Campylobacter enteritis

　　1. Jejunal campylobacter can cause diarrhea in humans and animals. The ones related to humans include jejunal campylobacter, fetus campylobacter, and enterocampylobacter, with jejunal campylobacter being the most pathogenic. Jejunal campylobacter is slender, curved, spiral, or comma-shaped, Gram-negative, and grows well at 42°C in a micro-oxygen environment.

　　2. After the bacteria enter the intestines, they rapidly multiply in a micro-oxygen environment, mainly invading the jejunum, ileum, and colon, attacking the intestinal mucosa, causing congestion and hemorrhagic injury. In recent years, some strains have been observed to produce toxins similar to cholera enterotoxins, causing an increase in fluid secretion in the intestinal lumen.

　　It has been reported that Guillain-Barré syndrome often occurs after jejunal campylobacter infection and is considered to be one of the causes of GB. The pathogenesis may be related to immune reactions.

　　1. The bacteria have similar antigenic properties to the myelin of nerve fibers, which can cause cross-immunity;

　　2. The enterotoxin binds with gangliosides;

　　3. Cellular-mediated immune injury.

　　1. Clinical manifestations:The onset is acute, with fever, abdominal pain, diarrhea, nausea, vomiting, mild diarrhea with watery stool, severe stool with mucus, blood, pus, like bacterial dysentery, even with bloody stool, feces 6 to 10 times a day, not much, severe up to 20 times. It is reported that in children with jejunal campylobacteriosis abroad, bloody stools account for 60% to 90%, and in China, it accounts for 3% to 10%, which may be due to the pathogenicity of different strain types. During the course of the disease, mesenteric lymphadenitis, appendicitis, cholecystitis, or sepsis may occur concurrently.

　　2. Disease diagnosis:A rapid diagnosis can be made by observing the rapid movement of Campylobacter under a dark-field microscope or related microscope in fresh feces, and the diagnosis can be confirmed by culturing the feces.

　　The most important source of infection for jejunal campylobacteriosis is animals. How to control animal infection and prevent the contamination of water and food by animal excrement is crucial, therefore, doing a good job of the three management, namely, managing water, feces, and food, is a powerful measure to prevent the spread of campylobacteriosis. Currently, research is being conducted on attenuated live vaccine and heat-inactivated bacteria, which are expected to play an important role in eliminating the source of infection and preventing infection.

　　1. Routine feces examination

　　The appearance is mucus stool or loose watery stool, with a high number of white blood cells or red blood cells observed under the microscope.

　　The method of direct smear examination for pathogens is to apply a thin layer of feces on a glass slide, and then slowly heat and fix it. After that, immerse the smear in a 1%碱性品红solution for 10 to 20 minutes, followed by thorough rinsing with water. Microscopic examination of the smear shows fine, single or in a string,鸥翼形, S-shaped, C-shaped, or spiral-shaped bacilli with pointed ends as positive.

　　2. Bacterial examination

　　Feces, intestinal swabs, or blood, puncture fluid from febrile patients can be taken as specimens. They are cultured in selective media under anaerobic conditions, and bacteria are isolated. If the colony morphology and special biochemical characteristics are typical, a diagnosis can be made.

　　3. Serological examination

　　Early and convalescent serum samples should be taken for indirect coagulation tests, and the antibody titer should show a 4-fold or more increase to make a diagnosis.

　　What should Campylobacter enteritis patients eat?
　　1. Mainly eat light and healthy foods, and pay attention to dietary regularity.
　　2. Follow a reasonable diet as advised by the doctor.
　　3. There are no significant dietary restrictions for this disease, and a reasonable diet is sufficient.

　　General treatment includes gastrointestinal isolation, thorough disinfection of the patient's feces, and isolation period from onset to negative stool culture. Symptomatic treatment, including fever, abdominal pain, and severe diarrhea, should be provided, and bed rest is recommended. Infection with this bacterium in pregnant women can lead to abortion and preterm delivery, and can also infect newborns. After infection, specific serum antibodies can be produced, which can enhance the function of phagocytes.

　　Western treatment methods for Campylobacter enteritis

　　Most patients with Campylobacter enteritis can recover on their own, depending on the patient's own immunity, but they may continue to shed bacteria for several months, and the longest shedding may reach 1 year after the disease. Antibacterial drug treatment can quickly control diarrhea and stop shedding. Amikacin, gentamicin, amoxicillin, and other drugs can be selected. Symptomatic treatment should also be emphasized, and dehydration should be corrected if present.

　　First, Amikacin

　　Clinical use is mainly for Gram-negative bacilli resistant to gentamicin and kanamycin, such as Escherichia coli, Proteus, and Pseudomonas aeruginosa, which cause various infections.

　　1. Adults are administered intramuscularly or intravenously, 0.25g every 12 hours for urinary tract infections; for other systemic infections, 5mg/kg per 8 hours or 7.5mg/kg every 12 hours based on body weight. The daily dose for adults should not exceed 1.5g, and the course of treatment should not exceed 10 days.

　　2. The initial dose for neonates is 10mg/kg intramuscularly or intravenously, followed by 7.5mg/kg every 12 hours; the dosage for children is the same as for adults.

　　3. Intramuscular or intravenous administration, 15mg/kg per day, divided into 2-3 doses. The daily dose for adults should not exceed 1.5g. For simple urinary tract infections, a single dose of 250mg is sufficient, taken twice a day. The initial dose for neonates is 10mg/kg, followed by 7.5mg/kg every 12 hours. Generally, the course of treatment should not exceed 10 days.

　　Second, Gentamicin

　　1. This product is applicable for neonatal sepsis, septicemia, central nervous system infections (including meningitis), urinary tract and reproductive system infections, respiratory tract infections, gastrointestinal tract infections (including peritonitis), biliary tract infections, skin, skeletal, otitis media, sinusitis; soft tissue infections (including burn injuries), listeriosis caused by Pseudomonas aeruginosa, Proteus (indole-positive and negative), Escherichia coli, Klebsiella, Enterobacter, Serratia, Citrobacter, and Staphylococcus (including penicillin-resistant and methicillin-resistant strains).

　　2. When this product is used for severe central nervous system infections caused by Pseudomonas aeruginosa or Staphylococcus (meningitis, encephalitis), it can be used simultaneously with intrathecal injection as an adjuvant therapy.

　　3. This product is not indicated for the initial treatment of simple urinary tract infections, unless the causative organism is not sensitive to other antibacterial drugs with lower toxicity, this product is ineffective against most species of Streptococcus (especially group D), Streptococcus pneumoniae, and anaerobic bacteria (such as Bacteroides or Clostridium spp.).

　　4. This product can be taken orally for intestinal infections or as a preoperative preparation for colon surgery, and can also be used in combination with Clindamycin or Metronidazole by intramuscular injection to reduce the infection rate after colon surgery. Adults can be administered intramuscularly or diluted for intravenous infusion, 80mg (80,000 units) at a time, 2-3 times a day, with an interval of 8 hours. Or according to body weight 1-1.7mg/kg (same as Gentamicin, below). Once every 8 hours; or according to body weight 0.75-1.25mg/kg, once every 6 hours, for a total of 7-10 days. Children are administered 3-5mg/kg per day, divided into 2-3 doses. After hemodialysis, the dose can be replenished according to the severity of the infection, 1-1.7mg/kg for adults according to body weight; 2-2.5mg/kg for children according to body weight.

　　Third, Amoxicillin

　　Indicated for the following infections caused by sensitive bacteria (strains not producing β-lactamase).

　　1. Upper respiratory tract infections such as otitis media, sinusitis, pharyngitis, and tonsillitis caused by Streptococcus hemolyticus, Streptococcus pneumoniae, Staphylococcus, or Haemophilus influenzae.

　　2. Urinary and reproductive tract infections caused by Escherichia coli, Proteus mirabilis, or Enterococcus faecalis.

　　3. Skin and soft tissue infections caused by Streptococcus hemolyticus, Staphylococcus, or Escherichia coli.

　　4. Acute lower respiratory tract infections such as acute bronchitis and pneumonia caused by Streptococcus hemolyticus, Streptococcus pneumoniae, Staphylococcus, or Haemophilus influenzae.

　　5. Acute simple gonorrhea.

　　6. This product can also be used for the treatment of typhoid fever, carriers of typhoid fever, and leptospirosis; Amoxicillin can also be used in combination with Clarithromycin and Lansoprazole in triple therapy to eradicate Helicobacter pylori in the stomach and duodenum, and reduce the recurrence rate of gastrointestinal ulcers.