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诊断与治疗中的当前挑战

Current Challenges in Diagnosis and Treatment.

作者信息

Grygiel-Górniak Bogna

机构信息

Department of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Sciences, 61-701 Poznan, Poland.

出版信息

Microorganisms. 2025 May 15;13(5):1133. doi: 10.3390/microorganisms13051133.

Abstract

bacteria (, ) are commonly found in nature in all climatic zones and are isolated from food (mainly raw pork, unpasteurized milk, or contaminated water), soil, and surface water, rarely from contaminated blood. infection occurs through sick or asymptomatic carriers and contact with the feces of infected animals. The invasion of specific bacterial serotypes into the host cell is based on the type 3 secretion system (T3SS), which directly introduces many effector proteins ( outer proteins-Yops) into the host cell. The course of yersiniosis can be acute or chronic, with the predominant symptoms of acute enteritis (rarely pseudo-appendicitis or septicemia develops). Clinical and laboratory diagnosis of yersiniosis is difficult. The infection requires confirmation by isolating bacteria from feces or other biological materials, including lymph nodes, synovial fluid, urine, bile, or blood. The detection of antibodies in blood serum or synovial fluid is useful in the diagnostic process. The treatment of yersiniosis is mainly symptomatic. Uncomplicated infections (diarrhea and abdominal pain) usually do not require antibiotic therapy, which is indicated in severe cases. Surgical intervention is undertaken in the situations of intestinal necrosis. Given the diagnostic and therapeutic difficulties, this review discusses the prevalence of and , their mechanisms of disease induction (virulence factors and host response), clinical manifestations, diagnostic and preventive methods, and treatment strategies in the context of current knowledge and available recommendations.

摘要

耶尔森菌( )在所有气候带的自然环境中普遍存在,可从食物(主要是生猪肉、未经巴氏消毒的牛奶或受污染的水)、土壤和地表水中分离得到,很少从受污染的血液中分离得到。感染通过患病或无症状携带者以及接触受感染动物的粪便发生。特定细菌血清型侵入宿主细胞是基于Ⅲ型分泌系统(T3SS),该系统可将许多效应蛋白(外蛋白 - Yops)直接导入宿主细胞。耶尔森菌病的病程可为急性或慢性,主要症状为急性肠炎(很少发展为伪阑尾炎或败血症)。耶尔森菌病的临床和实验室诊断较为困难。感染需要通过从粪便或其他生物材料(包括淋巴结、滑液、尿液、胆汁或血液)中分离出耶尔森菌来确诊。检测血清或滑液中的抗体在诊断过程中很有用。耶尔森菌病的治疗主要是对症治疗。单纯感染(腹泻和腹痛)通常不需要抗生素治疗,严重病例则需使用抗生素。在肠道坏死的情况下进行手术干预。鉴于诊断和治疗上的困难,本综述结合当前知识和现有建议,讨论了耶尔森菌的流行情况、致病机制(毒力因子和宿主反应)、临床表现、诊断和预防方法以及治疗策略。

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