly entering tuberculosis mycobacteria are inactivated (they die or encapsulate);
antibodies do not play a protective role, and their high titer only indicates the severity of the process (protection is mainly due to immune T-lymphocytes);
immunity is accompanied by the development allergies;
Non-sterile immunity after the release of the body from the pathogen becomes sterile.
Microbiological diagnostics carried out by microscopy of stained smears from the material, by the microbiological method, by infection with material from a sick guinea pig (biological method); Allergodiagnosis is also carried out (Mantoux test with tuberculin).
Specific treatment: in accordance with the sensitivity of the isolated, strain is prescribed antibiotics(streptomycin, kanamycin, rifampicin, etc.), drugsPACK(para-aminosalicylic acid), preparations GINK(hydrazides of isonicotinic acid - ftivazid, etc.)
Specific prevention: administered intradermally at 5-7 days of age live vaccine BJ (BCG - attenuated strain of M. bovis obtained by Calmette and Guerin); revaccination is carried out for persons under 30 years of age with a negative Mantoux test. This test is put
annually by intradermal administration tuberculin(specific extractable protein allergen of Mycobacterium tuberculosis). In adults, the Mantoux test is usually positive; in the absence of clinical manifestations, this indicates infection of the body with tubercle bacilli and, therefore, the presence of immunity to tuberculosis. In children, the test is either negative or positive with a swelling diameter at the injection site of 5-10 mm (vaccination allergy). If the diameter is more than 10 mm or the intensity of the reaction increases by 6 mm or more per year, the child needs an additional examination in order to exclude or confirm tuberculosis.
Pathogendiphtheria
Corynebacterium diphtheria (Corynebacterium diphtheriae) - Gr + thin, slightly curved rods, located at an angle to each other in preparations. There are no spores and capsules (they form a microcapsule in the body), they are immobile. Volutin grains are located in the thickenings at the ends of the sticks, which are revealed using special staining methods. They do not grow on simple media, they are grown on clotted horse serum, blood-tellurite and other media. Diphtheria is more often caused by C. diphtheriae biovar gravis, less often - other biovars (mitis or intennedius). Biovars are distinguished by cultural and biochemical properties. As part of the normal microflora of the human body, there are non-pathogenic corynebacteria (false diphtheria bacilli, diphtheroids), which are distinguished by morphological and physiological features.
Diphtheria bacilli are relatively stable in the external environment; can be stored on toys for up to 2 months, they are stored for a long time in diphtheria films. Sensitive to drying, heat, sunlight and common disinfectants. According to the ability to form exotoxin, diphtheria bacilli are divided into toxigenic and non-toxigenic. Non-toxigenic can acquire the ability to produce exotoxin under the influence of a moderate bacteriophage that carries toxigenicity genes (tox genes). C. diphtheriac exotoxin has general and local action. Locally, it causes necrosis (necrosis) of tissues and an increase in vascular permeability: a dense gray film is formed, "soldered" with the underlying tissues. In addition, exotoxin is absorbed into the blood and circulating in the body, affects its tissues, especially the myocardium, adrenal glands, nervous system (general effect).
Source of infection- sick person or microcarrier.
Infection more often occurs by airborne droplets, less often by contact-household (through toys, dishes) or alimentary.
Disease characterized by severe intoxication and local symptoms. Distinguish diphtheria of the pharynx, nose, larynx, wounds. eyes, other localizations. Immunity is mainly antitoxic, unstable.
diphtheria and diphtheria microcarriage is carried out by examining the material from the focus of inflammation (microscopy of stained smears, isolation of a pure culture with identification and mandatory determination of its toxigenicity).
specific treatment. At the first suspicion of diphtheria, an antitoxic diphtheria drug is administered. serum(heterologous). For antimicrobial therapy, antibiotics are prescribed; they are also used for sanitation of microcarriers.
Specific prophylaxis held diphtheria toxoid(from the 1st year of life). It is part of the associated DTP vaccines. ADS (ADS-M preparation with a reduced dose of antigen is administered to weakened individuals and children with allergic status m).
Pathogenwhooping cough
Whooping cough is caused by Bordetella pertussis (Bordetella pertussis) - Gr- polymorphic bacillus without spores and flagella. Forms a capsule in the body. Does not grow on simple media; it is grown on a potato-glycerin medium with blood, on casein-charcoal agar. It forms small, smooth, shiny (like droplets of mercury) colonies, which are studied with side illumination (they cast a cone-shaped beam of light onto the medium). Biochemically inactive. Identification is carried out by a complex of morphological and physiological characteristics and antigenic structure. The causative agent of whooping cough possesses endotoxin and forms substances such as exotoxins. Unstable in the external environment. Sensitive to heat, sunlight, common disinfectants.
Source of infection- a microcarrier or a sick person who is contagious in the last days of incubation and in the catarrhal periods of infection. Infection- by airborne droplets. Children get sick more often. Disease accompanied by allergization and proceeds in several periods: 1) catarrhal(characterized by symptoms of acute respiratory infections); 2) spasmodic(convulsive), when bordetell toxins irritate the endings of the vagus nerve and a focus of excitation is created in the brain: bouts of indomitable coughing are noted, which often ends in vomiting; 3)period convalescence. Immunity is cellular and humoral, persistent.
Microbiological diagnostics in the early period of the disease, it is carried out by isolating a pure culture of B. pertussis from sputum, in a later period - by serodiagnosis in the RSK, etc.).
Specific treatment: antibiotics, human immunoglobulin.
Specific prevention: killed vaccine (part of the DTP vaccine).
Pathogenmeningococcalinfections
Meningococci, or Neisseria meningitidis (Neisseria meningitidis) - G-cocci that look like coffee beans and are arranged in pairs with concavities to each other. No spores or flagella; form a capsule in the body. They do not grow on simple media; they are grown on serum media, where they form medium-sized rounded transparent colonies. Biochemically inactive. They have a complex antigenic structure. Serogroup A meningococci commonly cause epidemic outbreaks and most severe illness. The causative agent is very sensitive to cooling, quickly dies at room temperature; therefore, the test material (liquor, smears from the posterior pharyngeal wall, blood) is sent to the laboratory warm, for example, after being covered with heating pads. Disinfectants destroy instantly.
pathogenicity factors meningococci - fimbriae(provide adhesion of the microbe to the epithelium of the nasopharynx), capsule(invasive and antiphagocytic properties), enzymes hyaluronidase and neuraminidase (distribution in tissues). The bacteremia that occurs during infection is accompanied by the breakdown of microbial cells and the release of endotoxin, a large amount of which can cause endotoxic shock(with damage to blood vessels, coagulation of blood in them and the development of acidosis).
Source of infection:- a carrier or a sick person. Infection- by airborne droplets (with close contact). The incubation period is 5-7 days. Distinguish the following rmy meningococcal infection: epidemic cerebrospinal meningitis(inflammation of the soft meninges), epidemic nasopharyngitis(flows like an acute respiratory disease), meningococcal sepsis (meningococemia). Generalization of infection occurs, as a rule, in persons with immunodeficiency. Allergic reactions take part in the pathogenesis of severe forms of infection. Immunity is persistent, type-specific, cellular and humoral; recurrence is possible.
Microbiological diagnostics is carried out by the microbiological method, with meningitis, microscopy of stained preparations from the sediment of the cerebrospinal fluid is also carried out.
Specific treatment: antibiotics (in large doses); human immunoglobulin.
Specific prophylaxis: chemical vaccine(from polysaccharide antigens of the causative agent of meningococcal infection A and C)
1.2.
3.
The causative agent of diphtheria.
Pertussis causative agent.
causative agents of tuberculosis.
1. Taxonomy.
Sem.Actinomycetaceae
genus
Corinebacterium
representative of C. diphtheriae
C.diphtheriae Leffler stain
Morphology
--
-
These are thin, slightly curved sticks.
3-5 µm long, with a characteristic
arrangement in smears: in pairs, under
angle to each other ("click" type
divisions),
The ends of the sticks are club-shaped
thickenings containing grains of volutin
motionless
Spores and capsules do not form
G+
C.diphtheriae Neisser stain
C. diphtheriae Gram stain
cultural properties
Facultative anaerobesGrow on media containing blood
serum,
on tellurite blood agar
(Clauberg medium) form
two types of colonies
The nature of the colonies
biochemical properties and
ability to produce
hemolysin is secreted by three
biovar: gravis, mitis, intermedius
3. Antigenic structure and virulence factors.
C. diphtheriae contains Kantigen in the microcapsule, which allows to differentiatethem into serovars and group-specific
polysaccharide O antigen
walls.
Diphtheria histotoxin is the main
pathogenicity factor Feature of toxin formation of diphtheria
coli is determined by the presence in its DNA
specific lysogenic phage (prophage),
containing the structural toxicity gene. At
her
infection
prophage
going on
accession
gene
toxicity to
DNA
microbial cell. Histotoxin fixation
occurs on muscle membrane receptors
heart cells, heart parenchyma, kidneys,
adrenal glands, nerve ganglia. 5. Resistance.
Diphtheria bacteria have a significant
resistance to factors
environment. Survival in the autumn-spring period reaches 5.5 months and does not
accompanied by the loss or weakening of their
pathogenic properties. Diphtheria microbes
sensitive to direct sunlight
high temperature, alcohol and peroxide
hydrogen.
6. Epidemiology.
Source of infection - a sick person or a carrier
human. The route of transmission is airborne.
6. Pathogenesis and clinic of caused diseases.
Entrance gate - mucous membranes of the pharynx,nasopharynx and nose, less often - the mucous membrane of the eyes, external
genital organs, wound surface of the skin.
At the site of the introduction of the causative agent of diphtheria
fibrinous films are formed in the form of grayish-white overlays.
The exotoxin produced causes necrosis and
inflammation of the mucous membranes and skin.
Absorbed, it affects the nerve cells,
cardiac muscle, parenchymal organs,
causes the phenomenon of general heaviness
intoxication. Clinical manifestations
A. Diphtheria pharynx
B. Skin diphtheria
10. 7. Immunity
Immunity after an illnessunstable, possibly re-disease;
The main role in the prevention of diphtheria
belongs to the formation of an active
artificial antitoxic immunity in
as a result of routine vaccination
11. 8. Laboratory diagnosis of diphtheria
Clinical material: throat swab, nasopharyngeal mucus, etc.Methods:
1.
2.
Bacterioscopic (smear staining according to Leffler and
Neisser - preliminary)
Bacteriological (cultural) - the main one.
Seeding of clinical material on blood
tellurite agar (Clauberg medium). Identification by
set of properties: cultural, morphological, tinctorial,
biochemical, mandatory determination of toxigenicity by the method
Ouchterlony; sensitivity to antibiotics.
3.
4.
Serological (ELISA, neutralization reaction
antibodies, RNHA) to detect antibodies and/or
toxin in serum
Shik's test - in vivo toxin neutralization test
12. Double Ouchterlony Gel Diffusion (may be performed without isolating a pure culture)
13.
The Shik test is performed forcondition assessment
antitoxic immunity;
intradermally administered minimal
amount of toxin
In the presence of antibodies against
diphtheria toxin visible
there will be no changes
With absence
antitoxic immunity
inflammatory
reaction
14.
Specific prophylaxisThe active ingredient in all vaccines is diphtheria toxoid.
(diphtheria histotoxin, which has lost its toxicity, but
preserved antigenic properties as a result of processing
formalin at 37-40C for 3 weeks:
AD - adsorbed diphtheria toxoid
ADS - adsorbed diphtheria-tetanus toxoid
ADS-M toxoid
- vaccine for the prevention of diphtheria and tetanus with a reduced content of antigens
AD-M toxoid
antigen-reduced diphtheria vaccine
Imovax D.T. adultery
vaccine for the prevention of diphtheria and tetanus, analogue of ADS-M (Aventis Pasteur, France)
DT Wax
vaccine for the prevention of diphtheria and tetanus, analogue of ADS
(Aventis Pasteur, France)
15. Specific prophylaxis
Tetrakt-HIBAdsorbed vaccine against diphtheria, tetanus, whooping cough and Haemophilus influenzae type b
(France)
Tritanrix
vaccine to prevent whooping cough, diphtheria, tetanus and hepatitis B
(SmithKline Beecham, Belgium)
Tetrakok 05
vaccine for the prevention of whooping cough, diphtheria, tetanus and poliomyelitis (Aventis Pasteur, France)
Infanrix
acellular vaccine for the prevention of whooping cough, diphtheria and tetanus (Belgium)
Pentaxim
Vaccine for the prevention of diphtheria and tetanus adsorbed, whooping cough
acellular, poliomyelitis inactivated, Haemophilus infection
influenzae type b conjugated.
DTP - adsorbed pertussis-diphtheria-tetanus vaccine
16. Treatment
1. Neutralization of the toxin byintroduction of antidiphtheria
antitoxic serum
(donor or horse)
2. Antibiotic therapy: penicillins,
cephalosporins, quinolones, etc.
17. Genus BORDETELLA Species BORDETELLA PERTUSSIS
Appearance of a sick childwhooping cough, during
spasmodic attack
18.2. Morphology
small, ovoid,gram stick with
rounded
ends
Motionless. Dispute
no. There are no flagella.
Forms a capsule
drank.
19. Cultural properties
Optimal cultivation t37°C at pH 7.2.
Does not grow on simple
nutrient media,
cultivated on potato glycerol agar and
semi-synthetic casein charcoal agar without the addition of
blood.
Forms on blood media
area of hemolysis.
Colonies are small, round, with
smooth edges, shiny
reminiscent of droplets
mercury or pearl grains.
Growth of Bordetella pertussis on agar
Borde-Gangu
20.
Strict aerobesEnzymatically inactive: not
ferment carbohydrates, no proteolytic
activity, does not restore nitrates
3. Antigenic properties.
OAS
K-Ag
4. Resistance.
Very unstable in the environment. Fast
destroyed by disinfectants
antiseptics, sensitive to sunlight
radiation. At 50-55°C they die in 30 minutes, at
boiling instantly.
5. Epidemiology.
Airborne route of transmission.
Source - patients or carriers.
21.6. Whooping cough pathogenesis
Entrance gate of infection -upper mucosa
respiratory tract.
Main role in development
disease belongs
toxic substances,
conditioning
constant irritation
nerve receptors
mucous membrane of the larynx,
trachea and bronchi,
which results in
cough.
7. Immunity after
past illness
lifelong, durable.
Colonization of the tracheal epithelium
Bordetella pertussis (cells without
cilia are free from bacteria)
22. 8. Laboratory diagnosis of whooping cough
Basic Methodslaboratory
diagnostics
whooping cough
bacteriological
and serological
23. Bacteriological method
Collecting clinical material- with a dry swab from the back of the pharynx and make
sowing on nutrient media
- cough plate method
24.
The purpose of bacteriological research:- Isolation of pure culture and
whooping cough identification
- Differential analysis
cultural properties of pathogens
whooping cough (B.pertussis) and parapertussis
(B.parapertussis)
Serological method for diagnosing whooping cough
ELISA is used to determine IgA in
nasopharyngeal mucus, starting from 2-3 weeks
diseases
RNHA is used in the analysis of sera
after 10-14 days, diagnostic titer
1:80, in healthy children 1:20
CSC in paired sera
25. 9. Specific treatment and prevention.
Combined DPT vaccine(adsorbed whooping cough -
diphtheria-tetanus
vaccine) includes
diphtheria and tetanus
toxoids, as well as dead
Whole organisms that cause whooping cough
Infarinx (Belgium):
3 components (against whooping cough,
diphtheria, tetanus)
26. Mycobacterium tuberculosis.
FamilyGenus
Kinds
Mycobacteriaceae
Mycobacterium
M.tuberculosis,
M.bovis,
M. avium
27. 2. Morphology
Gram-positive thinstraight or slightly curved
sticks;
The cell wall contains
lots of waxes and
lipids, which
hydrophobicity, resistance to
acids, alkalis, alcohols;
Motionless, spores and capsules are not
forms;
Breeding on dense
media form "braids" of plexus, in which
microbial cells are linked by Mycobacterium tuberculosis (red rods) in
sputum.
between themselves.
Ziehl-Neelsen staining.
28. Mycobacterium tuberculosis inside lung cells. Ziehl-Neelsen stain
29. cord factor - mycobacteria sticking together in bundles are visible
30. Cultural properties
Levenshtein-Jensen medium andgrowth of mycobacteria.
Aerobes;
Grow on media containing eggs,
glycerin, potatoes. Glycerin
agar, meat-peptone-glycerol
bouillon.
The most commonly used egg medium
Levenshtein-Jensen and
Soton's synthetic medium;
grow slowly (growth
detected after 2-3 weeks
later);
Colonies dry, wrinkled,
grayish;
Possess biochemical
activity that allows
differentiate species
The main test - niacin test
accumulation in a liquid medium
nicotinic acid
31. 3. Antigenic structure and virulence factors.
Group-specific antigen - proteinSpecies-specific - polysaccharide
The main antigen on which it develops
immune response - tuberculin glycoprotein
Toxic effect on the body
provide cell components and products
metabolism.
32.
4. Resistance.Due to the special chemical composition (up to 41%
fat) tuberculosis bacteria are characterized
high stability in objects of external
environment, the action of alcohol, acids.
5. Epidemiology.
The source of infection is a person, large and small
cattle.
The main route of transmission is airborne and
air-dust.
Less significant food (with dairy and meat
products), contact household and
intrauterine.
33. Epidemiology (continued)
Tuberculosis is ubiquitousSocio-economic factors contribute to the increase in the incidence (the main factor is starvation)
Since 1990, there has been a sharp rise in
incidence
Human Immunodeficiency Virus (HIV) and Syndrome
acquired immunodeficiency caused a marked
an increase in tuberculosis cases in some
countries
On the other hand, the problem is
the spread of mycobacteria with multiple
drug resistance
34. Pathogenesis of tuberculosis
Interaction of Mycobacterium tuberculosis with the human bodybegins when the pathogen enters the lungs
the initial entry of the pathogen into the lungs or other organs
causes the development of small or non-specific inflammation After 2-4
weeks after infection, the next stage of interaction begins
mycobacteria with a macroorganism. In this case, two processes are observed - the reaction of tissue damage according to the type of DTH (specific inflammatory
reaction) and macrophage activation reaction.
With the development of immunity and the accumulation in the primary focus of a large
the number of activated macrophages, tuberculous
granuloma.
35. Structure of tuberculous granuloma
36. Clinical manifestations
There are three clinical formsdiseases:
Primary tuberculous intoxication in
children and teenagers
Tuberculosis of the respiratory organs
Tuberculosis of other organs and systems
37. 7. Immunity.
In tuberculosis, it is non-sterile,allergic, provided by cellular
immune system, for
manifestation requires the presence in the body
viable bacteria.
38. Laboratory diagnostics
Clinical material: pus, sputum, blood, bronchial exudate,cerebrospinal fluid, pleural fluid, urine, etc.
Methods:
1.
Bacterioscopic: direct staining of sputum smear
Ziehl-Neelsen method or smear after enrichment (concentration
flotation or homogenization methods)
Direct smear staining
sputum according to Ziehl-Neelsen
A swab from a flotation
layer according to Ziehl-Neelsen
39.
2. Luminescent method (staining with rhodamine-auromin));3. Price microculture method (thick sputum smear on slide
treated with acid, not fixed and placed in
serum; after 5-7 days stained according to Ziehl-Neelsen; at
the presence of a cord factor is visible stuck together in bundles
mycobacteria)
40. Mantoux skin-allergic test
Intradermal administration of highly purifiedtuberculin (PPD=Purified Protein Derivative)
causes in those infected with mycobacteria
people local inflammatory response in
in the form of infiltrate and redness (HRT reaction).
Uninfected people no reaction to
the introduction of tuberculin is not given. This sample
used to detect infected
sensitized people.
41. Treatment
Currently by degreeeffectiveness of anti-tuberculosis
drugs are divided into 3 groups:
Group A - isoniazid, rifampicin and their
derivatives (rifabutin, rifater)
Group B - streptomycin, kanamycin,
ethionamide, cycloserine, fluoroquinolones and
others
Group C - PASK and thioacetozone
42.
Specific prophylaxisBCG vaccine (BCG - Bacillus Calmette
and Guerin) - contains live
avirulent mycobacteria,
obtained from M.bovis by
multi-year passages on media,
containing bile
Post-vaccination immunity is associated with
formation of HRT
(hypersensitivity delayed
Intestinal infection is a concept that unites more than 30 types of diseases as a result of the activity of viruses and bacteria. To avoid trouble in connection with them, it is necessary to understand the features of infection and the symptoms of the disease.
Definition
An intestinal infection is a disease in which its pathogens penetrate the intestines of the victim. Intoxication, indigestion, fever are the main symptoms in this case. Such types of causative agents of intestinal infections as salmonella, dysentery, typhoid fever, cholera - disrupt the digestive processes and dehydrate the body.
Ways of infection:
- airborne;
- air-dust;
- food.
The source of infection can be both sick and cured patients for some time (about three weeks). The presence of microbes is observed in feces, as well as in urine, vomit, saliva. Bacterial diseases are rightly called "dirty hands disease".
Immunity to viruses is not developed, so there is no guarantee that after the illness it will not return.
Species: bacterial and viral
Intestinal infections are divided into two groups: pathogenic (immediately provoking inflammation) and conditionally pathogenic (developing under certain conditions, weakening the body). Both viruses and bacteria can act as pathogens. Both have individual effects on the body, and it is difficult to determine the greater degree of harm to one of them.
Viruses enter the environment along with the feces of an infected patient, animals, and poultry. All items that come into contact with faeces pose a risk of transmission.
Common viral and bacterial pathogens of intestinal infections:
- enteropathogenic Escherichia coli;
- campylobacteriosis;
- salmonella;
- rotaviruses;
- halophilia;
- escherichiosis;
- dysenteric shigella;
- staphylococci;
- cholera vibrios.
What are the classifications of pathogens?
Viral. Transmission of infection: oral, household, airborne way. The risk of infection is higher compared to bacterial. The sick person is dangerous to others for three weeks after recovery. Varieties:
- enteroviral - the muscular and nervous system, heart are affected;
- enteral hepatitis A and E - with poor-quality water, infected products, unwashed dishes;
- rotavirus gastroenteritis - the source of infection is a person.
Protozoan. Infection occurs with the ingestion of water from an infected reservoir.
Treatment is long, involves the use of specialized drugs. Varieties:
- amebiasis, toxoplasmosis - due to microorganisms in the body of a person, animal;
- giardiasis - in the absence of treatment, resettlement occurs throughout the body;
- balantidiasis - reproduction of ciliates balantidi, accompanied by ulcerative colitis.
Bacterial diseases:
- Escherichiosis. The disease occurs due to the activity of Escherichia coli. Bacteria remain active for several months.
- Dysentery. Shigella intoxication. The human body produces toxins. The source of infection is a person, water, food.
- Typhoid fever. Sources of infection - water, food. The lesions of the gastrointestinal tract increase, ulcers and ruptures form. It is dangerous because its incubation period reaches two weeks.
- Salmonellosis. Infection is possible after eating low-quality meat, butter, eggs, milk. Of the complications are possible: cerebral edema, renal failure.
- Cholera. The causative agent is Vibrio cholerae: severe dehydration due to diarrhea and vomiting. Fatalities are not uncommon.
- Brucellosis. Damage to the gastrointestinal tract, musculoskeletal, reproductive, nervous systems. The reason is low-quality dairy products. A person is not a source of infection.
- Helicobacteriosis. Leads to damage to the duodenum and other parts of the digestive system. There are ulcers on the mucous membranes.
- Botulism. A deadly disease caused by botulinum toxin. Reproduction occurs in the absence of oxygen. The source of infection is home-made canned food made in violation of technology.
- Staphylococcus. Opportunistic pathogens, symptoms are confused with a cold. Wrong treatment leads to complications.
The causative agents of intestinal infections multiply rapidly, and if you do not contact a specialist in time, serious complications are not ruled out.
The reasons
As a rule, the bacteria that cause intestinal infections enter the body due to poor hygiene, improper storage and processing of products, and eating certain categories of food.
Sources of infection:
- raw water, milk;
- cake with cream, dairy products;
- improper storage conditions for products (on the same shelf there are fresh fruits and products that must undergo heat treatment - meat, fish);
- improper storage temperature (at room temperature, bacteria actively multiply);
- infected rodent feces that fall on the dishes;
- insufficiently thermally processed meat;
- eggs: raw, poorly cooked, uncooked;
- soil-contaminated vegetables and herbs;
- common hygiene items (dishes, towels);
- contact with objects in the room where the patient lives;
- ignoring the rules of hygiene;
- transmission of infection by insects (flies);
- swallowing contaminated water while swimming in a pond.
In some patients, susceptibility to pathogens of intestinal infections is significantly higher than in others.
- elderly people;
- alcohol abusers;
- premature babies;
- babies who are bottle-fed;
- born with disorders of the nervous system;
- suffering from immunodeficiency.
Symptoms
The incubation period, depending on the type of pathogen, lasts from several hours to 10 days. The main symptoms, in addition to loose stools mixed with mucus and blood (or without them) are fever and cramping pains, vomiting, and other signs of intoxication. In addition to this, there are clinical manifestations due to a specific causative agent of intestinal infections.
In the first hours, there may be no symptoms, but then there are pain in the abdomen - attacks that last from four minutes or more. The main signs of acute intestinal infections are similar.
List of common symptoms of intestinal diseases:
- loss of appetite;
- diarrhea (it is important to stop it to avoid dehydration);
- insomnia;
- skin rash;
- nausea, vomiting;
- noises in the abdomen;
- drowsiness, fatigue.
Specific symptoms of the main pathogens of intestinal infections:
- gastritis syndrome: pain in the stomach, continuous bouts of vomiting, nausea after eating;
- gastroenteritis syndrome: discomfort in the navel, the masses look greenish, they may contain mucus, blood;
- enteric syndrome: frequent watery stools (typical for cholera);
- enterocolitic syndrome: severe abdominal pain, frequent urge to defecate (typical of dysentery, salmonellosis);
- colitis syndrome: pain in the lower abdomen, traces of mucus, blood, false urge to defecate, there is no feeling of relief after emptying, the pain does not subside;
- intoxication: weakness, body aches, headaches, nausea, dizziness, fever;
- bacterial infection: signs of dehydration leading to death if left untreated;
- combinations of all symptoms in various variants.
Secondary symptoms of carriage of pathogens of intestinal infections:
- manifestations of pneumonia (occurs against the background of partial dehydration, often occurs in children);
- kidney failure (water exposure to toxins, dehydration);
- infectious-toxic shock: manifests itself soon after infection, as a result of an increased concentration of toxic substances in the body;
- fungal lesions of the gastrointestinal tract;
- dehydration: after vomiting, diarrhea.
The name of the pathogen and the possible clinical picture:
- campylobacteriosis - the condition resembles appendicitis;
- yersiniosis infection - development of nodular erythema, joint damage;
- salmonellosis - bacteremia and meningitis, pneumonia, abscesses of internal organs;
- infection caused by strains of Escherichia coli - hemolytic-uremic syndrome, renal failure, hemolytic anemia.
When dehydrated, the patient can fall into a coma with a fatal outcome. Signs of problems are: prolonged lack of urination, frequent pulse, low blood pressure, change in skin tone, dry mucous membranes. The faster the characteristic signs appear after eating infected foods, the more severe the intestinal infection.
In some cases, the analysis for the carriage of pathogens of intestinal infections is carried out by the appearance of feces:
- salmonellosis: frequent and liquid bowel movements of a greenish tint;
- escherichiosis: yellowish-orange loose stools;
- cholera, halophiliasis: watery stools with whitish mucus;
- dysentery: mucous stools with blood;
- rotavirus infection: loose, frothy, brown stools.
To analyze the causative agents of intestinal infections, there are not enough external symptoms; for this purpose, a detailed laboratory study is necessary.
Diagnostics
In each case, the disease is diagnosed in advance, as a result of examination and questioning of the patient. But the exact definition of the causative agent of intestinal infection will give blood, vomit.
Laboratory diagnostics includes sowing and feces for the intestinal group, a blood test for RNGA with shigellosis diagnosticums.
For the purpose of a preliminary diagnosis, a relationship is established between the quality of food consumed and external. Then a test for rotavirus infection is carried out.
If the result is negative, the diagnosis of the following type is necessary:
- sowing feces;
- the study of washing water for a nutrient medium for bacteria that provoked the disease;
- the vomit mass is examined by a similar method.
Test results may take up to five days. The serological method allows you to detect specific antibodies to viruses of various types using ELISA, RNGA.
The patient passes an analysis for the carriage of pathogens of intestinal infections from a vein, which is carried out not on the first day of the disease, but in the process of fighting a progressive virus.
It is mandatory to study the characteristics of a particular type of bacteria in the biological material (PCR study). Changes in the intestinal microflora inherent in a particular type of gastrointestinal tract lesion will help to detect studies using sigmoidoscopy, colonoscopy and other methods.
If the culture result was negative, immunological diagnostic methods are used. Immunoenzyme methods can detect antibodies to Campylobacter and Salmonella; enterotoxins of pathogenic strains can be detected using PCR, latex agglutination.
How to take an analysis?
In order to obtain reliable results, the patient is recommended to prepare accordingly:
- for five days, refrain from meat, alcohol, eat dairy products, cereals, potatoes, white bread;
- three days before the sowing procedure for intestinal infection pathogens, stop taking antibiotics, laxatives, iron preparations, rectal suppositories;
- prepare a container for analysis: a container purchased at a pharmacy, hermetically sealed and sterile.
Rules of procedure:
- prevent the ingress of foreign substances into the feces: urine, blood;
- the container for the contents cannot be treated with aggressive chemicals: it is necessary to wash the container with soap and then scald it with boiling water;
- for storage of the analysis, about 4 hours are permissible in the refrigerator; the longer the transportation period, the less accurate the results are, since some of the pathogens die.
At home, the analysis is taken in a sterile container. The amount to be guided by is a full teaspoon. In the office of an infectious disease specialist, a rectal swab is taken with a swab, which is injected at a shallow depth into the rectum and placed in a test tube. A referral issued by a doctor is attached to the container.
Research types:
- For greater accuracy of the result, a three-fold analysis of feces is provided. The material is placed in a nutrient medium for 5 days. At the same time, colonies suitable for a smear on the intestinal group grow, even with a small number of microorganisms. Pathological pathogens can be identified by their appearance, the mobility of organisms under a microscope.
- The laboratory assistant, when viewing feces dissolved in water, on the first day can give a preliminary result. Bacteriological examination allows you to determine the infectious agent, as well as susceptibility to antibiotics.
- The microbiological method involves the obligatory sowing of feces on special media, and if this is not possible, samples of the material are placed in a solution with glycerin.
- Biochemical tests: determine the amount of fatty acids in the intestine, as a result of which they draw conclusions about the qualitative composition of the intestinal group.
- Rapid results are obtained by serological studies of blood reactions. takes into account the entire spectrum of microorganisms.
Duration of analysis: it will take about seven days for the final result of studies on causative agents of intestinal infections. This period is necessary to establish the characteristics of the growth of the pathogen. You can speed up the process using express methods that provide less reliability.
The presence of a variety of the pathogen is noted in the appropriate column of the research form or fits into the conclusion under the signature of the doctor. A detailed analysis, taking into account the number of colony-forming units, makes it possible to judge the nature of dysbacteriosis against the background of beneficial microflora.
You should not decipher the analysis yourself, only bacteriologists, infectious disease specialists, and gastroenterologists will give the correct answer.
Treatment
Infectious intestinal disease requires an integrated approach and cannot go away on its own. Treatment is aimed at eliminating the causative agents of acute intestinal viral infections, and a properly constructed therapy regimen provides a phased recovery.
Basic principles of treatment:
- bed rest;
- a certain diet;
- the use of specialized medicines.
In the fight against pathogens of intestinal infections, antibiotics or intestinal antiseptics are prescribed. They have the advantage that they can be used before the pathogen is identified.
In each case, sorbents are prescribed for the accelerated removal of toxins from the body (Smecta, Atoxil, Enterosgel, Filtrum).
In the process of normalization, probiotics ("Linex", "Hilak forte", "Acipol"), products containing bifidus and lactobacilli are shown. Enterogermina, Mezim, Creon, Pancreatin, Bio-gay, Enterol, yoghurts are successfully fighting dysbacteriosis.
At the next stage, rehydration is necessary, since the patient loses large volumes of salt and fluid, which is fraught with consequences. In addition to this, antipyretic drugs, diarrhea drugs, diet food, and bed rest are prescribed. In the pharmacy, you can buy ready-made saline products, from which saline is made.
Means recommended in the fight against pathogens of viral intestinal infections: Norfloxacin (in tablets), Oralit, Regidron, Humana. Symptomatic treatment for gastritis includes the use of "Omez", "Ranitidine", "Omeprazole", with nausea - "Cerukal". If a person is not sent to a hospital with a dropper, then he is prescribed a plentiful drink.
You should not delay contacting a doctor if young patients are unwell, even if the urge to vomit is infrequent. They need urgent screening for intestinal infections to avoid rapid dehydration. And before the arrival of the ambulance, you need to give the child a drink at intervals of ten minutes, 5 ml each.
Diet
Any intestinal infection requires a diet. Medicines are useless without special nutrition. Meals are selected taking into account the severity of the disease, general recommendations and the category of excluded products. In case of exacerbation, soups, low-fat broths, cereals, fish, steamed scrambled eggs, baked apples without skins, and lean cookies are recommended.
Prohibited foods for diarrhea:
- milk and dairy products;
- dishes containing raw vegetables;
- fresh berries and fruits;
- fried, fatty;
- spicy (spices, onions, garlic);
- salted, smoked;
- canned food;
- alcohol.
To compensate for the lack of fluid in the body, dried fruit compotes, a weak rosehip broth, still water are recommended. Milk should be excluded from the diet for a period of three months after recovery.
What not to do if you suspect an infection
It happens that when an intestinal infection is suspected, people make independent attempts to improve their condition. But without research on the causative agent of intestinal infection, such treatment can be harmful or lead to complications.
Activities prohibited in case of infectious diseases:
- pain relief with painkillers: an altered state will complicate the study of the carriage of pathogens of intestinal infections and the development of a treatment program;
- the use of fastening drugs without a doctor's prescription: toxins continue to accumulate in the intestines, which threatens to exacerbate the condition, while diarrhea helps to cleanse the body;
- use of a heating pad: heat enhances the reproduction of bacteria;
- the use of folk or homeopathic remedies: methods are possible only as additional after consultation with a specialist.
The occurrence of any kind of infection during pregnancy poses a threat to the development of the fetus. Accumulations of toxins can become a prerequisite for spontaneous miscarriage. Dehydration is dangerous, in which the delivery of oxygen and nutrients is difficult. Often there is fetal hypoxia, which affects its further development.
Delay in contacting a doctor in the presence of a virus, the causative agent of intestinal infections, can lead to death.
Prevention
The slightest signs of spoilage indicate the low quality of the entire product. And not having confidence in the safety of food, it is better to throw it away. As a preventive measure, vaccinations and other measures are not provided. But it does not hurt to follow a number of measures for your own safety.
List of preventive actions:
- remember about hygiene;
- boil water and milk before drinking;
- wash hands with soap after using the toilet;
- change towels more often;
- refuse to eat raw eggs, even from poultry;
- thoroughly cook or process meat in another thermal way;
- control the expiration date of purchased products;
- wash greens well before eating;
- store food in the refrigerator;
- do not give pure milk to an infant;
- maintain the cleanliness of the living quarters, do not accumulate garbage, which serves as a breeding ground for bacteria;
- if possible, monitor the humidity of the premises, which is favorable for the reproduction of bacteria;
- in case of illness, boil the dishes of the infected;
- treat the patient's stools with a chlorine solution.
The highest activity of pathogens of intestinal infections in water and the environment is in the summer season. It is in the warm season that many allow themselves to drink from open sources. As you know, tap water that has stood in the heat is a breeding ground for dangerous bacteria. Due to the high temperature, products such as meat, fish quickly become unusable, without changing their appearance.
Not everyone considers it necessary to fight insects. Not everyone knows that on the body of a fly there can be up to tens of millions of microorganisms that provoke serious diseases. Therefore, it is unacceptable for insects to crawl on products.
In summer, a person drinks a lot of liquid, which, when it enters the stomach, dilutes the composition of enzymes and thereby reduces their protective functions. At the first symptoms of intoxication, you should immediately consult a doctor. Self-medication is unacceptable. The study on carriers of pathogens of intestinal infections should be repeated three times to be sure that there are no dangerous microorganisms for the family, the work team.
An analysis for pathogens of intestinal infections is mandatory for:
- medical workers of maternity hospitals, children's, infectious diseases departments;
- personnel of preschool institutions, schools;
- food workers;
- workers involved in the production and processing of products, packers, transporters, sellers.
The listed contingent passes tests according to the approved schedule from 2 to 4 times a year. Upon confirmation of infection, the study for the carriage of pathogens of intestinal infections can be expanded to the level of a general check of personnel at the request of the sanitary supervision authorities. In case of a dangerous epidemic, the powers of inspection are increased - up to the closure of the institution.
In this way, a source of infection, a bacteriocarrier, a person who has been ill and has the remains of an infection in the body, an undertreated patient can be identified. An unscrupulous attitude to hygiene threatens the health of the person himself and the people around him.
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