Food poisoning by bacterial toxins

Food poisoning by bacterial toxins - disease occurring after the use of the products, contamination by various microorganisms and containing bacterial toxins. These include the poisoning of botulinum toxin, Cl. perfringens and staphylococcus poisoning. This section describes the poisoning staphylococcal toxin and Cl. Perfringens (see. Also Botulism).

Etiology, pathogenesis. Food poisoning staphylococcal origin associated with pathogenic strains of staphylococci, capable of producing enterotoxin. They can also form gematoksiny, hyaluronidase, give a positive reaction plasma-coagulation. When injected into the products (from people suffering from pustular diseases or from healthy carriers aerogenic staphylococci) they are able to multiply, leading to accumulation of toxin in the product. Staphylococcal poisoning usually associated with the consumption of milk, dairy products, meat, fish, vegetable dishes, cakes, pastries, fish canned in oil. Products containing interotoksin in appearance and flavor do not differ from benign. Staphylococci tolerate high concentrations of salts and sugars. If staphylococci killed by warming up to 80 grams. C, the toxin can withstand heating of up to 100 grams. For 1.5 - 2 h. To the enterotoxin are very sensitive kittens and puppies, in which a biological sample is carried out. Microbes Cl. perfringens are major gram-negative bacilli. Grow under anaerobic conditions, are able to form spores. By antigenically divided into six serotypes (A, B, C, D, E, F). Poisoning most often associated with pathogen type A.

Staphylococcal poisoning caused by toxins only, may occur and the absence of the pathogen (eg, poisoning products containing enterotoxin). Enterotoxin is not destroyed by digestive enzymes, and is able to penetrate through the mucous membranes of the gastro - intestinal tract. Given the short incubation period (up to 2 hours), it can be assumed that the toxin absorption occurs in the stomach. The toxin causes the activation of motility - intestinal tract, acts on the cardio - vascular system (a significant reduction in blood pressure).

If poisoning clostridial toxins lecithinase greatest importance is attached to C (alpha - toxin). The toxins cause damage to the intestinal mucosa, violate its absorptive function hematogenically penetrate the various bodies associated with the mitochondria of liver cells, kidney, spleen and lungs. Damages the vascular wall that leads to the development of hemorrhagic syndrome. In severe cases, may develop sepsis, anaerobic.

Symptoms within. The incubation period for staphylococcal poisoning usually lasts for 1.5 - 2 hours, in case of poisoning by toxins clostridia -. 6 to 24 hours at the most characteristic of staphylococcal poisoning symptoms - cutting cramping pain in the epigastric region, vomiting. The body temperature is normal or low-grade. Diarrhea may not be; short-term frustration of a chair is observed in about half of patients. Typical of increasing weakness, pale skin, cold extremities, decreased blood pressure. Can develop collaptoid state. However, even with pronounced symptoms of the initial period to the end of the day from the onset of the disease recovery occurs only in individual patients within 2 - 3 days weakness persists.

Poisoning caused by Clostridium tohsinami, is much greater. The disease begins with pain in the abdomen, especially in the umbilical region; growing weakness, chair quickens up to 20 times or more, it is copious, watery, sometimes in the form of rice broth. Vomiting and diarrhea sometimes lead to marked dehydration. In some cases, there is a picture of necrotic enteritis. Mortality reaches 30%.

Diagnosis of staphylococcal poisoning can be made based on characteristic symptoms and epidemiological prerequisites (the group nature of diseases, the link with a particular product). To prove the diagnosis selection aureus producing enterotoxin can be used, from the remnants of food or stomach contents. In the presence of food poisoning heated enterotoxin adjusted with a biological sample or for kittens: precipitation reaction. Evidence of poisoning clostridial toxins is the detection of microorganisms in a suspicious products in the wash water or vomit.

Treatment. To remove toxins from the body the stomach is washed with water and 5% sodium bicarbonate, and then with staphylococcal poisoning may have a saline laxative. With the development of dehydration (clostridial toxin poisoning) is carried out a complex of measures for rehydration. When administered in the form of moderate / drip in isotonic sodium chloride solution or its equal volumes of 5% glucose solution in an amount of 1000 - 1500 ml. In severe and very severe forms of the solution has been successfully used "Trisol". Its composition is as follows: 1000 ml apyrogenic sterile water, 5 g sodium chloride, 4 g sodium bicarbonate and 1 g of potassium chloride, "Trisol" should be combined with the colloidal solutions which promote the removal of toxins from the body, migrotsirkulyatsii recovery. Principles rehydration therapy are the same as in the treatment of cholera patients (cm.). When poisoning staphylococcal antibiotics to prescribe. When poisoning caused by clostridia, given the possibility of anaerobic sepsis, prescribe broad-spectrum antibiotics (tetracycline, chloramphenicol, erythromycin).

The prognosis of staphylococcal poisoning is favorable. When poisoning clostridial toxins serious prognosis, especially in the development of anaerobic sepsis.

Prevention. Carry out measures to reduce the carriage of staphylococci among food service workers (prevention and treatment of pustular disease, the treatment of chronic inflammatory diseases of the tonsils, upper respiratory tract). Not allowed to work face with pustular diseases. It is necessary to correct storage of ready meals, excluding breeding of staphylococci. To prevent poisoning toxins klostrkdy primary importance is control of slaughtering, processing, storage and transportation of meat.