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What causes intestinal yersiniosis?
Last reviewed: 23.04.2024
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Causes of intestinal (intra-intestinal) yersiniosis
The causative agent of intestinal yersiniosis is a short Gram-negative rod, mobile at a temperature of +4 to -28 ° C, fixed at 37 ° C. Facultative aerobic, not encapsulated, does not form a spore. It is unpretentious to nutrient media, it grows well at low temperatures. According to biochemical properties, strains of Y. Enterocolitica are divided into five biovars. In humans, biovars III and IV are more often found, rarely - II. More than 30 serovars have been identified for O-antigen. The predominance of individual serovars in certain areas was noted. The microorganism has antigenic kinship with salmonella, and strains of the serovar 09 - with brucella.
[Pathogenesis of intestinal (intra-intestinal) yersiniosis
The causative agent passes through the stomach, localizes in the small intestine, where it begins to multiply. Particularly frequent localization is the place of passage of the small intestine into the blind (terminal section of the small intestine, appendix). Possessing enterotoxigenic and invasive properties, Y. Enterocolitica penetrates and destroys the cells of the epithelium of the intestinal mucosa. Inflammatory process can be different - from catarrhal to ulcerous-necrotic. The length of the inflammatory process is also different. The infection spreads to the regional lymph nodes, which increase as a result of hyperplasia of the lymphoid tissue. In them, foci of necrosis or microabscesses may form. The liver and pancreas can be involved in the process.
At this enteric, or regional, stage of the disease can end. In more severe cases, a breakthrough of microorganisms in the bloodstream is possible, which leads to generalization of infection and the occurrence of abscesses of the liver, spleen, lungs, bones.
The causative agent can persist for a long time in the lymph nodes, causing repeated waves of disease or transition to a chronic form. A variety of infectious and allergic manifestations with iersiniosis - exanthema, poly- and monoarthritis, arthralgia, myalgia, tendovaginitis, myositis, heart damage, knotty and other erythema, Reiter syndrome - some authors explain by the similarity of the structure of Y. Enterocolitica antigen and HLA B-27 antigen , which is found in 90% of these patients, compared with 14% in the general population.