Yersinia pseudotuberculosis is known to cause septicemia, mesenteric lymphadenitis enteritis and erythema nodosum. Most of the infections were found in European countries, but none in Korea ti11 now. For the first time in Korea Y. pseudotuberculosis was isolated form a 51-year-old ma1e with liver cirrhosis. The patient showed chills, abdominal pain and diarrhea followed by a comatose state. The organism was isolated from both blood and peritoneal fluid. The isolation and identification were difficult as the organism grew slowly and many of the characteristics were similar to other enteric bacilli. The isolate was susceptible to all antibiotics tested in vitro, but our chemotherapy with ampicillin and kanamycin did not save the patient's life.
Antibiotics/pharmacology ; Human ; Male ; Middle Age ; Septicemia/microbiology* ; Yersinia/drug effects ; Yersinia/isolation & purification ; Yersinia Infections/microbiology* ; Yersinia pseudotuberculosis Infections/microbiology*

BACKGROUND: Yersinia pseudotuberculosis is known to cause fever, gastroenteritis, or acute kidney injury (AKI). There have been several Y. pseudotuberculosis infection outbreaks to date associated with ingestion of contaminated food or unsterile water. While this disease was considered to have practically been eradicated with the improvement in public health, we encountered several cases of AKI associated with Yersinia infection. METHODS: We retrospectively collected data from medical records of patients with suspected Y. pseudotuberculosis infection who visited Seoul National University Children’s Hospital in 2017. RESULTS: There were nine suspected cases of Yersinia infection (six males and three females; age range 2.99–12.18 years). Among them, five cases occurred in May, and seven patients were residing in the metropolitan Seoul area. Three patients had history of drinking mountain water. Every patient first presented with fever for a median of 13 days, followed by gastrointestinal symptoms and oliguria. Imaging studies revealed mesenteric lymphadenitis, terminal ileum wall thickening, and increased renal parenchymal echogenicity. Creatinine levels increased to 5.72 ± 2.18 mg/dL. Urinalysis revealed sterile pyuria, proteinuria, and glycosuria. Oliguria continued for 4 to 17 days, and two patients required dialysis; however, all of them recovered from AKI. Mucocutaneous manifestations developed later. In the diagnostic work-up, Yersinia was isolated from the stool culture in one patient. Anti-Yersinia immunoglobulin (Ig) A and IgG were positive in 6 patients. CONCLUSION: Y. pseudotuberculosis infection is an infrequent cause of interstitial nephritis presenting with AKI. When a patient presents with fever, gastroenteritis, and AKI not resolving despite hydration, the clinician should suspect Y. pseudotuberculosis infection.
Acute Kidney Injury ; Creatinine ; Dialysis ; Disease Outbreaks ; Drinking ; Eating ; Female ; Fever ; Gastroenteritis ; Glycosuria ; Humans ; Ileum ; Immunoglobulin G ; Immunoglobulins ; Male ; Medical Records ; Mesenteric Lymphadenitis ; Nephritis, Interstitial ; Oliguria ; Proteinuria ; Public Health ; Pyuria ; Retrospective Studies ; Seoul ; Urinalysis ; Water ; Yersinia Infections ; Yersinia pseudotuberculosis ; Yersinia

A 40-yr-old buddhist monk was admitted to the hospital with abdominal pain, fever, and confusion. He had a history of drinking untreated mountain spring water in his temple, and experienced the above symptoms for several days before admission. In past medical history, he had suffered from hepatic cirrhosis. Yersinia pseudotuberculosis was isolated from his blood and ascitic fluid. The mountain spring water that he had ingested was cultivated and Y. pseudotuberculosis was also isolated. For identification of pathogenic Y. pseudotuberculosis, each isolate from the three sources (blood, ascitic fluid, and drinking water) was also analysed for the inv gene for Y. pseudotuberculosis and the virF gene for virulent plasmid by PCR. All strains were positive for both the virF and the inv genes and also positive for autoagglutination test. For relationship study, each isolate from the three sources was also analysed with serotyping and restriction endonuclease analysis of virulence plasmid DNA (REAP) using BamHI. All belonged to the serotype 4b and REAP pattern D. Thus, all these findings supported that the mountain spring water was the source of the Y. pseudotuberculosis infection in this case.
Adhesins, Bacterial/genetics ; Adult ; Agglutination Tests ; Bacterial Proteins/genetics ; DNA, Bacterial/analysis ; Feces/microbiology ; Food ; Human ; Male ; Plasmids ; Restriction Mapping ; Septicemia/diagnosis/microbiology ; Serotyping ; Virulence Factors/genetics ; *Water Supply ; Yersinia pseudotuberculosis/classification/*genetics/isolation & purification ; Yersinia pseudotuberculosis Infections/*diagnosis/*transmission

Humans ; Yersinia Infections/diagnosis* ; Yersinia enterocolitica

China ; epidemiology ; Humans ; Yersinia Infections ; epidemiology ; microbiology ; Yersinia enterocolitica ; classification ; drug effects ; isolation & purification ; pathogenicity

OBJECTIVETo investigate the distribution of Yersinia enterocolitica in Henan province from 2005 to 2011.

METHODSA total of 6700 samples of stool specimen were collected from diarrhea patients and different domestic animals between 2005 and 2011 from Zhengzhou, Suixian and Dengfeng, as well as flies and the daub specimens of raw and cooked meat products. The bacteria were isolated by cold enrichment method, analyzed by the systematic biochemistry to determine the serotypes and bio-types, and tested the virulence genes by PCR method.

RESULTSA total of 216 strains of Yersinia enterocolitica were isolated from 11 kinds of animal hosts and foods, while 29.63% (64/216) of them were from swine. The dominant epidemic serotypes of the Yersinia enterocolitica were O: 5 and O: 8, accounted for 23.2% (50/216) and 20.4% (44/216), respectively; type 1A was the dominant bio-type, accounted for 84.7% (183/216). The dominant serotype and bio-type differed a lot among various hosts.16 pathogenic strains were isolated from swine, followed by diarrhea patients (6 strains) and dogs (6 strains).

CONCLUSIONThe distribution of the host of Yersinia enterocolitica was widespread, while swine was the dominant animal host.

Animals ; Animals, Domestic ; microbiology ; Bacterial Typing Techniques ; China ; epidemiology ; Humans ; Yersinia Infections ; epidemiology ; Yersinia enterocolitica ; isolation & purification

Reactive arthritis comprises a subgroup within infection-associated arthritides in genetically susceptible hosts. Researchers and clinicians recognize two clinical forms of reactive arthritis which occurs after genitourinary tract infection and after gastrointestinal tract infection. Chlamydia infection has been implicated as the most common agent associated with post-venereal reactive arthritis. Studies have proposed Shigella infection, Salmonella infection, or Yersinia infection as the microorganisms responsible for the post-dysenteric form. The human leukocyte antigen (HLA)-B27 antigen is the best-known predisposing factor. We report a case of HLA-B27-associated reactive arthritis after Salmonella enteritis at Pusan National University hospital.
Arthritis ; Arthritis, Reactive ; Child ; Chlamydia Infections ; Enteritis ; Gastrointestinal Tract ; HLA-B27 Antigen ; Humans ; Leukocytes ; Salmonella ; Salmonella Infections ; Shigella ; Yersinia Infections

OBJECTIVETo analyze the genetic evolution and bacterial type changes of Yersinia enterocolitica in the Ningxia area between year 1984 and 2011.

METHODSA total of 296 strains of Yersinia enterocolitica was collected from diarrhea patients, pig, rodents, sheep and dogs between year 1984 and 2011. The serotype, biotype, ail, ystA, ystB, yadA, virF and other toxic genes were detected. The PFGE subtypes of serotype O:3 and O:9 strains and the cluster features were analyzed.

RESULTSOut of 296 Yersinia enterocolitica strains, pig was the main host, accounting for 65.20% (193/296), followed by rodents, accounting for 32.43% (96/296). Serotype and biotype had their own respective dominant types in different periods. During 1984 and 1985, 2 strains of serotype O:3 and 3 strains of serotype O:9 were isolated, all belonged to biotype 3. Because of lack of strains, there were no obvious dominant types found. Between 1997 and 1999, 177 strains of serotype O:9 Yersinia enterocolitica were isolated as the dominant strain; and there were 178 strains of biotype 2 Yersinia enterocolitica were found. During 2007 and 2011, 54 strains of serotype O:3 Yersinia enterocolitica were isolated as dominant strain; followed by 26 strains of serotype O:5. There were separately 44 and 59 strains of biotype 1A and biotype 3. The PCR test divided the 248 strains into 4 types, including pathogenic strains as type I (ail(+), ystA(+), ystB(-), yadA(+), virF(+)). The PFGE divided the serotype O:3 into 12 types, in which K6GN11C30021 and K6GN11C30012 were the dominant types, accounting for 63.64% (42/66). The serotype O:9 were divided into 14 types, in which K6GN11C90010, K6GN11C90008, K6GN11C30018 and K6GN11C90003 were the dominant types, accounting for 89.01% (162/182).

CONCLUSIONThe different serotypes of isolated strains in Ningxia district showed different dominant bacteria in different periods; while the biotypes also changed with serotypes. The Yersinia enterocolitica isolated from different years showed great variation.

Animals ; DNA, Bacterial ; genetics ; Dogs ; Electrophoresis, Gel, Pulsed-Field ; Genes, Bacterial ; Genetic Variation ; Humans ; Rodentia ; Sheep ; Swine ; Yersinia Infections ; microbiology ; Yersinia enterocolitica ; classification ; genetics ; isolation & purification

Yersinia enterocolitica infection in adults in Korea is reported rarely. Therefore, the possibility of Yersinia infection as a cause of abdominal pain may be overlooked. Because its clinical features are similar to those of acute appendicitis or other diseases that require operations, Yersinia enterocolitis should be diagnosed before surgery. We recently experienced a case of Y. enterocolitica enterocolitis accompanied by postoperative colonic adhesion. A 39-year-old female patient with a 5-year history of asymptomatic uterine myoma underwent transabdominal hysterectomy due to abdominal pain. However, the pain worsened. On CT, diffuse swelling of the right colon and adhesion of the sigmoid colon with luminal narrowing were found. Colonoscopy showed multiple aphthous ulcers with mucosal hyperemia from the cecum to the sigmoid colon. Multiplex PCR with stool specimens, a hemagglutination test for Y. enterocolitica O:3, and tissue culture were positive for Y. enterocolitica. After fluids and antibiotic therapy, her symptoms were relieved.
Abdominal Pain ; Adult ; Appendicitis ; Cecum ; Colon ; Colon, Sigmoid ; Colonoscopy ; Enterocolitis ; Female ; Hemagglutination Tests ; Humans ; Hyperemia ; Hysterectomy ; Korea ; Multiplex Polymerase Chain Reaction ; Myoma ; Phenobarbital ; Stomatitis, Aphthous ; Yersinia ; Yersinia enterocolitica ; Yersinia Infections

Granulomatous appendicitis is a rare condition that accounts for less than 0.1~0.2% of all the cases of appendicitis. The great majority of cases are subacute or recurrent appendicitis and they are treated with interval appendectomy. The remaining causes include Yersinia infection, foreign body reaction, infection by mycobacteria, fungi or parasites, and Crohn's disease isolated to the appendix. Crohn's disease isolated to the appendix has several characteristics such as slow progression, a low recurrence rate and a good prognosis. Crohn's disease isolated to the appendix has recently been called "Idiopathic Granulomatous Appendicitis", and some authors have tried to distinguish it from Crohn's disease involving the appendix. We experienced a case of isolated appendiceal Crohn's disease in a 39-year-old woman and we report on it here along with a review of relevant literature.
Adult ; Appendectomy ; Appendicitis ; Appendix ; Crohn Disease ; Female ; Foreign-Body Reaction ; Fungi ; Humans ; Parasites ; Prognosis ; Recurrence ; Weight Loss ; Yersinia Infections