Petit disease. Foodborne toxic infections - definition, relevance, treatment. Treatment of food poisoning

For patients with severe and moderate course, socially unsettled persons with food toxic infection of any severity, hospitalization in an infectious diseases hospital is indicated.

Pathogenetic treatment of foodborne toxic infections depends on the degree of dehydration and body weight of the patient, and is carried out in two stages: I - elimination of dehydration. II - correction of ongoing losses.

Standard of treatment for patients with food poisoning

Clinical forms of the disease	Etiotropic treatment	Pathogenetic treatment
Mild IPT (intoxication is not pronounced, degree HI dehydration, diarrhea up to five times, vomiting 2-3 times)	Not shown	Gastric lavage with a 0.5% solution of sodium bicarbonate or 0.1% solution of potassium permanganate, oral rehydration (volume flow rate 1-1 5 l "h)" sorbents (activated carbon): astringents and enveloping agents (vicalin, bismuth subgallate): intestinal antiseptics ( intetrix, enterol): antispasmodics (drotaverine, papaverine hydrochloride - 0.04 g each): enzymes (pancreatin, etc.); probiotics (sorbed bifido-containing, etc.)
IPT of moderate severity (fever, degree II dehydration, diarrhea up to 10 times, vomiting - 5 times or more)	Antibiotics are not indicated. They are prescribed for prolonged diarrhea and intoxication in the elderly, children	Rehydration using a combined method (intravenous with transition to oral administration): volume 55-75 ml/kg body weight, volumetric flow rate 60-80 ml, min. Sorbents (activated carbon): astringents and enveloping agents (vicalin, bismuth subgallate): intestinal antiseptics (intetric C, enterol): antispasmodics (drotaverine, papaverine hydrochloride - 0.04 g each); enzymes (pancreatin, etc.): probiotics (sorbed bifidocontaining, etc.]
Severe IPT (fever, grade III-IV dehydration, vomiting and diarrhea without counting)	Antibiotics are indicated for fever lasting more than two days/when dyspeptic symptoms subside), as well as for elderly patients and children. persons suffering from immunodeficiency. Ampicillin - 1 g 4-6 times a day IM (7-10 days): chloramphenicol - 1 g three times a day IM (7-10 days), Fluoroquinolones (norfloxacin, ofloxacin, pefloxacin - 0 4 each g IV after 12 hours) Ceftriaxone 3 g IV every 24 hours for 3-4 days until the temperature normalizes. For clostridiosis - metronidazole (0.5 g 3-4 times a day for 7 days)	Intravenous rehydration (volume 60-120 ml, kg body weight, flow rate 70-90 ml/min). Detoxification - rheopolyglucin 400 ml intravenously after the cessation of diarrhea and elimination of dehydration, Sorbents (activated carbon): astringents and enveloping agents (vicalin, bismuth subgallate) intestinal antiseptics (intetrix, enterol): antispasmodics (drotaverine, papaverine hydrochloride - 0.04 g each) ; enzymes (pancreatin, etc.): probiotics (sorbed bifidocontaining, etc.)

Treatment of foodborne toxic infections begins with gastric lavage with a warm 2% sodium bicarbonate solution or water. The procedure is carried out until clean wash water leaves. Gastric lavage is contraindicated in cases of high blood pressure: persons suffering from coronary artery disease, gastric ulcers: in the presence of symptoms of shock, suspected myocardial infarction, chemical poisoning.

Treatment of food toxic infection is based on the use of rehydration therapy, which promotes detoxification, normalization of water-electrolyte metabolism and acid-base status, restoration of impaired microcirculation and hemodynamics. elimination of hypoxia.

Rehydration therapy to eliminate existing and correct ongoing fluid losses is carried out in two stages.

For oral rehydration (with I-II degree of dehydration and absence of vomiting) use:

glucosolan (oralite);
citroglucosolan;
rehydron and its analogues.

The presence of glucose in solutions is necessary to activate the absorption of electrolytes and water in the intestine.

The use of second generation solutions made with the addition of cereals, amino acids, dipeptides, and maltodextran is promising. rice base.

The volume of fluid administered orally depends on the degree of dehydration and the patient’s body weight. The volumetric rate of administration of oral rehydration solutions is 1-1.5 l/h; solution temperature - 37 °C.

The first stage of oral rehydration therapy is continued for 1.5-3 hours (enough to obtain a clinical effect in 80% of patients). For example, a patient with food poisoning with grade II dehydration and a body weight of 70 kg should drink 3-5 liters of rehydration solution in 3 hours (the first stage of rehydration), since with grade II dehydration, fluid loss is 5% of the patient’s body weight.

At the second stage, the amount of fluid administered is determined by the amount of ongoing losses.

In cases of grade III-IV dehydration and the presence of contraindications to oral rehydration, intravenous rehydration therapy is carried out with isotonic polyionic solutions: Trisol, Quartasol, Chlosol, Acesol.

Intravenous rehydration therapy is also carried out in two stages. The volume of fluid administered depends on the degree of dehydration and body weight of the patient.

The volumetric rate of administration for severe cases of foodborne toxic infection is 70-90 ml/min, for moderate cases - 60-80 ml/min. The temperature of the injected solutions is 37 °C.

When the injection rate is less than 50 ml/min and the injection volume is less than 60 ml/kg, symptoms of dehydration and intoxication persist for a long time, and secondary complications develop (acute renal failure, disseminated intravascular coagulation, pneumonia).

Calculation example. A patient with food toxic infection has III degree of dehydration, body weight is 80 kg. The percentage of losses averages 8% of body weight. 6400 ml of solution should be administered intravenously. This volume of fluid is administered at the first stage of rehydration therapy.

For the purpose of detoxification (only after eliminating dehydration), you can use a colloidal solution - rheopolyglucin.

Drug treatment of foodborne diseases

Astringents: Kassirsky powder (Bismuti suhnitrici - 0.5 g, Dermatoli - 0.3 g, calcium carbonici - 1.0 g) one powder three times a day; bismuth subsalicinelat - two tablets four times a day.
Preparations that protect the intestinal mucosa: dioctahedral smectite - 9-12 g/day (dissolve in water).
Sorbents: hydrolytic lignin - 1 tbsp. three times a day; activated carbon 5 - 1.2-2 g (in water) 3-4 times a day; smecta 3 g in 100 ml of water three times a day, etc.
Prostaglandin synthesis inhibitors: indomethacin (relieves secretory diarrhea) - 50 mg three times a day with an interval of 3 hours.
Means that help increase the rate of absorption of water and electrolytes in the small intestine: octreotide - 0.05-0.1 mg subcutaneously 1-2 times a day.
Calcium preparations (activate phosphodiesterase and inhibit the formation of cAMP): calcium gluconate 5 g orally twice a day after 12 hours.
Probiotics: acipol, linex, acylact, bifidumbacterin-forte, florin forte, probifor.
Enzymes: orase, pancreatin, abomin.
In case of severe diarrheal syndrome, intestinal antiseptics are used for 5-7 days: intestopan (1-2 tablets 4-6 times a day), intetrix (1-2 capsules three times a day).

Antibiotics are not used to treat patients with foodborne illnesses.

Etiotropic and symptomatic treatment of foodborne toxic infections is prescribed taking into account concomitant diseases of the digestive system. Treatment of patients with hypovolemic ITS is carried out in the ICU.

Food poisoning- not a rare phenomenon. Especially often cases of foodpoisoning occurs in the summer or during holidays (for example, during the New Year holidays), when a large volume of prepared food is stored for a long time, various microorganisms that produce bacterial toxins (for example, staphylococcal enterotoxin and hematoxin) multiply in the products. Also, food poisoning can be caused by eating foods that contain substances toxic to the body (watermelons stuffed with herbicides, chicken meat treated with formaldehyde).

There have been cases in history where children ate corn straight from the field, freshly treated for pests, and died.

But still, food poisoning caused by pathogenic microorganisms is more common than food intoxication with chemical toxins.

Staphylococcal poisoning is often associated with eating spoiled meat and dairy products, vegetable dishes, pastries, pies, and canned fish in oil. Purely externally, they may not differ from benign products. Moreover, enterotoxin can withstand temperatures of 100 degrees for 1.5 - 2 hours. That is, if such products are boiled, the staphylococci themselves will die, but the enterotoxin contained in them will still cause food poisoning. Botulinum toxin is destroyed when heated, but clostridia spores are not killed when preserving food at home (for example, when pickling mushrooms).

Food poisoning: symptoms

Toxins that cause food poisoning are not destroyed by digestive enzymes and can be absorbed into the blood through the gastric mucosa. Children are especially sensitive to them. Symptoms of food poisoning appear within the first two hours after eating low-quality foods (for poisoning with clostridia toxins - from six to 24 hours).

A patient with food poisoning is concerned about:

Vomit.
Cutting pain in the upper abdomen (in the epigastric region), rumbling of the abdomen, bloating.
Body temperature can be normal or subfebrile (not higher than 37.5).
Short-term stool disorder occurs in half of the cases of food poisoning.
Food poisoning is characterized by weakness, pale skin, cold hands and feet, and a drop in blood pressure (BP).
The development of a collaptoid state is possible.

The symptoms of food poisoning caused by clostridia exotoxins are much more severe, with the development of necrotic enteritis and anaerobic sepsis. The death of patients with botulism occurs in 30% of cases.

Treatment of food poisoning

Before you start treating food poisoning yourself, you need to be absolutely sure that this is exactly it, and not the first signs of an intestinal infection (salmonellosis, dysentery, gastroenteric form of enterovirus infection, rotavirus gastroenteritis, and so on).

Food poisoning is indicated by:

Connection with eating a certain product. Usually, when collecting anamnesis, patients themselves indicate: “I ate something wrong.”
Group nature of the disease.

What to do first in case of food poisoning:

Rinse the stomach with water or 5% sodium bicarbonate (soda).
After which, in order to delay the absorption of the poison and its entry into the blood, as well as to cleanse the intestines, you can prescribe a saline laxative once (magnesium or sodium sulfate is given to children at the rate of 1 g per 1 year of life; in case of renal failure, they cannot be drunk).
Then give the patient any sorbent: activated carbon, smecta, polyphepan, enterosgel.
To prevent dehydration, give the patient mineral water, tea (regular, ginger, green), and a decoction of dill seeds. To restore the balance of electrolytes, you need to drink a rehydron solution.
Romazulan is a good medicine for food poisoning.,aloe gastric juice (increases the secretion of the gastrointestinal tract, has bactericidal activity and a laxative effect), marshmallow root (contains up to 35% plant mucus, has an anti-inflammatory effect). Hilak forte (it has many effects, you need to read the instructions, in addition, it has a slightly sour taste, and patients drink it willingly).

Should antibiotics be given for food poisoning?
The decision to prescribe antibiotics and sulfonamides is made only by the doctor. In most cases, in case of food poisoning, they are useless; moreover, they can cause harm in the form of intestinal dysbiosis.

Should I take Imodium (Loperamide) if I have diarrhea?

No. Let the body cleanse itself of toxins. Otherwise, they will be absorbed into the blood, and the abdominal lymph nodes may react to this with lymphadenitis, and then food poisoning will be difficult to distinguish from acute surgical pathology requiring surgical intervention.

Diet after poisoning

Before the appearance of appetite, the diet should be gentle. It is not recommended to eat anything fried or smoked. Everything is just boiled. It is necessary to exclude from the diet all products that cause rotting and fermentation processes: milk, eggs, black bread. The enzyme system of the digestive tract after poisoning is weakened, and it is not able to digest heavy foods. You can drink compotes, jelly, eat crackers. The daily amount of calories must be reduced to 2,000 kcal.

Forecast

Even with pronounced symptoms in the initial period, recovery occurs by the end of the day from the onset of the disease. And only in some patients weakness persists for two or three days. In the presence of chronic diseases of the gastrointestinal tract, food poisoning can cause their exacerbation.

Botulism has a serious prognosis.

When should you call an ambulance for food poisoning?
If you are not sure that it is food poisoning, if the disease is severe, if botulism is suspected, if food poisoning is in a small child, then you should urgently seek medical help. But first aid must be provided even before the doctors arrive.

Prevention

Food poisoning can be prevented. To do this, you need to properly store food (without exceeding its shelf life), and do not defrost meat (especially minced meat) at room temperature. You can't drink unboiled milk that has been left in the refrigerator for a day in an open package.

Observe hygiene rules when preparing food. Do not allow persons with a pustular infection on the skin to participate in this process. Buy products only from trustworthy places and from trusted manufacturers. Carefully look at the expiration dates of products.

Food poisoning(bacteriotoxicosis, bacterial food poisoning) - an acute, short-term disease caused by opportunistic bacteria capable of producing exotoxins outside the human body (in food) and occurring with symptoms of damage to the upper gastrointestinal tract (gastritis, gastroenteritis) and water disorders salt metabolism.

Relevance.

Determined by the fact that PTI are predominantly social in nature in connection with the reasons for their development. Group and explosive (explosive) nature of morbidity, in which almost everyone who consumed the infected product becomes ill in a short time (several hours); the presence of PTI in organized teams; severity: likelihood of complications caused by intoxication and dehydration; predominance among sick children and elderly people require knowledge of the basics of diagnosis and treatment of PTI.

Characteristics of pathogens.

Causative agents of foodborne toxic infections include many types of opportunistic bacteria, capable of producing toxins during their life outside the human body on various food products. Among the exotoxins are enterotoxins (heat-labile and heat-stable), which enhance the secretion of fluid and salts into the lumen of the stomach and intestines; a cytotoxin that damages the membranes of epithelial cells and disrupts protein processes in them.

The most common pathogens, capable of producing enterotoxins are Clostridium perfringens, Proteus vulgaris, Proteus mirabill, Bacillus cereus. Enterotoxins are also produced by pathogens belonging to the genera: Klebsiella, Enterobacter, Citrobactcr, Serratia, Pseudomonas, Aeromonas, F. dwardsiella, Vibrio.

Enterotoxin has pronounced thermostable properties. St. aureus. It is not inactivated by boiling for up to 30 minutes (according to some sources - up to 2 hours) and retains the ability to cause a clinical picture of the disease in the absence of the pathogen itself.

Among the pathogens of PTI, the ones that have the ability to produce cytotoxin are:: Klebsiella pneumoniae, Enterobacter cloacae, Aeromonas hydrophila, Clostridium perfringens type C and Clostridium difficile. Vibrio parahaemolyticus, St. aureus and a number of other microbes.

The main manifestations of the epidemic process.

Pathogens of PTI are widespread in nature and are found everywhere: in the feces of people and animals, in soil, water, air, on various objects. Therefore, in most cases, it is not possible to determine the source of the disease. However, in some cases, when the sources of infection are persons working in the food industry and suffering from pustular skin diseases (pyoderma, felon, purulent wounds) or sore throats, nasopharyngitis, laryngotracheobronchitis, pneumonia, their identification is not only necessary, but also possible. Among the zoonotic sources of food poisoning, animals with mastitis can be identified - cows, goats, sheep, etc.

The route of spread of infection is nutritional. Among the transmission factors are solid (sausages, jellies, eggs, canned meat and fish, etc.) and liquid (soup, milk, juices, compotes, jelly, kvass, lemonade, beer, cocktails, etc.) food products that are suitable for bacteria nutrient medium. Staphylococcal intoxication is most often associated with consumption of infected milk and dairy products, confectionery creams, meat, fish and vegetable dishes. Proteus and clostridia reproduce well on protein products (meat, fish, including canned fish, sausage, milk).

Susceptibility to this group of diseases is high. It is not uncommon for 90-100% of people who consume the contaminated product to become ill. PTI disease is a vivid example of an infection occurring in conditions of gross violations of food preparation and storage technology.

The incidence of IPT is recorded throughout the year, but more often in warm weather, since it is during this period that it is most difficult to carry out impeccable storage of prepared food products.

Pathogenesis.

With IPT, by the time food enters the stomach, in addition to bacteria, it already contains a significant amount of exotoxin. This determines the development of the shortest incubation period in infectious pathology. In some cases, no more than 30 minutes pass from the effect of toxins on the gastric mucosa to the development of clinical symptoms (usually 2-6 hours).

Enterotoxins affect the enzymatic systems of epithelial cells(adenyl cyclase and guanyl cyclase), which increase the formation of biologically active substances (cAMP and cGMP) in the cells of the mucous membrane. Under the influence of toxins, the rate of formation of prostaglandins, histamine and other biologically active compounds increases. All this leads to increased secretion of fluid and salts into the lumen of the stomach and intestines, the appearance of vomiting and diarrhea. Cytotoxin damages membranes epithelial cells and disrupts protein synthetic processes in them, leads to increased permeability of the intestinal wall, promotes the development of intoxication, impaired microcirculation and local inflammatory changes in the intestinal mucosa.

Clinic.

The incubation period lasts from 30 minutes to 24 hours (usually 2-6 hours). The clinical picture of infections caused by various pathogens has much in common and is represented by similar symptoms. The onset of the disease is acute. Nausea appears, which is accompanied by vomiting. Vomiting is rarely one-time, more often it is repeated, sometimes indomitable, painful, debilitating. Almost simultaneously with vomiting, loose, watery stools appear, from 1 to 10-15 times a day, usually have an enteritic nature and do not contain mucus and blood. In a significant proportion of patients, the disease is not accompanied by any severe abdominal pain or fever. In the clinical picture of PTI, in addition to gastrointestinal symptoms, chills, increased body temperature, moderate headache, weakness, and malaise are observed. An increase in body temperature to a maximum (38-39°C) occurs already in the first hours of illness, and after 12-24 hours it, as a rule, decreases to normal and returns to normal.

Objectively, patients are found to have pale skin, sometimes their cyanosis, coldness of the extremities. The tongue is covered with a white-gray coating. The abdomen is soft on palpation, painful in the epigastrium, less often around the navel. The cardiovascular system naturally suffers: bradycardia is determined (with hyperthermia - tachycardia), blood pressure is reduced, a systolic murmur is heard at the apex of the heart, and the young hearts are deaf. In some cases, fainting and short-term collaloid states develop. With repeated vomiting and profuse diarrhea, symptoms of dehydration, demineralization and acidosis may appear. Possible cramps in the muscles of the limbs, decreased diuresis, decreased skin turgor, etc. The liver and spleen are not enlarged. The hemogram showed leukocytosis, neutrophilia, and a moderate increase in ESR. With timely and adequate therapy, these phenomena quickly stop. The duration of the disease in most cases is 1-3 days.

Diagnostics.

Clinical and epidemiological data are of greatest importance in the diagnosis of PTI. Among them:

acute onset and dominance in the clinical picture of symptoms of gastritis or gastroenteritis;
absence of hyperthermia or its short-term nature;
short incubation period and short duration of the disease itself;
the group nature of the morbidity and its connection with the consumption of the same food product;
explosive (explosive) nature of morbidity.

In laboratory diagnostics, the bacteriological method is of great importance, including the study of the toxigenic properties of isolated pathogens. The materials for the study are vomit, gastric lavage, the patient’s feces, and the remains of uneaten food. In IPT, the isolation of a particular microbe from a patient does not allow it to be considered the causative agent of the disease. It is necessary to prove its identity with the strains that were isolated from simultaneously ill people, as well as those obtained from an infected product. The serological method has no independent significance in diagnosis, since only an increase in the titer of antibodies to the autostrain of the isolated microbe is conclusive.

Treatment.

When establishing a clinical and epidemiological diagnosis of PTI, it is necessary to perform thorough and repeated gastric lavage until clean lavage water is obtained. Washing is carried out with a 2-4% solution of sodium bicarbonate or 0.1% solution of potassium permanganate. For severe diarrhea, activated carbon or other adsorbents (polyphepan, calcium carbonate) are prescribed. If there is no stool, a counter high siphon enema is performed.

Further therapy is carried out taking into account the degree of dehydration of the patient’s body. In case of dehydration of I-II degree (weight loss up to 3-6%) and the absence of uncontrollable vomiting, oral rehydration is performed with glucose-electrolyte solutions. In severe cases of the disease or with grade III-IV dehydration (weight loss more than 6%), intravenous administration of polyonic solutions is indicated: “Quartasol”, “Acesol”, “Lactasol”, “Trisol”, etc.

Food poisoning is an infectious disease that occurs in an acute form. It manifests itself when consuming food products containing bacteria and toxic substances resulting from their vital activity. Most often the disease is detected in the warm season. Penetrating into the human body along with food, microorganisms synthesize substances that are dangerous to humans. The infection has similar symptoms to other types of intoxication, so treatment methods are largely the same. With a well-chosen treatment regimen, the pathology does not cause any complications, but the lack of treatment can lead to unpredictable consequences.

Pathogens

Foodborne toxic infections are diseases of the digestive tract that are formed by the introduction of pathogenic microorganisms that synthesize toxins and affect the upper regions of the stomach. The most dangerous are enterotoxins, which multiply in meat and fish dishes, fruits and vegetables, as they are able to survive at high temperatures. That is why it is recommended to wash them before use and also subject them to thorough heat treatment.

Pathogens that provoke toxic infections are microorganisms that enter the body and release toxins:

Staphylococcus aureus. A bacterium whose toxic substances affect the intestines. Most often found in food left at room temperature for a long time. It is in this environment that staphylococcus is capable of active reproduction.
Bacillus cereus. These pathogens of toxic infections are found in undercooked rice. They are considered one of the most dangerous microorganisms, as they are able to withstand repeated heat treatment.
Clostridium perfringens enters the human body through insufficient heat treatment of meat, poultry, and legumes. Typically, infection with a bacterium provokes a mild illness that lasts no more than 24 hours and can go away on its own.

In addition, the following microorganisms and their metabolic products can penetrate into food:

enterococci;
proteas;
salmonella;
clostridia;
shigella;
streptococci and others.

Symptoms of poisoning can be observed in humans not only due to general intoxication with toxic substances, but also as a result of the breakdown of the bacteria themselves that have entered the food.

According to distribution, the disease is divided into:

gastric infection;
gastroenteric nature of the course;
gastroenterocolitic course.

According to the degree of intensity, the following classification is adopted:

mild infection;
moderate severity;
severe course.

Based on the presence of complications that arise during the disease process, they are divided into:

uncomplicated form of the course;
complicated form.

It is typical that people employed in the food industry and who have purulent diseases, for example, sore throat or furunculosis, can release bacteria into the environment, household items and food. In addition, animal feces containing staphylococci, streptococci and other microorganisms can act as a pathogen. Penetrating into soil and water bodies, the bacterium often affects agricultural products, becoming a potential threat to human health.

Epidemiology

The source of infection can be both people and animals, as well as other surrounding objects - soil and water. The mechanism of transmission of the microorganism is fecal-oral.

Most often, the pathogen enters through food: many cases of food poisoning are registered after eating low-quality food contaminated with bacteria, or through dirty hands during the preparation of dishes.

In addition, bacteria can enter the body along with raw water or products if their storage conditions are violated, which, in turn, provokes the activation of the pathogen and the accumulation of toxic substances and metabolites in the internal organs.

Often the infection is group in nature and occurs in an acute form. Most often, outbreaks of such infections are observed among members of the same family, in children's and adult groups. Infants and newborns are more susceptible to the disease. In addition, people who have undergone recent surgical interventions, have been using antibiotics for a long time, and also have various disorders of the functioning of the stomach are susceptible to infection.

Symptoms

The pathological process is characterized by an acute course and begins suddenly, approximately 30-40 minutes after consuming contaminated food. One of the first characteristic signs is the foul odor of stool, repeated vomiting that does not stop for several hours.

In especially severe cases, the patient experiences convulsions of the lower extremities, febrile syndrome, sepsis and even death.

Food poisoning can manifest itself in simultaneously poisoned people at different times and may differ in symptoms: all patients have different functioning of the immune system.

The incubation period is approximately 16 hours. The main signs of the disease are:

temperature rise to 38-39 °C, however, in some cases, febrile syndrome may not occur;
soreness in the head;
prostration.

Symptoms of toxic infection occur under the influence of toxins that stimulate gastrointestinal motility. Obvious manifestations include:

diarrhea;
intense nausea;
gag reflexes, after which, as a rule, the patient feels relief.

Diarrhea is characterized by a frequent urge to defecate and can occur up to 10 times a day; the stool is watery. Most often, the pathological process is accompanied by pain symptoms in the abdomen, diarrhea and vomiting occur simultaneously or are independent of each other.

In addition, some patients may exhibit other signs of poisoning:

chills;
aching sensations in the muscles;
dehydration.

Such symptoms usually lead to general exhaustion of a person, pale skin, and cold extremities. Most often, the disease lasts no more than 1-3 days, after which the manifestations gradually subside.

Other signs of infection include: dry mouth, intense thirst, rapid pulse.

Depending on the type of pathogen, the pathology may have some features:

The introduction of staphylococcus is characterized by an acute onset of the pathological process, absence of fever and diarrhea. In the early stages, convulsive syndromes and bluish discoloration of the skin are noted. These clinical manifestations last no more than 2 days. Staphylococcus most often does not provoke severe disorders of the water-salt balance in the human body.
When infected with clostridia, the patient experiences streaks of blood in the stool. Clostridiosis is characterized by acute gastroenteritis with signs of poisoning and excessive fluid loss. The bacterium affects the large intestine and causes intense diarrhea, characterized by an unpleasant odor of feces. In addition, the infection does not cause an increase in body temperature. Usually the disease has a short course and does not leave serious complications. However, with a weakened body, the patient may develop cardiovascular failure, hypovolemic shock, and sepsis. If help is not provided in time, the patient’s skin becomes yellow, strong gag reflexes and diarrhea can occur up to 20 times a day. In addition, mucous and blood streaks in the stool, enlargement of the liver and spleen may be detected. The main complications of infection are progression of the pathology with cardiac arrhythmia and peritonitis.
With cereosis, symptoms of gastroenteritis occur. Most often, this condition is mild, but negative consequences can be observed in older people and people with immunodeficiency.

Having identified the pathogen, it is possible to prescribe adequate treatment taking into account individual characteristics.

Toxic infections in childhood

Intestinal toxic infections in children are not particularly different from similar diseases in adults. Children attending child care institutions are at increased risk.

Often, infectious pathology is detected when staphylococcus or E. coli enters a child’s body during insufficient compliance with sanitary standards and personal hygiene of adults working in preschool or school institutions, as well as in the family. Pathogenic microorganisms spread to objects that the child drags into the mouth or together with food.

Often, outbreaks of infection are recorded when adults neglect the necessary sanitary rules for the use and storage of food. Most often, such cases are observed in summer camps, maternity hospitals, and kindergartens.

Infants have a hard time suffering from the disease. Characteristic signs of infection are: nausea, vomiting, diarrhea, pain in the navel area. One of the dangerous consequences is dysbiosis of the intestinal system. Newborns may develop a purulent rash, stomatitis, and also experience a state of shock caused by the activity of bacteria and viruses. In these cases, the baby requires immediate medical attention.

Diagnostics

The infection can be established in various ways. The main methods include differentiated and laboratory research methods.

It is worth noting that food poisoning has similar manifestations to other infectious diseases, for example, salmonellosis, enteritis, cholera and others, but there are still some differences in the pathological processes.

The infection is diagnosed when the pathogen is identified from the patient’s feces, vomit, or gastric lavage fluids.. In addition, specialists inoculate bacteria on various nutrient media and determine the toxicogenic characteristics of bacteria. However, such an analysis is not always possible.

The detected microorganisms may not be the causative agents of the disease. The most effective method is the serological test, identifying the pathogen from food that the person consumed, as well as from other people who consumed the same food as the patient.

Treatment

The first aid measure for manifestations of pathology is gastric lavage, helping to eliminate remnants of contaminated products and toxic substances from internal organs. To do this, the patient should drink 2 liters of water with a solution of soda or potassium permanganate, and then artificially induce vomiting. Next, it is necessary to provide the infected person with a hot drink, as well as any adsorbent, for example, polysorb or activated carbon. If intense cramping pain occurs, any antispasmodic, for example, no-spa, will help.

In addition, you can effectively cleanse the stomach and intestines with the help of an enema and the use of a rehydration solution, which compensates for excessive fluid loss. For severe dehydration, such solutions are administered intravenously.

Severe disease requires the use of antibacterial drugs. After suppressing gag reflexes and diarrhea, enzymes are prescribed: pancreatin, amylase, which help stabilize the digestion process, as well as probiotics, which normalize the functioning of the intestinal system.

Foodborne toxic infection requires immediate replenishment of the water-electrolyte balance, the failure of which occurs with severe loss of fluid. That is why the patient is advised to drink plenty of fluids.

As for binding drugs, you can take Kassirsky powder: one sachet three times a day. To protect against damage to the mucous surfaces of the intestinal system, smecta, previously dissolved in water, is used. To stop diarrhea, indomethacin is used: 50 mg 3 times a day. In some cases, calcium supplements are used, as well as medications that increase the rate of absorption of water and electrolytes, for example, octreotide. The doctor may prescribe antiseptic drugs: intestopan 1-2 tablets several times a day.

The use of antibiotics is advisable in severe forms of the disease. Most often, ampicillin and chloramphenicol are prescribed to young children, as well as if there is a threat of sepsis. In these cases, parenteral administration is recommended.

In case of acute and intense manifestations, the patient is recommended to follow a special diet that includes certain foods.

In case of severe exhaustion, the patient must refrain from eating for 24 hours. At the end of acute symptoms, diet No. 4 is prescribed, which involves consuming the following foods:

wholemeal bread;
low-fat broth;
lean varieties of meat and fish;
light dairy products;
steamed omelette;
steamed vegetable dishes;
mashed porridge;
jelly and others.

You should exclude from your diet baked goods, fatty broths, varieties of meat and fish with a high fat content, salted and smoked foods, hard-boiled eggs, pasta, legumes, raw vegetables and fruits, jam, caffeinated drinks and soda.

Foodborne illness cannot be treated with anti-diarrhea drugs, such as Imodium or Loperamide, which slow the elimination of contents from the intestinal system. This can lead to poisoning with toxic substances and worsening of the disease.

Forecast

Most often, the patient’s recovery occurs within two to three days, but in some cases, infectious-toxic shock and other serious complications and dysbiosis may develop.

Heavy bowel movements and loss of fluid can cause a decrease in the number of beneficial bacteria inhabiting the intestinal system, and, as a result, lead to dysbiosis. Often this condition manifests itself as chronic diarrhea and requires the use of special therapy.

Dehydration is one of the serious consequences of infection. It manifests itself as excessive loss of fluid resulting from diarrhea and vomiting.

There are 4 stages of dehydration:

The first degree is characterized by a loss of 1-3% of the patient’s weight. In this case, the patient feels intense dryness in the mouth.
The second degree is manifested by the following symptoms: fluid loss - 4-6%, severe thirst, hoarseness, dry mouth and nose, slight blueness of the lips and fingertips, tremors of the limbs.
The third degree of dehydration is established when there is a significant deterioration in the patient’s condition, based on wrinkled skin, fluid loss of 7-9% of body weight, the appearance of convulsions, and difficulty urinating. When these symptoms appear, the patient must be hospitalized.
The fourth degree is observed in rare cases and occurs most often with cholera. Characterized by a loss of 10% or more fluid. It is worth noting that toxic infection is not accompanied by 3-4 degrees of dehydration.

Other complications include acute abdomen, characterized by thrombosis of mesenteric vessels, as well as cerebral circulatory disorder, myocardial infarction, pneumonia.

If the symptoms of the disease do not stop after two days, treatment in a hospital is necessary: against the background of dehydration and general exhaustion, other pathologies may appear.

Prevention

Measures to prevent the disease include sanitary and hygienic control over public catering establishments, preventing food contamination by microorganisms and their proliferation in food.

People working in public catering must comply with sanitary standards when preparing dishes, storing and transporting food, as well as personal hygiene.

Every person should not forget to wash their hands before eating and after using the restroom. In addition, foods that have expired should be excluded from the diet, as some microorganisms can survive at low temperatures.

Products that are approaching their expiration date are considered potentially hazardous.

You should eat thermally processed meat and fish products, thoroughly washed vegetables, fruits and herbs. When visiting countries with a high level of intestinal diseases, you must be careful, eat only freshly prepared meals, exclude raw vegetables, unpeeled fruits, and drink filtered and boiled water. To avoid contamination, drink water only in sealed containers. This is especially true for travelers on long trips, young children and the elderly.

Foodborne toxic infections (FTI), or food bacteriotoxicosis, belong to a group of acute infectious diseases caused by food poisoning in which opportunistic pathogenic flora producing exotoxins have multiplied. The course of PTI is accompanied by the following general symptoms:

intoxication,
dehydration,
acute gastroenteritis.

The prevalence of food bacteriotoxicosis is second only to ARVI, it is so ubiquitous. The danger of PTI is determined by:

frequency of mass outbreaks,
the likelihood of dehydration and/or infectious toxicological shock,
fatal outcomes, especially often among children and the elderly,
difficulties in detecting the source of toxins.

Causes of food poisoning

PTI – infections can be caused by many bacteria. Most often health problems arise due to:

Proteus vulgaris,
Staphylococcus aureus,
Clostridium perfringens,
Bacillus cereus,
representatives of the genera Klebsiella,
Clostridium difficile,
Citrobacter,
Enterobacter,
Enterococcus,

These and other pathogens are very common in nature, have strong resistance and can multiply outside the human body. Moreover, all of them, in a certain concentration, are part of the healthy intestinal microflora of both animals and humans. This is the difficulty of diagnosing and treating food poisoning, because sometimes it is difficult to isolate the causative agent of the disease. In addition, opportunistic microorganisms mutate under the influence of external factors, developing resistance to medications.

Sources of food poisoning

Sources of infection are sick animals and people. Among the latter, those suffering from purulent diseases (furunculosis, tonsillitis, etc.) are especially dangerous. If we talk about animals, the carriers of pathogenic bacteria are sheep, cows, and patients with mastitis.

In most specified cases, patients secrete a pathogen, most often staphylococcus, which gets onto food when they are touched. There the bacteria multiply and the toxin accumulates.

Not only sick people are dangerous, but also carriers of infections. These are people who have recently recovered from the above-mentioned diseases. The period of contagiousness can be clearly established and one can be careful, but regarding the period of time when a person is simply a carrier, experts disagree.

There are a number of foodborne pathogens that animals and people excrete in their feces. They can be contracted through soil, water and anything else that may be accidentally contaminated with feces.

How do PTIs become infected?

The transmission mechanism of PTI is fecal-oral; bacteria enter the body through saliva, food or drink. For food bacteriotoxicosis to occur, a large concentration of pathogens must be “accepted” or sufficient time has passed for them to multiply in food or water. Most often, PTI occurs due to contamination (contamination) of the following products:

milk and dairy products,
canned fish in oil,
vegetable, fish, meat dishes,
confectionery products containing cream.

Any type of meat is a favorable environment for the proliferation of clostridia. Moreover, some options for preparing meat products and dishes - repeated heating, slow cooling - create comfortable conditions for the reproduction of vegetative forms and the germination of spores.

You can become infected with foodborne pathogens through any environmental objects:

Houseware,
patient care products,
water,
soil,
plants.

Products contaminated with staphylococci and other toxins taste and smell no different from safe, benign food.

Most of all, food bacteriotoxicosis “loves” the warm season, because then favorable conditions are created for pathogens for rapid reproduction and accumulation of toxins. Diseases have the nature of individual cases and outbreaks.

Human susceptibility to diseases

This figure is quite high. If people ate contaminated food, in all cases they will definitely get poisoned. Those in whose bodies there are additional factors contributing to intoxication, such as certain chronic diseases, weakened immunity and others, will especially suffer. Symptoms of food poisoning in children, people after surgery or who have been taking antibiotics for a long time are more pronounced, and poisoning is very severe.

The prevalence of disease from opportunistic bacteria depends on how many people have eaten the contaminated food. Therefore, outbreaks are familial in nature, and when food is contaminated in catering establishments, the diseases spread throughout the population.

Quite often this problem has a “group” character when the following are poisoned:

ship passengers,
tourists,
hotel residents,
team members.

PTI flares can be compared to an explosion; they manifest themselves quickly and spare no one. There was no particular connection to age or gender in this regard. The only thing that correlates with age is the type of food product contaminated with bacteria.

In addition to domestic reasons, there are also hospital cases that contribute to outbreaks of IPT. Due to long-term use of antibiotics in the gastrointestinal tract, favorable conditions are created for the abnormal reproduction of C. Difficile.

Beaches also pose some danger, since in warm weather many bacteria multiply well in the water. People who drink such water after a while suffer from an acute intestinal infection.

Mechanism of development of food toxic infections

When contaminated food enters the body, it contains not only pathogens, but also exotoxins that they managed to produce. Therefore, their incubation period is quite short; a person can feel the symptoms of poisoning after 30 minutes, but most often this happens after 2-6 hours.

How the disease manifests itself depends on what toxins predominate in the body and their “dose” contained in the food consumed.

Enterotoxin

It can be heat-stable and heat-labile, binds to epithelial cells of the gastrointestinal tract, affects the fermentation systems of epithelial cells. Enterotoxin activates the production of the enzymes guanyl cyclase and adenyl cyclase, which change the cells of the mucous membrane. The formation of intestinal hormones, histamine, and prostaglandins is also accelerated. As a result of all this, the secretion of salts and fluid into the lumen of the intestines and stomach increases, diarrhea and vomiting develop.

Cytotoxin

It disrupts the protein synthetic processes of cells and damages their membranes. Thus, the permeability of the intestinal wall and various toxic substances (enzymes, lipopolysaccharides) of bacterial origin increase, and sometimes the bacteria themselves easily pass through it. Intoxication begins, microcirculation of the mucous membrane is disrupted, and inflammation occurs.

We conclude: the manifestations of PTI, provoked by bacteria that produce only enterotoxin, are not so severe. Most often, this disease is not accompanied by serious inflammation of the gastrointestinal mucosa. But if you are unlucky enough to eat foods with enterotoxins and exotoxins, the disease is much more severe. It is accompanied by fever and inflammatory changes in the gastrointestinal mucosa.

Usually, IPT treatment quickly produces positive results. When the bacteria are removed, the effect of their toxins stops literally immediately. Additionally, medications are taken to inactivate unbound toxin molecules.

However, under certain conditions, food poisoning can torment the patient for quite a long time. This happens if, due to some current or experienced disease, the antibacterial protection of the small intestine does not work well in the body. It is also especially difficult:

who have undergone gastrectomy,
patients with malnutrition,
suffering from blind loop syndrome.

Symptoms of food bacteriotoxicosis

Poor health makes itself felt after different periods of time - from half an hour to 6 hours. The symptoms of PTI, which are caused by different bacteria, are similar, so we will summarize them in one section.

It all starts with

nausea,
vomiting,
diarrhea,
severe abdominal pain.

Most often, vomiting cannot be stopped; it is long-lasting and debilitating. Diarrhea often appears simultaneously with vomiting, the stool is very watery, to the point that a person runs to the toilet up to 15 times a day.

increase in body temperature,
short-term redness of the skin,
headache,
malaise, weakness.

After 12-24 hours, the body temperature returns to normal, and the skin turns pale and even has a bluish tint. The tongue becomes covered with a gray-white coating.

There are disturbances in the functioning of the cardiovascular system:

bradycardia or tachycardia,
lowering blood pressure,
systolic murmur at the apex of the heart,
Heart sounds are muffled.

In some cases, the patient may lose consciousness. Repeated vomiting and diarrhea cause dehydration, acidosis and demineralization. Sometimes observed:

leg and arm cramps,
decreased diuresis (urine output),
decreased skin turgor.

If timely and competent assistance is provided, these phenomena quickly stop. In general, such symptoms in an aggravated form are observed for up to 3 days.

Complications can be caused by dehydration - shock occurs. Acute heart failure also sometimes occurs. Other complications depend on the individual characteristics of the victim’s body.

The prognosis is often favorable; deaths are very rare and occur not from the poisoning itself, but from complications caused by it.

For the diagnosis of PTI, the following clinical and epidemiological factors are essential:

acute onset, the presence of dominant signs of gastroenteritis, gastritis,
short-term nature or absence of hyperemia (redness of the skin),
short duration of the disease,
the group nature of the disease, its connection with eating the same food,
explosive nature of the disease.

For laboratory diagnosis of food toxic infections, the bacteriological method is important, which includes the study of the toxigenic properties of detected bacteria. For study, vomit, feces of the patient, as well as leftover food, which served as a source of bacteria, are used.

Treatment and prevention of PTI

The first stage of treatment of toxic infection is expressed in the following actions:

Carefully, repeatedly, until clean rinsing water comes out. To do this, use special solutions or even ordinary water.
Then you need to give the victim sorbents.
If there is no stool, you need to do a high (siphon) enema.
If diarrhea is severe, it must be treated with special medications.

You should definitely call an ambulance, because only in a hospital will they be able to determine the type of bacteria that a person has become infected with and provide him with further qualified treatment.

If grade 1-2 dehydration occurs and there is no uncontrollable vomiting, oral rehydration with special solutions is prescribed.
For grade 3-4 dehydration, polyionic solutions are administered intravenously.
A diet and vitamin complex are selected.

Uncomplicated IPT cannot be treated with antibiotics or other chemotherapy drugs.

Preventing IPT outbreaks is primarily the responsibility of the state, which must:

Require food industry enterprises to introduce modern food processing technologies.
Encourage the development and application of new methods of storage and canning of perishable products.
Strengthen requirements for food quality.
To improve the work of sanitary services at food industry, trade and catering enterprises.

A very effective preventive measure is to exclude those who have pustular inflammations on the skin, sore throats, stomatitis and other similar diseases from working with products. And the veterinary service needs to carefully monitor the health of dairy cattle.