Acute intestinal infections caused by eating foods containing microorganisms and their toxins. Foodborne toxic infections are characterized by a sudden onset, attacks of nausea and repeated vomiting, diarrhea, cramping abdominal pain, fever and symptoms of intoxication. Diagnosis of foodborne toxic infections is made by bacteriological research vomit, gastric lavage, feces, food products. In case of food toxic infections, it is necessary to lavage the stomach, take enterosorbents, enzymes, probiotics, and perform oral or parenteral rehydration.

Diagnostics

When diagnosing foodborne toxic infections, the pathogen is isolated from vomit, feces, and gastric lavage. When a pathogen is identified, bacteria are inoculated on nutrient media and its toxigenic properties are determined. However, in many cases detection is not possible. In addition, the identified microorganisms are not always the direct cause of toxic infection. The connection of the pathogen with the disease is determined either through serological tests, or by isolating it from food products and from individuals who ate the same food as the patient.

Treatment of food poisoning

Paramount therapeutic measure in case of foodborne toxic infection, the fastest possible probing and gastric lavage is required (in the very first hours of the onset of clinical signs poisoning). If nausea and vomiting persist, this procedure can be done later. To get rid of intestinal toxins, enterosorbents are used and a siphon enema is performed. To prevent dehydration, the patient is given rehydration solutions and sweet tea in small portions. The amount of fluid taken by the patient should compensate for its loss through vomiting and feces.

If severe dehydration develops, intravenous administration rehydration mixtures. For patients with toxic infection for a while acute period recommended therapeutic nutrition. In severe cases, they may be prescribed antibacterial agents. After vomiting and diarrhea stop, it is often recommended enzyme preparations(pancreatin, trypsin, lipase, amylase) for speedy recovery digestion and probiotics or products containing bacteria necessary for the normalization of intestinal biocenosis.

Prognosis and prevention

In the vast majority of cases, the prognosis is favorable, recovery occurs within 2-3 days. The prognosis worsens with the development of complications, infectious-toxic shock. General prevention toxic infections consists of sanitary and hygienic control measures at enterprises and farms whose activities are related to the production, storage, transportation of food, as well as in institutions catering, children's canteens and production teams. In addition, veterinary control is carried out over the health of farm animals. Individual prevention consists of observing the rules of personal hygiene, storage and culinary processing food products. Specific prevention, due to the numerous types of pathogen and its wide distribution in nature, is not provided.

Food poisoning infection (FTI) is a disease caused by infection not with bacteria itself, but with toxins that are formed as a result of the activity of bacteria outside the human body - mainly in food. Exists large number bacteria capable of producing toxins. Many toxins can persist for a long time in contaminated products, and some can survive various types processing, including boiling for several minutes. A characteristic feature Foodborne illnesses are outbreaks when a large number of people become ill in a short period of time. This is usually associated with the joint consumption of an infected product. In this case, absolutely all people who have eaten the contaminated product become infected.

The main pathogens of food poisoning

The main bacteria whose toxins can cause foodborne illnesses are:

• Staphylococcus aureus - Staphylococcus aureus - is capable of producing a toxin that affects the intestines. Staphylococcus aureus widespread in environment and is perfectly preserved and multiplies in food products, which are a nutrient medium for it. If dishes are left at room temperature after cooking (especially salads with mayonnaise, cream cakes, etc.), then they create the most favorable conditions for the proliferation of staphylococci and the production of toxin.
• Bacillus cereus – the disease is usually associated with eating rice dishes (raw rice is often contaminated with Bacillus cereus). The pathogen multiplies in dishes left after cooking at room temperature. Bacillus cereus toxin is heat stable, and repeated boiling of the dish does not destroy it.
• Clostridium perfringens. This foodborne toxic infection is associated with the consumption of undercooked meat, poultry and legumes. The disease usually lasts no more than a day and goes away without treatment.

Symptoms of food poisoning

It takes several hours, sometimes minutes, for the toxin to enter the bloodstream. That's why incubation period(the time from the onset of infection to the first manifestations of the disease) is extremely short - no more than 16 hours.

Food toxic infections are characterized by an increase in body temperature to 38-39 ° C, accompanied by chills, weakness, and headache. However, such severe intoxication does not always occur - sometimes the temperature rises slightly or remains normal.

The most typical manifestations of food poisoning are vomiting and diarrhea. These symptoms may appear separately from each other or simultaneously. Vomiting is usually accompanied by nausea and is usually a relief. Profuse, watery diarrhea - up to 10-15 times a day, accompanied by cramping pain in the umbilical area.

Then signs of dehydration join the overall picture of the disease. The initial sign fluid loss is dry mouth; with a more severe course of the disease, the pulse quickens and decreases blood pressure, hoarseness of voice, cramps of the hands and feet appear. If convulsions occur, you must immediately call an emergency medical team.

Prevention of food poisoning

Prevention lies in observing the rules of personal hygiene: we must not forget about the “golden” rule - washing your hands before eating. It is not recommended to eat food that has expired, even if it has been stored in the refrigerator, since many toxins can persist. low temperatures. Wash vegetables and fruits thoroughly. You should be especially careful when traveling to developing countries, where acute intestinal infections (including foodborne illnesses) are extremely common. On such trips, it is recommended to eat only freshly prepared hot meals and avoid raw vegetables, salads, unpeeled fruits, drink only boiled or disinfected water, and do not drink drinks with ice.

Desmol (bismuth subsalicylate) – effective remedy for the prevention of traveler's diarrhea. The drug is taken orally at 524 mg (2 tablets) 4 times a day. It is safe to take for 3 weeks.

Dehydration due to food poisoning

Perhaps the most dangerous consequence PTI is dehydration that occurs as a result of significant fluid loss through diarrhea and vomiting.

There are 4 degrees of dehydration.

Grade 1: fluid loss is 1-3% of body weight.

One feels only a dry mouth, the skin and mucous membranes have normal humidity. Hospitalization is usually not required. However, we must not forget about the need to replenish lost volume by drinking plenty of fluids. If you have severe nausea and vomiting, you should drink a tablespoon of liquid every 2-3 minutes.

Grade 2: fluid loss is 4-6% of body weight.

With degree 2 dehydration, the following symptoms are observed:

• Intense thirst;
• The mucous membranes of the mouth and nose are dry;
• There may be some blueness of the lips and fingertips;
• Hoarseness of voice;
• Convulsive twitching of hands and feet.

The appearance of seizures is caused by the loss of electrolytes - substances that play important role in many processes in the body, including in the process muscle contraction and relaxation.

• There is also a slight decrease in turgor.

Turgor – This is the degree of elasticity of the skin, it depends on the amount of fluid in the tissues. Turgor is determined as follows: two fingers form skin fold- most often on back surface the hand, the front of the abdomen or the back of the shoulder; then they release it and watch the time of expansion. Normally and with the first degree of dehydration, the fold straightens instantly. With degree 2 dehydration, the fold can straighten out in 1-2 seconds.

• The volume of urine excreted decreases slightly.

You can replenish lost fluid in grade 2 dehydration through the mouth. However, if seizures occur, you should immediately seek medical attention. medical care.

Grade 3: fluid loss – 7-9% of body weight.

• The patient's condition is serious.
• Turgor is significantly reduced - the fold straightens out in 3-5 seconds.
• The skin is wrinkled.
• Convulsive contractions of the muscles of the arms and legs.
• The amount of urine excreted is significantly reduced.

Dehydration of the 3rd degree requires immediate hospitalization.

Grade 4: loss of 10% or more fluid. In fact is terminal condition. It occurs very rarely - mainly in cholera.

At food poisoning Grade 3 and 4 dehydration does not occur.

Dysbacteriosis due to food toxic infection

Abundant loose stools for several days can lead to a disruption in the quantitative and qualitative composition of bacteria living in the intestines - dysbacteriosis. Most often, dysbiosis manifests itself chronic diarrhea and requires special treatment.

Diet for food poisoning

An important component of treatment is diet. If diarrhea persists, therapeutic diet No. 4 is recommended, which is characterized reduced content fats and carbohydrates with a normal protein content and a sharp limitation of any irritants gastrointestinal tract. Also excluded are foods that can cause flatulence (increased formation of gases in the intestines).

• wheat crackers, thinly sliced ​​and not very toasted;
• soups with low-fat meat or fish broth with the addition of cereals: rice, semolina or egg flakes; as well as finely pureed boiled meat;
• lean soft meat, poultry or boiled fish;
• low-fat freshly prepared cottage cheese;
• eggs no more than 2 per day in the form of soft-boiled or steamed omelet;
• porridge with water: oatmeal, buckwheat, rice;
• vegetables only boiled when added to soup.

Products to exclude:

• bakery and flour products;
• soups with vegetables, in a strong fatty broth;
• fatty meat, pieces of meat, sausages;
• fat, salted fish, canned food;
• whole milk and other dairy products;
• hard-boiled eggs, scrambled eggs;
• millet, barley, pearl barley porridge; pasta;
• legumes;
• raw vegetables, fruits, berries; as well as compotes, jam, honey and other sweets;
• coffee and cocoa with milk, carbonated and cold drinks.

After stool normalization, you can switch to therapeutic diet No. 2. It is somewhat milder than diet No. 4. In this case, the following is added to the diet:

• day-old or dried bread. Inconvenient bakery products, cookies;
• meat and fish can be cooked in pieces;
• fermented milk products, including cheese;
• eggs, other than hard-boiled eggs;
• vegetables: potatoes, zucchini, cauliflower, carrots, beets, pumpkin;
• ripe fruits and pureed berries;
• creamy caramel, marmalade, marshmallows, marshmallows, jam, honey>.

Treatment of food poisoning

Treatment mainly consists of replacing lost fluid. It is necessary to understand that with diarrhea and vomiting not only water is lost, but also essential microelements, so it is wrong to replenish the liquid with water. The drug "Regidron" is suitable for this - a powder containing all necessary substances. The contents of the package are dissolved in 1 liter boiled water, you need to start drinking the solution as early as possible.

At 1 degree of dehydration, the volume of administered fluid is 30-50 ml/kg body weight. At stage 2 – 40-80 ml/kg body weight. The rate of fluid replenishment should be at least 1-1.5 liters per hour; You need to drink slowly in small sips.

If you are vomiting, you should try to drink a tablespoon every 2-3 minutes. If uncontrollable vomiting prevents you from drinking fluids, you need to call a doctor.

In addition to liquids, sorbent preparations are used - substances that bind toxic toxins and remove them from the body. Suitable for this activated carbon, Smecta, Enterosgel, Polyphepam, etc. Sorbents are taken 3 times a day.

NB! Antibiotics are not prescribed for food poisoning, since the cause is not a bacterium, but a toxin.

It is very important to remember that if you have a foodborne illness, you should not take Imodium (loperamide). This drug causes a significant slowdown in the elimination of intestinal contents, which can lead to greater toxicity and worsening of the disease.

FOOD TOXIC INFECTIONS

Foodborne toxic infections are a polyetiological disease that occurs when microbial agents and (or) their toxins enter the body along with food. The disease is characterized by an acute onset, a rapid course, symptoms of general intoxication and damage to the digestive organs.

Etiology. TO food intoxication include diseases caused by staphylococcal (St. aureus and St. epidermidis) enterotoxin types A, B, C, D and E. Diseases caused by Cl. perfringens, it is more correct to refer to food toxic infections. There are 6 serovars of the pathogen:

A, B, C, D, E and F. Foodborne toxic infections are caused mainly by clostridia serovar A, less commonly Cyr. The causative agent is a gram-positive rod, an anaerobe, and can form spores. Enterobacteriaceae of the genus Salmonella, Escherichia and Shigella also play a role in the etiology of foodborne toxic infections. The clinical characteristics of the diseases they cause are given in the relevant sections. The second group of foodborne pathogens includes opportunistic microorganisms of the genus Proteus, Citrobacter, Enterobacter, Klebsiella, Acinetobacter, Pseudomonas, Erwinia, Vibrio, Bacilus, etc.

Epidemiology. The diseases are united by the food transmission mechanism. The source of pathogens is a sick person or a bacteria carrier, as well as animals - patients and bacteria carriers. Staphylococcal intoxication is more often associated with the consumption of milk, dairy products, cakes, ice cream, and less often - meat, fish and vegetable dishes. Clostridiosis develops after eating meat, meat products, mushrooms contaminated with the pathogen. In case of food poisoning caused by V. Parahaemolyticus, the main factors of pathogen transmission are dried and fried sea fish, shrimp, squid and crabs. Infection with phytopathogenic microorganisms of the genus Erwinia is observed when consuming vegetables and fruits, in particular cabbage, cucumbers, tomatoes and citrus fruits. Diseases are mainly recorded in summer and autumn, but can occur in any season.

Clinic. The incubation period is short and can be calculated in hours. At the onset of the disease, severe chills, increased body temperature, nausea and repeated vomiting, and cramping abdominal pain are noted, mainly in the epigastric or periumbilical region. The stool is frequent, copious, watery with greens and mucus. The skin and visible mucous membranes are dry. The tongue is coated and dry. The pulse is frequent, blood pressure is low. The symptoms of general intoxication are pronounced - headache, weakness, dizziness, lack of appetite. Leukocytosis is observed with a pronounced shift in the leukocyte formula to the left.

There are clinical and epidemiological features depending on the etiology. Thus, with food poisoning caused by clostridia, the incubation period can range from 6 to 24 hours. When infected with clostridia A, D and E, the disease manifests itself as a syndrome acute gastroenteritis of varying severity.

For a disease caused by Cl. perfringens, the development of severe necrotic enteritis and hemocolitis is possible. Severe anaerobic sepsis is sometimes observed in diseases caused by you. Cereus, the incubation period averages 5-6 hours with fluctuations from 3 to 19 hours. In most patients, cereosis is mild, but sometimes symptoms of severe toxic infection such as acute gastroenteritis develop, dehydration, desalination, convulsions and sharp diffuse abdominal pain are noted. With enterococcal food toxic infection incubation period 2-17 hours With staphylococcal food intoxication, the incubation period is the shortest and lasts from 1 to 5-6 hours. The disease begins with chills, symptoms of acute gastritis, general intoxication, cardiovascular disorders develop up to collapse. In diseases caused by parahemolytic vibrio, the disease proceeds mildly like acute gastroenteritis. Occasionally it is observed severe course foodborne illness, signs of dehydration develop II-III degrees Recovery occurs in 5-7 days. For Proteus, Citrobacter, Enterobacter, Klebsiella, Pseudomonas and other etiologies of infection, the clinical picture differs little from the one given. When making an etiological diagnosis of foodborne toxic infections caused by opportunistic microorganisms, it is necessary to take into account the following clinical, epidemiological and laboratory tests: data The infectious nature is evidenced by group outbreaks of foodborne toxic infections after consuming a common food product, an acute onset with a short incubation period, chills, fever, symptoms of intoxication, repeated vomiting, cramping pain in the epigastric region, frequent loose stools. The results of bacteriological examination of feces, vomit, washing water and food products are of decisive importance; pathogenic microorganisms in a monoculture, an increase of 2-4 times or more in antibody titer in an agglutination reaction with autostrains and a high titer in a single study, detection of pathogens wow their toxins in food products, which served as a factor in the transmission of infection

Differential diagnosis carried out with acute surgical diseases of organs abdominal cavity, various pathological conditions, poisoning with poisons, drugs

In acute appendicitis, In contrast to food toxic infections, intense constant pain occurs in the abdomen, localized in the right iliac region and only in the initial phase of the disease - in the epigastric region. Vomiting 1-2 times, loose stools no more than 5-7 times a day, without mucus and blood. Voltage is determined abdominal wall, appendicular symptoms and signs of peritoneal irritation There is pronounced neutrophilic leukocytosis in the blood.

Spicy cholecystitis characterized by sudden attacks of severe pain in the right hypochondrium, radiating under right shoulder blade, in the shoulder joint and collarbone, chills and fever. Repeated vomiting does not bring relief. Yellowness of the sclera and skin appears. Palpation reveals muscle tension in the right hypochondrium, enlargement of the liver and gall bladder, symptoms of peritoneal irritation, and positive symptoms of Ker, Murphy, Ortner and Mussi. There are no pathological impurities in liquid feces. There is high leukocytosis in the blood. The history contains indications of chronic diseases of the hepatobiliary system, consumption of fatty fried foods, and alcohol. The results of X-ray examinations and culture of feces and vomit for opportunistic bacterial flora are important

Acute pancreatitis characterized by a sudden onset after errors in diet, consumption of fatty foods and alcohol. Abdominal pain is very strong, often of a girdling nature, less often localized in the epigastric region or on the left. Indomitable vomiting of bile is observed, which does not bring relief. The abdomen is distended, phenomena of dynamic intestinal obstruction may be observed, painful shock and collapse There is high leukocytosis in the blood, increased activity of amylase and diastase in the urine

At thrombosis And vascular embolism mesentery there is a rapid progressive course, a sudden onset, the pain, unlike foodborne toxic infection, is unbearable, the temperature at the onset of the disease is normal. An admixture of blood is detected in the stool and vomit. Signs of intoxication and dynamic intestinal obstruction are rapidly increasing. History of rheumatism, chronic cardiovascular diseases, thrombophlebitis, arteritis and disorders in the PACK system. There is high leukocytosis and coagulation abnormalities in the blood.

Acute intestinal obstruction due to strangulation, obstruction, intussusception and volvulus, it is characterized by the sudden appearance of severe cramping pain in the abdomen at normal temperature and the absence of signs of general intoxication. Unlike food toxic infections, stool and gas retention is characteristic. With partial passage of feces and gases, the patient's condition does not improve. In advanced cases, repeated vomiting of fecal contents develops. Sometimes it is possible to palpate to determine the intussusception or tumor that caused the obstruction. Positive symptoms of “splashing noise”, Valya, with a survey fluoroscopy of the abdominal organs, Kloiber’s cups are visible. The patient's medical history includes surgeries on the abdominal organs and frequent foodborne illnesses.

In the differentiation of foodborne toxic infections and perforated ulcer stomach and duodenum a long “ulcerative” history is important, sudden appearance sharp “dagger” pain in the abdomen and the absence of general intoxication and diarrhea. At the onset of the disease, the temperature remains normal. Positive symptoms of peritoneal irritation Free air is determined by percussion and x-ray in the abdominal cavity. High leukocytosis is characteristic.

At acute pyelonephritis And renal colic Unlike food toxic infections, in which the pain syndrome is not the leading one, the patient groans and rushes about from a sharp cramping pain in the lower back, radiating to the groin area and genitals. Dyspeptic symptoms are absent or mildly expressed; there is no mucus or blood in the stool. Patients complain of dysuric phenomena. Positive Pasternatsky symptom: Increased protein content in the urine, hematuria, cylindruria and bacteriuria are determined. Data from the life history and epidemiological history are taken into account, as well as the results of bacteriological, serological and urological research methods.

For gastrointestinal bleeding characterized by a sudden onset of general weakness, dizziness, pallor of the skin and mucous membranes, tachycardia and hypotension against the background of normal temperature and the absence of other signs of general intoxication. Soon bloody profuse vomiting appears, stool becomes more frequent, feces are profuse, tar-like. A decrease in the content of red blood cells and hemoglobin is noted in the blood. The most common causes of gastrointestinal bleeding are duodenal or gastric ulcers, Mallory-Weiss syndrome, portal hypertension, disintegrating tumors, polyposis , blood diseases, etc. The results of endoscopic research methods, in particular gastroduodenoscopy and colonoscopy, are decisive in diagnosis.

For abdominal form myocardial infarction anamnestic data, indications of ischemic disease heart disease in the past, absence of signs of intoxication, elevated temperature, frequent loose stool Pain appears suddenly, radiates to the left shoulder, back, less often detected in the epigastric region Pulse is initially frequent, weak, often arrhythmic Collapse Electrocardiography results are decisive for diagnosis

Hypertensive crisis And acute cerebrovascular accident develop, as a rule, after mental and physical overexertion, stressful situations, alcohol intake, during changes in atmospheric pressure in people with chronic cardiovascular pathology, in particular hypertension. General cerebral and focal neurological symptoms are noted, the temperature remains normal, there is no characteristic abdominal pain and frequent loose stools.

The results of bacteriological examination of vomit and feces for pathogenic and opportunistic microflora are negative. There are no corresponding immunological changes in the serological study of paired sera.

Meningitis of various etiologies occasionally occur under the clinical mask of foodborne toxic infections. In patients with meningitis, vomiting is associated with intracranial hypertension and intoxication. With meningitis, meningeal signs are positive, in particular stiffness of the neck muscles, Kernig's, Brudzinski's, and Lesage's symptoms, and focal neurological symptoms are observed. The data of lumbar spinal puncture are of decisive importance in making a diagnosis: the flow of cerebrospinal fluid under high pressure, changes in its color and transparency and the content of cells, protein, sugar and chlorides in it, as well as an increase in the activity of a number of enzymes - aspartate and alanine aminotransferase, malate and lactate dehydrogenase.

At Addisonian gastrointestinal crisis severe general weakness and dyspepsia develop against the background of normal or low temperature, there is no mucus or blood in the stool. The skin is cool and pigmented. Blood pressure drops sharply. There is a low glucose content in the blood, the content of potassium, sodium and chlorine, 11- and 17-OX are impaired. History of Addison's disease and violations of regimen and treatment

Pelvioperitonitis of genital origin, endoperimetritis, adnexitis, toxicosis of pregnant women, abortion, ectopic pregnancy and other diseases of the female reproductive system can occur with symptoms characteristic of foodborne toxic infections. However, pain with pelvioperitonitis is more intense than with foodborne toxic infections, increases with palpation and vaginal examination, radiates to the lower back, labia, rectum, thighs. Local tension in the abdominal wall is determined, the Shchetkin-Blumberg symptom is positive. There is high neutrophilic leukocytosis in the blood. With a disturbed ectopic pregnancy and bleeding, signs of hypovolemia and anemia develop. The results of vaginal examination, life history and epidemiological history, as well as bacteriological and serological data are of important diagnostic importance.

For food allergies In addition to dyspeptic symptoms, a maculopapular itchy rash and other manifestations of allergosis are characteristic. The disease most often develops soon after consuming milk, eggs, fish, crabs, shrimp, citrus fruits, strawberries, nuts and chocolate. Allergy history and skin tests with food allergens are taken into account. In the blood there is leukopenia, thrombocytopenia, eosinophilia.

Insufficient activity of disaccharidases and other enzymes that ensure digestion processes, and also malabsorption are accompanied by symptoms of intoxication and enteritis, which disappear with dietary restrictions or complete withdrawal of carbohydrates and foods containing high amounts of sugars. After loading with di- and mono-saccharides, increased intestinal dysfunction is observed. With lactase deficiency, a history of intolerance to milk, sour cream, cream and dairy products is noted; with insufficient sucrose activity, patients cannot tolerate sugar, honey, sweet fruits and vegetables. The final diagnosis is established based on the results of differentiated carbohydrate loads of poly-, di- and monosaccharides.

Poisoning by poisons - see “Dysentery”.

Toxins that enter the body with food often affect the digestive system and cause foodborne illnesses. Despite the fact that many of these disorders go away within a couple of days, some of them can lead to fatal outcome. So, it is important to correctly diagnose the disease and take measures to treat it.

What is it?

Foodborne illnesses and intoxications are a group of diseases that cause toxic substances, accumulated in food products due to the activity of microorganisms. However, the bacteria themselves may not be in the food.

Toxins from pathogenic microorganisms enter the bloodstream and cause symptoms of a variety of diseases. In this case, several people who ate the same infected food usually get sick at once.

Bacterial toxins are divided into:

• Endotoxins. They enter the bloodstream after the breakdown and death of bacteria. The patient notes elevated temperature bodies, headache, malaise and other symptoms of intoxication of the body.
• Exotoxins. These are substances, often of protein origin, that are secreted by living bacteria. Among the latter type, enterotoxins pose the greatest danger to humans. They affect the intestinal mucous membranes, causing inflammation and disrupting the water-salt balance.

Symptoms of infection vary from person to person. They depend on the amount of toxins “eaten”, immunity and the state of the digestive tract.

ICD code

By international classification toxicoinfectious diseases have ICD-10 code A05. Other bacterial food poisoning:

• A05.0. Staphylococcal food poisoning.
• A05.2. Food poisoning caused by clostridia.
• A05.3. Food poisoning caused by halophilic vibrio.
• A05.4. Food poisoning caused by Bacillus cereus.
• A05.8. Other specified bacterial food poisonings.
• A05.9. Bacterial food poisoning, unspecified.

All these diseases have a similar course and symptoms, although the etymology of the bacteria and toxins is diverse.

Main features

Among the main signs of pathology are:

• The latent period of infection is very short, since the toxin penetrates the bloodstream in a matter of hours or even minutes.
• Body temperature in most cases rises to 39 degrees. In some poisonings it increases slightly or remains within normal limits.
• Diarrhea and vomiting are observed, and they appear either simultaneously or separately. Vomiting is accompanied by nausea, but brings noticeable relief. Diarrhea is watery and profuse. The disease is characterized by cramping pain in the abdomen.

After these manifestations, dehydration often develops. The first symptom is dry mouth and thirst. As it worsens, blood pressure drops, the voice becomes hoarse, and convulsions occur.

Pathogens of infections

Toxic infections are caused by the following pathogens:

Opportunistic bacteria

Diseases are caused by strains of enterococci. They are representatives of normal intestinal microflora human body and warm-blooded representatives of the animal world, but they also act as sources of infection. They end up in huge quantities in external environment. Penetrating into food, bacteria actively multiply at room temperature.

The development of infection depends on many circumstances - the concentration of living microorganisms in food, the type of enterococcus, and the individual sensitivity of a person.

The causative agent can be various types of enterococci:

1. Staphylococcal enterotoxin, which causes staphylococcal toxic infections. You can become infected with them by consuming dairy products, cream, smoked meats, canned food in oil, made from the meat of infected animals or infected with diseases - mastitis, sore throat, purulent inflammations. The first sign of illness is nausea, and then:

• vomiting and retching begin;
• pain syndrome is localized in the epigastric zone;
• body temperature remains normal or subfebrile, but can jump to 40 degrees;
• sometimes there are convulsions.

Despite the acute clinical picture, the disease goes away within 2 days.

2. Escherichia endotoxin causes sudden illness within 4-6 hours after eating contaminated food. The patient suffers from nausea, abdominal pain, diarrhea without mucus and blood. Symptoms of intoxication are moderate.

3. Protea provoke toxic infections, which proceed in almost the same way as the previous one, but the pain is concentrated in the umbilical area, and the stool is smelly, in some cases there is an admixture of blood in it.

Spore anaerobes and aerobes

Clostridia, which are spore anaerobes, are part of the intestinal microflora healthy person. Foodborne illnesses are caused by bacteria types A and D. Infection occurs through consumption of meat products stored at room temperature and cold meat snacks. The cause of the disease can also be undercooked legumes - peas, beans, soybeans.

Aerobes Bacillus cereus found in undercooked rice, dry concentrates, powdered milk and egg powder. He is considered one of the dangerous pathogens, since it can withstand not only secondary heat treatment, but also sterilization of products. When a large concentration of toxins in food is reached, there is no change in them organoleptic properties- color, smell, taste, consistency, appearance.

Halophilic vibrio (parahaemolytic vibrio)

It's a pathogen acute diarrhea and enteritis. The main source is seafood dishes that are stored for a long time in a warm place or prepared in violation of technology. There is a chance of becoming infected by eating raw fish, shellfish or food that has been contaminated with sea ​​water. The patient complains of abdominal pain and diarrhea, which develops within 24 hours after infection.

Salmonella

The main sources of infection are animals, and less often humans. The latent period of the disease - salmonellosis - in animals can last for years. Human infection occurs through the food route - through consumption of animal meat, poultry and fish, dairy products, eggs, and water.

The infection develops within 6 hours. Its onset is usually acute - the temperature rises to 39 degrees, the patient complains of weakness, headache, cramping abdominal pain, nausea and vomiting. Foamy stool has a greenish tint and foul odor. There may be an admixture of mucus and blood. Complications of salmonellosis are peritonitis, reactive polyarthritis, and dehydration.

Shigella

They cause shigellosis, which affects the mucous membrane of the large intestine and is accompanied by intoxication, diarrhea with mucus and blood. The infection causes complications - rectal prolapse or intestinal bleeding.

The source of infection is a sick bacteria carrier or a person with acute or chronic form. The greatest danger is posed by sick people with erased or mild form acute dysentery, working in food processing plants or water supply. Infection occurs through the fecal-oral route. The surge in incidence occurs in the spring-summer season. Flies and cockroaches play an important role in the spread of infection.

Despite the large number of pathogens, salmonella most often causes toxic infections. Salmonellosis ranks first among food poisonings.

Diagnostics

To identify the pathogen, carry out laboratory tests vomit, feces and water after gastric lavage. If it is detected, which happens relatively rarely, they perform bacteriological culture, that is, they place the bacterium in favorable conditions for reproduction on a nutrient medium and study its toxic properties.

It is also necessary to identify the connection between the pathogen and the disease through specialized research, since sometimes the identified microorganisms are not the direct cause of toxic infection.

Urgent Care

As soon as a person feels unwell, an ambulance should be called. Bye medical workers on the way, there is no time to waste. Proper first aid is required:

• rinse the stomach;
• take enterosorbents that bind exogenous and endogenous toxins in the gastrointestinal tract in order to remove toxins from the intestines as soon as possible;
• do an enema.

At the same time, to avoid dehydration, the patient is prescribed drinking plenty of fluids- sweet tea, rehydration solutions. The amount of fluid lost through vomiting and diarrhea must be compensated.

Treatment

The main stages of treatment include the rapid removal of toxins from the body, as well as restoration of water-salt balance and fluid loss. In some cases, a specialist may prescribe antibiotics and intestinal antiseptics.

Reception medicines against diarrhea in case of toxic infections is usually not prescribed, as this contributes to the retention of toxins in digestive system, which can aggravate the course of the disease.

After vomiting and diarrhea stop, enzyme preparations are prescribed that speed up recovery digestive processes, and probiotics that normalize intestinal microflora.

In especially severe cases, hospitalization of the patient is required, where the necessary medical care will be provided.

Diet therapy for illness has at least important, how drug treatment. It is aimed at restoring the mucous membranes of the gastrointestinal tract and normalizing digestive processes.

So, you need to completely avoid spicy, sour and salty foods, and also follow these rules:

• at the beginning of the disease, food should be chemically and mechanically gentle;
• dishes should be warm, so you should not give the patient hot or cold food - it will greatly irritate the intestines;
• the consistency of the dishes should be homogeneous;
• protein foods should predominate in the diet;
• The amount of fat and carbohydrate intake should be minimal.

The patient is prepared with pureed cereal soups with minimal fat content, steamed omelettes, enveloping porridges made from barley, rice, buckwheat, oatmeal and semolina, mucous decoctions, steamed chopped fish low-fat varieties. Also recommended low-fat cottage cheese.

Prevention

There is no specific prevention aimed at combating toxic infections, since there are a large number of types of pathogens that cause it, and they are widespread in nature. However, in order to avoid becoming a victim of toxic infection, it is recommended:

• always wash your hands before eating, and if it is not possible, use wet wipes;
• properly store food and dishes;
• do not eat expired food;
• do not violate process cooking;
• refuse to buy ready-made salads in stores;
• buy confectionery with creams in trusted stores;
• purchase dairy products and meat products only in hermetically sealed, undamaged packages;
• Wash fruits and vegetables thoroughly.

Remember that raw eggs, milk, cottage cheese and sour cream bought secondhand can pose a health hazard.

Features of toxic infection in children

This disease is quite common in children, as they learn the world around us, feeling all the objects around, which are then pulled into the mouth. Therefore, the pathogen more often enters the body through oral cavity child.

Infections in children's body are much more severe than in adults, so signs of dehydration and intoxication are more pronounced. Children under 2 years of age must be hospitalized. Depending on the severity of the disease in older children, the doctor decides on outpatient or inpatient treatment. Symptoms of toxic infections are the same as in adults.

Food poisoning This is food poisoning, which can be caused not only by bacteria that produce toxins , but also toxins if they were contained in food. Once in the body along with the food consumed, the bacteria are “activated” producing substances harmful to the human body. It is not uncommon for several people to get sick at once if they consumed foods that initially contained bacteria and toxins.

It is precisely in the case that people ate the same food, and their health deteriorated significantly over time, we're talking about exactly about group disease of toxic infection. Since food poisoning is similar to other poisonings, the symptoms and treatment methods may be largely the same. In fact, the disease does not have any serious complications other than causing diarrhea, vomiting and dehydration. However, if you do not provide timely assistance to someone who is sick, the consequences can be very unpredictable.

Bacteria that cause toxic infection

Toxic infection can occur for several reasons, the main one of which is the entry into the body of bacteria that produce toxins. The most common pathogens of food poisoning are:

Staphylococcus aureus - a bacterium whose toxins affect the intestines. Considering that this is one of the most common bacteria, it can be contained in anything, while constantly being in the environment that surrounds us. Most often it is found in food products (this environment is the most acceptable for the bacterium). At the same time, food products, left in a room at room temperature will be an almost ideal environment in which staphylococcus is most predisposed to multiply.

Bacillus cereus - appears mainly in undercooked rice, and, like most bacteria, multiplies at room temperature. Is one of the most dangerous bacteria, since it does not destabilize even with repeated boiling.

Symptoms of food poisoning

Symptoms of foodborne illness may appear in different people absolutely different times. This is due to the fact that immune system Each person functions differently. Despite this, the period (the time during which bacteria and/or toxins interact with the body) is no more than sixteen hours.

The main symptoms of the disease are as follows: body temperature rises to 38-39 ° C (although not always), headaches may begin, the patient experiences severe weakness. Despite this, the most obvious signs of intestinal toxic infection will be diarrhea And vomit . Along with vomiting occurs strong feeling nausea, as a rule, after the patient vomits, he feels better. Diarrhea is very watery in consistency and can occur more than ten times a day, while the patient experiences pain in the navel area.

It is also worth noting such a symptom as dehydration . Dehydration occurs after vomiting and diarrhea. Clear signs dehydration - the appearance of dry mouth, sweat, limb cramps, increased heart rate, and the voice may become hoarse.

Dehydration due to food poisoning has several stages, which, in turn, develop as a result of vomiting or diarrhea. There are 4 stages of dehydration in total, but the third and fourth stages do not occur with toxic infection. Most often, the 3rd and 4th stages appear when cholera .

1st stage- the body loses from one to three percent of moisture relative to its mass. The skin and mucous membrane do not lose their moisture. At the same time, moisture in the body must be replenished. One or two glasses of water per hour is enough.

2nd stage- the body loses from four to six percent moisture. At the same time, the person experiences very extreme thirst. The mucous membranes of the nose and mouth will become dry. The voice may become hoarse and the limbs may experience cramps. The skin becomes less elastic. The required amount of moisture can be restored by taking water orally, but this is only valid if there are no cramps. If they appear, you should immediately call emergency medical help.

Treatment of food poisoning

Treatment of food poisoning is carried out as follows. It is necessary to lavage the stomach and replenish moisture in the body. However, after diarrhea and vomiting, replenishment requires not only moisture, but also , the amount of which in the body is noticeably reduced.

As for moisture, in stages 1 and 2 of dehydration you need to drink at least a liter of water within an hour. The amount of moisture replenished depends on the degree of dehydration. If dehydration is the first stage, the amount of moisture replenished should be 30-50 ml per kilogram of body weight.

If dehydration is stage 2, the amount of moisture consumed should be from 40 to 80 ml per kilogram of body weight. Consume moisture orally only in small sips. At the same time, if the patient is nauseous, water should be poured in using a tablespoon every few minutes. At the same time, it is possible that it will be possible to drink due to nausea. In this case, you should immediately seek medical help. Since dehydration during food poisoning can develop only up to two stages, if treated in time necessary help, and replenish moisture in the body, there should be no complications.

During a toxic infection of any nature, the patient must take sorbents , this will help remove toxins from the body. A number of sorbent preparations such as or are suitable for this. Absorbing drugs are usually taken three times a day. Treatment of food poisoning, as well as the prescription of drugs, should be carried out by doctors, otherwise there is a possibility of making the situation only worse.

If there is abdominal pain, you can take painkiller tablets 3 times a day (no more than a tablet at a time). It should be noted that during food poisoning, antibiotic drugs are contraindicated for use ( ), since the substances that they contain not only will not help, but can also aggravate the situation by interfering with the removal of toxins from the body.

Doctors

Medicines

Prevention of food poisoning

Prevention of food poisoning primarily consists in the fact that it is necessary wash your hands before eating. You should also monitor the quality of the food you eat. That is, pay attention to the condition of the products, their expiration date, while not leaving them for a long time in a warm environment without first covering them with anything.

When traveling to southern countries the necessary part is to see which diseases are most common. If among them there are those caused by poisoning and E. coli, it is not recommended to buy food instant cooking from vendors on the street.

Diet, nutrition for food poisoning

in case of food poisoning is a necessary measure. First of all, it is necessary to exclude the sick person from the diet. fatty foods, products with increased content fats and carbohydrates, as well as foods that can cause gas in the intestines (usually junk food all of the above properties are present).

You can eat cereals, boiled meat, soft-boiled eggs, crackers, low-fat cottage cheese, low-fat soups, boiled vegetables (if added to the soup). Recommended products are also rice, semolina, buckwheat porridge, cooked in water. Under no circumstances should you eat fried foods (fried potatoes, grilled chicken, cutlets, steak, fried eggs), flour food ( fresh bread, pasta, spaghetti, baked goods), legumes (beans, peas), sweets (sweets, cookies, chocolate, condensed milk). You will need to exclude coffee, carbonated water, and cold drinks. A diet for foodborne illness should be prescribed either by a doctor or nutritionist .

If the prevention of foodborne illnesses has been observed and the necessary measures, the likelihood of getting sick is reduced to almost zero. However, possible consequences failure to comply can be very dangerous. Sometimes they can be mistaken for ordinary poisoning. serious illness, the consequences of such an error may be irreversible, it is possible that they will even lead to death. Many diseases of the esophagus arise precisely because poor nutrition, or eating low-quality foods.

In this regard, it is strongly recommended to carefully select food products and check their expiration dates. Since the symptoms of foodborne illness are essentially similar to many of the symptoms of other gastrointestinal diseases, it is still recommended to seek medical help.

List of sources

• Child Zh.A. Food poisoning. - Minsk: Belarusian Science, 2004.
• Bacterial food poisoning.// Moscow M.D. Krylova. 2001
• Infectious diseases and epidemiology.//textbook for universities, publishing house GEOTAR.2000. Pokrovsky V.I., S.G. Pak, N.I. Brico, B.K. Danilkin.
• Yushchuk N.D., Brodov L.E. Acute intestinal infections: diagnosis and treatment. M.: Medicine, 2001
• MM. Nuraliev, Foodborne toxic infections and toxicoses of bacterial origin / Nuraliev M.M. - Uralsk: Zap. - Kazakhstan, CNTI, 2000.