Identification of intestinal bacteria toxins markers for acute intestinal infections diagnostics and evaluation of treatment efficacy
- Authors: Belaya OF1, Gyulazyan NM1, Andrekayte NA1, Belaya O1, Gyulazyan N1, Andrekaite N1
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- Issue: No 4 (2010)
- Pages: 58-63
- Section: Articles
- URL: https://journals.eco-vector.com/2073-4034/article/view/278299
- ID: 278299
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Abstract
The authors have conducted clinical and laboratory examination of 273 patients with acute intestinal infections (AII) of different etiology with moderate course of disease, and diagnosis was bacteriologicaly confirmed in 14.7% of cases only. S. sonnei O-antigens, S. flexneri 1-6, S. dysenteriae 1, Salmonella В, С1, С2, D, E serogroups, Y. pseudotuberculosis I and III, Y. enterocolitica О3, О7,8, О9, О4,33, О6,30, Campylobacter (C. jejuni, C. coli, C. lari), V. sholerae 01, as well as markers of Shiga toxin, C. difficile toxins A and B, C. perfringens enterotoxin type A, and cholera enterotoxin were identified in coprofiltrates by coagglutination. Simultaneous identification of 2 to 5 toxin markers was observed in 66.7% of patients (often - a combination of C. perfringens enterotoxin A with C. difficile toxin A/B or Shiga toxin). By the time of discharge from the hospital markers toxins remained in the fecal masses in 12.5% of patients. Levels of markers and frequency of these toxins occurrence in the CIC of blood serum were identified. Increase of toxigenic strain (the number of toxins in the fecal masses) lead to decrease of levels of markers of Shiga toxin and the Clostridium diffitsile toxin A in the CIC of blood serum. There is a trend to increase of level of a marker of Shiga toxin in the circulating immune complexes (CIC) of blood against the background of ciprofloxacin use in the treatment of AII. In contrast, the treatment without the use of ciprofloxacin leads to decrease of level of marker of Shiga toxin. A complete cessation of identification of O-antigen and toxins in coprofiltrates can serve as indicator of high treatment efficiency. For the purpose to verify the diagnosis of AII, identification of bacterial mixed-infections and difficult diagnosable yersiniosis, campylobacteriosis, clostridiosis, the use of wide range of diagnostic test kits for detection of markers of exotoxins and specific O-antigens is reasonable.
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