Proteas - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Infectious Diseases

infections caused by Proteus, is now becoming more popular due to improvement of detection methods as well as increase alertness of physicians to the problem.

Proteus - a microorganism from the group of opportunistic, belonging to the family Enterobacteriaceae (Enterobacteriaceae), class gammaproteobacteria, type proteobacteria (Proteobacteria).The main habitat of Proteus - the intestines, where the organism is part of the normal microflora.Normally, in the amount of feces Proteus must not exceed 104 CFU in 1 gram of feces.Proteus - Gram (Gram staining does not stain) bacteria are facultative anaerobes (especially vital functions in the absence of oxygen, however, and the presence of oxygen is not fatal), does not form spores.Proteus - a small organism to 3 microns, has the form of threads or thread-like rods, which are characterized by high mobility.Proteus have certain biochemical activity (for example, their lecithinase activity detected).

There are several types of Proteus: Proteus mirabilis, Pr

oteus vulgaris, Proteus myxofaciens, Proteus hauseri, Proteus penneri.Some protea - P. morganii, P. rettgeri - assigned to other groups.The main properties of Proteus pathogenicity - the ability to produce endotoxin (toxigenic properties), as well as hemolytic properties.At Proteus, as well as many representatives of the Enterobacteriaceae family, have O-, H- and K-antigens, which are divided into serological variants, of which there are about 110. It breeds on special nutrient media (eg, protein nutrient medium, plain agar,meat-broth, Ploskireva Wednesday), the optimum growth temperature is 370 against the relatively stable in the environment, tolerates freezing, high temperature suffers worse - dies at 600 for 1 hour, at 800 - 5 minutes.By disinfecting solutions stable enough.
in microbiology Proteus is considered by the bacterium with sanitary and indicative properties.Upon detection of P. mirabilis conclude on the extent of fecal contamination of the material and, if detected, P. vulgaris - about the degree of organic pollution.

causes of infections caused by Proteus

Not all types of Proteus are pathogenic to humans.By Proteus, capable to cause infection include P. mirabilis (up to 85-90% of all diseases caused by Proteus), P. vulgaris, P. penneri.

source of infection for pathogenic species Proteus is a sick man and animal excrement with which Proteus gets into the environment (soil, water, waste water, organic fertilizers decomposition stage), where it can remain viable for a long time.

mechanism of infection - nutritional and way water (swimming in dubious in terms of their purity waters, swallowing contaminated water) and food (eating meat products, dairy products, fish, sausage products, a variety of semi-finished products).Less commonly, the infection can be transmitted through contact-household (through contaminated hands, pollution umbilical wound infants infected through urological catheters).

risk groups for infection Proteus - are persons with reduced immunity or age (neonates and young children, the elderly) or with underlying chronic bowel diseases, lung, abdominal organs.Also at risk are persons uncontrollably taking antibiotics, that is engaged in self-medicate.

Symptoms and signs of an infection caused by Proteus

incubation period (the period from infection to onset of symptoms) from a few hours (usually 2-6 hours) up to 3 days.

1. Gastrointestinal tract - the most frequent manifestation of proteus infection.It manifested in the form of gastroenteritis, enterocolitis, gastritis sometimes.As at the beginning of the acute intestinal infections can be acute: there are symptoms of intoxication - fatigue and headaches, loss of appetite and sometimes fever up to 37,5-39 °, depending on the severity of the process, gastritis and gastroenteritis common symptom - is vomiting, nauseaalmost immediately appear disorder chair as watery diarrhea with foul smelly odor, abdominal pain fickle, often cramping in nature, patients worried about increased gas (flatulence), "rumbling" of the intestine.Duration of disease 4-5 days.
Severe intestinal proteus infection can lead to the development of anemia, hemolytic-uremic syndrome, acute renal failure.

2. Dysbacteriosis intestine - recorded in excess of the threshold of the normal content of Proteus in the stool (more 104KOE / g).Signs of dysbiosis may be different from the small indulgences stool to watery stool after eating up to 2 times per day.

3. defeat urinary tract caused by Proteus manifested as pyelonephritis, cystitis, prostatitis.Symptoms of these diseases do not differ from them is caused by another infection.

4. Wound infections , caused by P. mirabilis.The risk for occurrence of wound infection - patients with trophic ulcers, burns hospital patients, trauma patients departments.

5. Nosocomial infections caused by Proteus may be different.This otitis, and cholecystitis, urinary tract infection, infection in infants with the development of severe forms of meningitis, sepsis.

Diagnostics Proteaceae infections

primary diagnosis takes place on the basis of detection of clinical symptoms of a particular form of the infection, the identification of risk groups for proteus infection, after which require laboratory confirmation of the preliminary diagnosis.

Laboratory diagnosis:

1) Bacteriological analysis feces and other materials (urine, discharge of wounds, burn surfaces, purulent discharge, etc.).Sowing is done in the differential diagnostic medium (Ploskireva), enriching environment.When sowing Proteus grows in the form of creeping fine plaque in a veil of bluish color.The feces often reveals P. vulgaris, is present in about 2% of healthy people, but a small amount - up to 104 cfu / g.Exceeding this number indicates intestinal dysbiosis, which is most often associated (by combined) with the discovery of other opportunistic bacteria (Klebsiella, tsitrobakter and others).
When sowing urine detection Proteus called bacteriuria and points to the urinary tract damage.True bacteriuria (in the absence of symptoms in a patient) is diagnosed if Proteus of at least 105 Proteus microbial bodies in 1 ml of urine (a smaller amount is regarded as its contamination with withdrawal).Bacteriuria (if any complaints of the patient), and provided further sampling of urine from the catheter 104 is diagnosed by detection of Proteus microbial bodies in 1 ml of urine.

Proteus on medium

2) Serology - definition of antibodies in the blood (rarely used, mainly for retrospective diagnosis).
3) Auxiliary research (complete blood count, urinalysis, biochemical blood tests, coprogram and others) to determine the severity of the patient's condition.

treatment of infections caused by Proteus

Organizational-regime activities are reduced to polupostelnomu and bed rest, depending on the severity of manifestations, the observance of water regime in order to restore the fluid loss, light diet with restriction of oily and spicy food.

Drug treatment of infections caused by Proteus

1) specific bacteriophages assigned when excessive growth of Proteus.The preferred phages are "Bacteriophage proteus liquid", "Bacteriophage koliproteyny liquid", "Intest bacteriophage-liquid", "Piobakteriofag combined liquid", "Piobakteriofag polyvalent purified liquid."Bakterifagi appointed for an hour and a half before a meal.Individual dosages are calculated depending on the age and amount up to 6 months - 10 ml, 6-12 months - 10-15 ml, 1-3 years - 15-20 ml, 3-12 years and older 30 ml.Multiplicity of reception and treatment determines only the attending physician.Before taking the bacteriophage is necessary to drink alkaline mineral water.

2) Probiotics and simbiotiki to restore normal intestinal flora (Atsipol, atsilakt, bifidumbakterin, bifiform, linneks, Normoflorin, Biovestin, Primadofilus, etc.).Appointed on an empty stomach, at least the course of 10-14 days.

3) In marked growth of Proteus in adult patients are assigned antibiotics (amoxicillin, nifuroxazide, cephalosporins 3-4 generations, fluoroquinolones, streptomycin).Before the appointment of antibacterial drugs is necessary to conduct a special study - antibiotikogrammy material to avoid medication errors.The group of some tetracycline resistant strains of Proteus.Antibiotics are appointed only by the attending physician!

4) Symptomatic treatment - treatment of specific symptoms (fever-reducing drugs, chelators, painkillers, anti-inflammatories, drugs, normalizing water and electrolyte balance, and others).

Prevention Proteaceae infections

1) Careful adherence to sanitation in health care institutions (especially children's profile).
2) Good hygiene at home.
3) Eating fresh and quality products, the removal of the diet in terms of quality food products suspected.
4) Caution when bathing in unfamiliar waters, with the exception of swallowing water while swimming.
5) Exceptions contact with sick children and adults.

infectious disease doctor Bykov NI