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[Diagnosis and therapeutic pitfalls in systemic yersiniosis (Yersinia enterocolitica)]
Abstract:
Yersinioses (Y. enterocolitica 0:3) account in the North Moravian region for 1.3% of all notified diarrhoeal diseases of bacterial origin. Since 1989 the authors recorded in samples of faeces and tissue biopsies 65 strains of Y.e. and by cold cultivation 47 strains of Y.e. In 48 systemic yersinioses the dynamics of specific antibodies were investigated by the method of passive haemagglutination. The authors produce the antigen from a pure culture of a strain of Y.e. from their collection. To test the level of specific titres they examined healthy controls. If titres of 1:640 or higher persist for some time, as a rule extraintestinal forms with a protracted course and with relapses are involved. The joints were affected most frequently (70%), mostly in women. High antibody titres were found also in articular exudates obtained by puncture. Subjects with HIA-B27 are a risk group. Usually a prolonged course of treatment with cotrimoxazole proved successful. Only in one instance with a protracted course and relapses, after a series of preparations was tested, mostly quinolones, synovectomy was performed. The authors assume that some cases of systemic yersinioses are not properly diagnosed. Usually it does not proved possible to elucidate the source of infection, although in some instances the disease has a clearly occupational character.
Insights
Yersinioses caused by Yersinia enterocolitica are a significant cause of bacterial diarrheal diseases. High antibody titers indicate persistent, extraintestinal infections, often affecting joints, particularly in women.
Area of Science:
- Infectious Diseases
- Microbiology
- Immunology
Background:
- Yersinioses, specifically Yersinia enterocolitica 0:3, represent 1.3% of bacterial diarrheal diseases in the North Moravian region.
- Since 1989, 65 strains of Y. enterocolitica have been recorded from fecal and tissue samples, with 47 isolated via cold cultivation.
Purpose of the Study:
- To investigate the dynamics of specific antibodies in patients with systemic yersinioses.
- To correlate antibody titers with clinical manifestations and treatment outcomes.
Main Methods:
- Passive haemagglutination assay used to measure specific antibody dynamics in 48 cases of systemic yersinioses.
- Antigen prepared from a pure culture of Y. enterocolitica strain.
- Healthy controls examined to establish normal antibody levels.
Main Results:
- Persistently high antibody titers (≥1:640) are associated with extraintestinal forms, protracted courses, and relapses.
- Joints were the most frequently affected site (70%), predominantly in women.
- High antibody titers were detected in articular exudates; HLA-B27 positivity is identified as a risk factor.
Conclusions:
- Systemic yersinioses may be underdiagnosed.
- While cotrimoxazole is often effective, prolonged treatment or synovectomy may be necessary for complicated cases.
- The source of infection is often unclear, though an occupational link is sometimes evident.