Clostridia is a genus of anaerobic bacteria, some of which are part of the normal microflora of the gastrointestinal tract and female genital tract. Also, sometimes these microorganisms are found on the surface of the skin and in the oral cavity, but their main habitat is the intestines.

Clostridia stool test

In the stool of healthy adults, clostridia may be contained in quantities of no more than 105 CFU/g. Bacteriological research stool containing clostridia may be prescribed to patients with such clinical symptoms, How:

• diarrhea;
• pain in the abdominal area;
• nausea;
• increase in body temperature.

Bacteriological examination of feces for clostridia is performed in the process of analyzing fecal masses for dysbacteriosis, which makes it possible to determine which microorganisms and in what quantities inhabit the human intestines. The reliability of the results is largely determined by the correctness of the collection of material for the study.

The danger of clostridia

Most types of clostridia are not pathogenic and are involved in protein processing. As a result, toxic substances indole and skatole are released, which are not large quantities ah stimulate intestinal motility and facilitate the passage of feces. But with an increase in the number of clostridia in the gastrointestinal tract, the amount of these toxic substances increases, which can lead to the development of a pathology such as putrefactive dyspepsia.

Some types of clostridia are dangerous and cause serious illnesses which can be fatal:

• tetanus;
• botulism;

When and tetanus are affected nervous system And muscle. Gas gangrene is a complication of the wound process, in which the body is quickly poisoned by the decay products of the affected fabrics.

Clostridium perfringens, which is the causative agent of gas gangrene, can also cause intoxication of the body when consuming contaminated food. Clostridia produce toxins, which are the main factor in the development of poisoning.

Another disease that these microorganisms can lead to is antibiotic-associated diarrhea. This disease develops as a result of taking antibiotics, which suppress not only pathogenic, but also normal intestinal microflora. As a result, the number of clostridia (as well as other pathogenic bacteria) increases.

Clostridia (Clostridium) are spore-forming microorganisms that develop in the complete absence of oxygen, feed on dead organic matter and transform organic matter to inorganic.

Clostridia are widely distributed in soil and water. Some species are pathogenic and cause many other diseases such as tetanus, gas gangrene, several types of colitis, etc. If conditions for the development of clostridia are unfavorable, then it forms spores that can persist in the presence of oxygen, in the air, dust, surfaces of objects, on hands.

When ingested, clostridia can destroy tissue, which, if left untreated, can lead to severe complications and even to death.

Scientists have found that clostridia poisons have an effect on the human psyche: for example, it is assumed that there is a connection between clostridia and autism. This confirms the danger of clostridia. On a positive note is that healing from clostridia leads to the disappearance of mental symptoms.

Clostridium perfringens is responsible for food poisoning (diarrhea).

Clostridium difficile begins to actively develop in the intestines when the microflora is disturbed, especially often while taking antibiotics.

What to do if clostridia is found in stool?

Clostridium difficile may normally be present in the intestine. According to statistics, it is found in the microflora of 3% of healthy people and 20-40% of hospital patients. In a stool analysis, it should not normally exceed 105 CFU/g. However, if the “health” of the intestinal microflora is disrupted, which especially often happens when taking antibiotics, then clostridia begin to multiply intensively, releasing a potent poison (toxin), which leads at least to diarrhea, but can also cause more serious diseases.

If clostridia is found in stool in permissible quantities, and there are no other alarming symptoms (diarrhea, nausea, abdominal pain), then you should not resort to drug therapy. In this case, it is necessary to pay Special attention formation of healthy intestinal microflora.

Clostridium perfringens

These clostridia produce a toxin (poison). The toxin is very persistent and persists even at temperatures of 100 degrees Celsius. Clostridium perfringens causes severe poisoning (gastroenteritis).

How is Clostridium perfringens transmitted?

The infection is most often found in meat and poultry. Infection of people most often occurs due to non-compliance with the technology for preparing and storing large quantities of food.

Clostridia strains that contaminate meat may persist during primary processing. During repeated processing, their spores are formed. When flashing acute infection Up to 70% of people in contact with the infection may become ill.

Symptoms

Symptoms of food poisoning appear 12-24 hours after the contaminated food is eaten.

There are Clostridia perfringens types A and C.

When infected with Clostridium perfringens type A, moderate gastroenteritis develops with the following symptoms:

• stomach ache,
• watery diarrhea.

When infected with Clostridium perfringens type C, necrotizing enteritis with severe symptoms may develop:

• sharp pain in the abdomen,
• bloody diarrhea,
• nausea,
• peritonitis.

Diagnostics

The diagnosis is established by the results of an analysis of the culture of Clostridium perfringens in the stool.

Treatment

Type A disease is treated with antibiotics.

In case of development of necrotizing gastroenteritis, urgent surgical intervention is necessary.

Prevention

Prevention of the disease is compliance sanitary requirements when storing meat, especially in catering establishments.

Can Clostridium perfringens be cured?

In most cases, the disease is completely cured. It is important to start treatment as early as possible to prevent the development of necrosis.

Clostridium difficile

Gastrointestinal discomfort while taking antibiotics is common, but all symptoms disappear when you stop taking the drug. If these symptoms are caused by clostridia, then they not only do not stop when antibiotics are stopped, but may continue for several weeks after discontinuation or even appear only a few weeks after stopping the drug.

Clostridium difficile is spread through direct contact with an infected person, such as through hands or shared objects such as doorknobs, railings, or toilets. Hospital patients are especially susceptible to clostridial infections.

The main symptom is diarrhea. As a rule, it appears 4-9 days after starting antibiotics.

Studies have shown that in patients who stay in a medical hospital for 1-2 weeks, the infection rate is 13%. If patients are in the clinic for more than 4 weeks, then Clostridium difficile is detected in 50% of the people examined.

Recently, this problem has become especially acute, since the incidence of this pathology has increased several times with an increase in mortality from it. In 2009, the European Society of Clinical Microbiologists and Infectious Diseases published its recommendations for treatment, severity and effectiveness of treatment for this infection.

Why is Clostridium difficile dangerous?

Clostridium difficile is an obligate anaerobe and is a gram-positive, spore-forming bacillus with a fecal-oral route of transmission.

This bacillus produces two cytotoxins: A and B.

Toxin A weakens the connection between colon epithelial cells, which allows toxin B to penetrate between them and trigger a whole series of inflammatory reactions, including the production of destructive agents and leading to severe tissue damage.

Only in 1978 was it established that Clostridium difficile leads to the development of pseudomembranous colitis that occurs when taking antibiotics.

When taking antibiotics, the intestinal microflora is disrupted. Clostridium difficile spores are acid resistant. Once in the stomach, they penetrate the intestines, where the disturbed microflora does not suppress them. They turn into a vegetative form and begin to produce toxins.

Microbiologists have described a new strain of Clostridium difficile, which produces 16-23 times more A and B toxins compared to previous strains. When infected with this strain, more severe types diseases.

Symptoms of diarrhea and colitis caused by Clostridium difficile

Symptoms usually appear 5-10 days after the start of antibiotic treatment, although there are cases of symptoms appearing on the 2nd day of therapy. But it is possible for symptoms to appear 10 weeks after stopping antibiotics.

Typical symptoms of diarrhea and colitis resulting from exposure to Clostridium difficile include:

• profuse offensive diarrhea
• mucus in stool
• cramping abdominal pain
• tenesmus (false contractions)
• occult blood in stool test (sometimes blood in stool)
• leukocytes in feces.

The abdomen is soft but painful when palpated in the area colon.

The disease is characterized by such general symptoms as:

• nausea
• vomit
• dehydration
• moderate fever.

Colitis, limited right half colon, manifested by local abdominal pain, leukocytosis, fever with moderate or mild diarrhea.

The most severe variant of the development of the disease is toxic megacolon. This condition can occur against the background of a decrease in stool, which is sometimes regarded as a positive dynamics of treatment.

However, symptoms such as gas retention, colon bloating, high leukocytosis, decreased circulating blood volume, fluid accumulation in abdominal cavity are typical manifestations this condition.

Treatment of toxic megacolon should be surgical.

The severity of the disease depends on the Clostridium difficile strain and the patient's immune status.

Asymptomatic carriage of Clostridium difficile is quite common.

Mild diarrhea caused by Clostridium difficile

A mild form of diarrhea is characterized by the following symptoms:

• moderate abdominal pain
• diarrhea 4 times a day
• absence common symptoms(nausea, vomiting, fever).

This type of diarrhea caused by Clostridium difficile does not require medication. It is necessary to discontinue antibiotics and prescribe drugs that restore intestinal microflora.

Colitis due to Clostridium difficile

A more severe form is colitis caused by Clostridium difficile. Colitis can occur in the form of colitis without pseudomembranes and in the form of pseudomembranous colitis.

Colitis without pseudomembranes occurs with all systemic signs of this disease: with fever, dehydration, abdominal pain, vomiting, loose, watery stools up to 20 times a day, but without abnormalities in the tests.

Pseudomembranous enterocolitis causes the same symptoms, but colonoscopy reveals pseudomembranes and can be confirmed by laboratory abnormalities.

Severity of diseases caused by Clostridium difficile

For ease of perception, they are summarized in a table.

Severity	Symptoms
Mild course	diarrhea up to 5-7 times a day moderate abdominal pain no fever absence of leukocytosis
Moderate to severe	diarrhea 10-15 times a day abdominal pain temperature moderate dehydration moderate leukocytosis
Severe course	hectic fever > 38.5 C severe intoxication circulatory disorders signs of peritonitis signs intestinal obstruction leukocytosis with a shift to the left presence of pseudomembranes signs of toxic megacolon signs of ascites severe dehydration electrolyte disturbance

Patients with moderate and severe forms of AAD (antibiotic-associated diarrhea) are subject to mandatory hospitalization.

Treatment of Clostridium difficile

In a significant number of patients, diarrhea caused by Clostridium difficile occurs in mild form. It goes away on its own after stopping antibiotics and does not require special treatment. Sometimes, in case of dehydration, it is necessary to replace fluids and salts (electrolytes).
To replenish fluids and salts it is recommended drinking plenty of fluids not carbonated mineral water, unsweetened herbal infusions or special pharmaceutical solutions.

In cases where the disease occurs with clear signs colitis, there is a need for antibacterial therapy, active against Clostridium difficile.

Criteria for assessing the effectiveness of antibacterial therapy have been determined:

• decrease in stool frequency,
• improving stool consistency,
• improvement of the patient's general condition,
• positive dynamics of clinical and laboratory parameters,
• no new signs of disease progression.

If these criteria are not met, then adjustment of the drug is necessary.

Surgical treatment of colitis caused by Clostridium difficile

Indications for surgical treatment of pseudomembranous colitis are as follows:

• perforation of the colon,
• progression systemic inflammation with the development of toxic megacolon and intestinal obstruction with adequate antibacterial therapy.

Prevention

1. Because the main reason development of Clostridium difficile are antibiotics, then main recommendation is rational use antibacterial drugs.
2. Compliance with sanitary and hygienic standards.
3. Isolation of a patient with diarrhea.
4. Quick diagnosis.
5. Washing hands with soap to remove spores from the surface of the skin.
6. Cleaning your hands with alcohol is useless because it does not remove spores.

Can Clostridium difficile be cured?

The prognosis depends on the severity of diarrhea or colitis caused by Clostridium difficile, the nature of the course, and the presence of complications.

In mild to moderate cases, the disease is completely cured. Fever goes away after 1-2 days, and diarrhea stops after 5-7 days.

IN Lately a new one has appeared effective method treating even severe cases of the disease with.

Unfavorable factors are pseudomembranous colitis, renal failure.

Clostridiosis – this is acute, anthroponotic, anaerobic infection with enteral infection, characterized by varying degrees severity of clinical manifestations.
The main reason for the development severe forms diseases withClostridium difficile is antibiotic therapy. Is the reason for the so-calledAntibiotic-associated diarrhea.
Moreover, studies show that even a single dose of antibiotic wide range action, regardless of the dose and route of administration, can lead to the developmentDiarrhea And Pseudomembranous colitis, conditional Clostridium difficile.
20% of complications of clostridiosis are antibiotic-associated diarrhea, and 90-100% are pseudomembranous colitis.

Poisoning with toxin Clostridiumperfringens also occurs after eating foods contaminated with clostridia.It is characterized by a severe course and high mortality.

Etiology.
PathogenClostridium difficile – strictly anaerobic, spore-forming, gram-positive bacillus.
Controversy Clostridium difficile highly resistant to environmental factors and standard disinfectants, and vegetative forms are resistant to most antibiotics.
MicrobesClostridium perfringens - These are large gram-positive rods. They grow in anaerobic conditions and are capable of forming spores.

Epidemiology .
Clostridium difficile often found in environment and can be isolated from soil.
The main mechanism of infection transmission is fecal-oral.
The source of infection is a person (more often - patients receiving broad-spectrum antibiotics, as well as children).
TO healthy persons the infection can be transmitted through hands and care items, as well as through bed dress, furniture, showers, toilets, etc.
The risk group also includes children early age(weakened), as well as patients who have been in hospital for a long time and, especially, receiving antibiotics.

Clostridium perfringens widely distributed in the soil, in the excrement of people and animals. All this creates opportunities for food contamination. Poisoning occurs more often when consuming meat products homemade, meat and canned fish. In some countries, toxin poisoning C.L. perfringens are registered quite often, occupying 3rd place after salmonella gastroenteritis and staphylococcal food poisoning.

Pathogenesis and pathomorphology.
Under the influence of antibiotics and other damaging factors, the normal intestinal microflora is disrupted and the anaerobic intestinal microflora is reduced. This creates favorable conditions for reproductionClostridium difficile and its transition to a toxin-forming form.

Vegetative forms Clostridium difficile produce exotoxins, of which enterotoxin (toxin A) and cytotoxin (toxin B) damage the intestinal wall.
Toxin A, by stimulating guanylate cyclase, increases fluid secretion into the intestinal lumen and promotes the development of diarrhea.
Toxin B has a pronounced cytopathogenic effect, acting on cell membranes intestines.
This leads to potassium loss and the development of electrolyte disturbances.
And the pathogen itself does not have invasive properties and does not have a cytotoxic effect on the intestinal mucosa.

In case of poisoning by toxins producedCLostridium perfringens, in the pathogenesis of human disease highest value has alpha toxin and beta toxin.
In the intestines, toxins damage the mucous membrane, entering the blood, penetrating into various organs, binding to the mitochondria of liver, kidney, spleen, and lung cells. They also damage vascular wall, which is accompanied by hemorrhagic phenomena. Sometimes the pathogen itself penetrates into the blood, and not just toxins; in these cases severe Anaerobic sepsis.

Clinical symptoms and course of Clostridium difficile.
Clostridiosis with Clostridium difficile may take the form of:

• Asymptomatic bacterial carriage,
• Easy
• Severe forms of the disease in the form Pseudomembranous colitis.

Antibiotic-associated diarrhea in childrenbecause of Clostridium difficile often characterized by clinical symptoms of mild colitis or enterocolitis.
Usually occurs without fever and intoxication.
In this case, abdominal pain may appear, but more often the pain is detected only by palpation of the intestines. There is a slight or moderate increase in stool frequency, which, as a rule, does not lead to pronounced water and electrolyte disturbances.

Symptoms Pseudomembranous colitis in children usually develop acutely and are characterized by lack of appetite, fever, intoxication, diarrhea, belching, bloating and cramping abdominal pain (abdominal colic). Palpation of the abdomen along the large intestine is painful.
Stools are frequent, with an admixture of mucus and blood in the stool (less frequently). Sometimes most of the stool is represented by thick whitish mucus and fragments of fibrinous deposits.
With repeated diarrhea, exicosis with circulatory disorders develops; collapse without previous diarrhea is much less common.
The course of pseudomembranous colitis can be complicated by intestinal bleeding, perforation and the development of peritonitis.
Therefore, in severe forms of clostridiosis, joint observation by a pediatrician and a surgeon should be carried out.

There are recurrent (repeating) forms of clostridiosis with the development of colitis with incomplete cure of clostridiosis and reinfection.
Clostridiosis can develop 1–2 weeks after discontinuation of antibacterial therapy.

Clinical Symptoms and Course of CLostridium perfringens.
The disease begins with abdominal pain, mainly in the umbilical region.
Growing rapidly general weakness, stool becomes copious, watery, sometimes takes the form of rice water, becomes more frequent up to 20 times a day, and there is profuse vomiting.
Severe dehydration begins (convulsions, characteristic face, wrinkled skin of the hands, non-retractable skin folds, cyanosis, aphonia, dry mucous membranes, etc.).
In case of poisoning caused by toxins of clostridia types E and F, it may developNecrotic enteritis (severe abdominal pain, nausea, vomiting, loose stool mixed with blood). The disease is very difficult. In addition to dehydration and hypovolemic shock, acute renal failure and infectious-toxic shock may develop.

Diagnostics .

First of all, it is necessary to carry out Bacteriological examination of stool.
For this purpose, the method of enzyme-linked immunosorbent assay (ELISA) and a cytotoxic test on cell cultures using specific antisera are used.
But the “gold standard” of laboratory diagnosticsCl. difficile – infection is a cytotoxic test aimed at detecting toxin B.

During endoscopic examination of the large intestine with the development of the most severe form of the disease (pseudomembranous colitis) against the background of pronounced inflammatory-hemorrhagic changes in the intestinal mucosa, small (usually up to 2-5 mm, less often up to 20 mm or more in diameter) raised yellowish plaques are found.
Plaques are formed by the accumulation of fibrin, mucin and cells involved in inflammation. Merging, plaques form pseudomembranes. Films may be torn away, exposing an ulcerated surface. intestinal wall.

Blood test results: neutrophilic leukocytosis, shift leukocyte formula to the left, ESR acceleration.

If you suspect food poisoning caused by toxins C. L. perfringens. , take suspicious products and material from patients (vomit or washing water, blood, feces).
The diagnosis is also made taking into account the medical history, epidemiological factors, and clinical manifestations.

TREATMENT OF CLOSTRIDIOSIS.

• For asymptomatic bacterial carriage Cl. difficile is not treated.
  In manifest forms Cl. difficile need to cancel urgently Antibiotic!!

• Purpose Etiotropic therapy necessary when:
  - in severe forms of the disease;
  -- continuing diarrhea after stopping the antibiotic;
  -- with relapse of diarrhea due to repeated use of antibiotics.
• Drugs of choice for etiotropic therapy for clostridiosis:
  -- 1st line drug -- Metronidazole:
  Daily dose– 30 mg/kg, the dose is divided into 3-4 doses per day, orally or intravenously. The course of treatment is 7-10 days.
  --2nd line drug -- Vancomycin (at Cl. difficile) :
  Daily dose – 40 mg/kg (but not more than 2 g per day), divided into 4 doses per day, orally. The course of treatment is 7-10 days.
• In case of poisoning C.L. perfringens To remove toxins from the body, gastric lavage with water or 5% solutionsodium bicarbonate.
• In case of poisoning C.L. perfringens broad-spectrum antibiotics are prescribed (Tetracycline, chloramphenicol, erythromycin).
• Enterosorbents are prescribed only in mild cases and when intravenous administration metronidazole.
  When administering etiotropic drugs orally, enterosorbents (cholestyramine, Activated carbon etc.), since a decrease is possible therapeutic effect antibiotics due to their binding to enterosorbents in the intestinal lumen.
• Drugs that reduce intestinal motility are contraindicated.
• After cancellation antimicrobials for complete sanitation of the intestines from pathogen spores are prescribed Probiotics.

When looking at the blanket sheet for dysbacteriosis tests, you will notice a long list of microflora. People who do not understand medicine can make erroneous conclusions and assumptions.

It should be noted that the form of the test sheet may vary depending on the medical institution. They can go first beneficial bacteria, then opportunistic and pathogenic. Or in a different order. We provide several different analysis forms so that you are aware of this and do not be alarmed if the form of the results differs from yours! Therefore, just find the line on your sheet of results and compare the value with the norm, which is shown here in the photo.

1. BIFIDOBACTERIA. Representatives of bifidobacteria can rightfully be considered beneficial inhabitants of the microflora. The optimal percentage of their number should not fall below 95, but it is better to be all 99%:

• Bifidobacterium microorganisms are involved in the breakdown, digestion and absorption of food elements. They are responsible for the absorption of vitamins,
• due to the activity of bifidobacteria, the intestines receive the proper amount of iron and calcium;
• bifidobacteria also play a significant role in stimulating parts of the intestine, especially its walls (responsible for eliminating toxins).
• Digestion, absorption, assimilation of all useful elements food
• We can talk for a long time about the benefits of bifidobacteria, but these are the most beneficial bacteria in our intestines, the more of them, the better!

Quantitative indicator of bifidobacteria in the test form - from 10*7 degree to 10*9 degree. A decrease in numbers clearly shows the presence of a problem, in our case, dysbiosis.

1. LACTOBACTERIA. The second place among the inhabitants of the intestines is occupied by lactobacilli. Their percentage in the body is 5%. Lactobacilli are also positive group microflora. Composition: lactobacilli, fermented milk molecules, representatives of streptococci. Based on the name, you can understand that lactobacilli (fermented milk viruses) are responsible for the production of lactic acid. It, in turn, normalizes the functioning of the intestines. Lacto bacteria help the body avoid allergenic attacks. Microorganisms stimulate the function of getting rid of toxins.

Blanket analysis assumes a strict number of lactobacteria - from 10*6 degrees to 10*7 degrees. With a decrease in these microorganisms, the body will undergo a reaction from allergens, constipation will become more frequent, and lactose deficiency will occur.

• it does not allow opportunistic microorganisms to proliferate in your intestines and fights them day and night;
• E. coli absorbs oxygen, thereby saving bifidobacteria and lactobacilli from death.
• with its direct participation, the production of B vitamins and the absorption of iron and calcium occur!
• if there is a decrease in E. coli below or above the norm (i.e. below 10 to the 7th degree and more than 10 to the 8th degree) - this may indicate the presence in the intestines, firstly, of dysbacteriosis, and secondly, the presence of worms . Normal - 107-108 CFU/g

E. coli LACTOSE NEGATIVE - opportunistic bacteria. Their norm is 10 to the 4th power. An increase in this value leads to an imbalance of intestinal flora. In particular, these are constipation, heartburn, belching, there is pressure and bursting in the stomach. Prominent representatives of these bacteria are PROTEI and KLEBSIELLA.

PROTEUS - facultative anaerobe, rod-shaped, non-spore-forming, motile, gram-negative bacterium. Bright representative opportunistic bacteria.

Opportunistic - means that their quantity within the normal range does not cause disturbances in the intestines. As soon as the norm is exceeded and these bacteria multiply, they become pathogenic, harmful, and dysbacteriosis occurs.

KLEBSIELLA is an opportunistic microorganism that is a member of the Enterobacteriaceae family. It got its name from the name of the German scientist, bacteriologist and pathologist who discovered it - Edwin Klebs.

E. coli HEMOLYTIC - Escherichia coli is present in parts of the large intestine; it is a competitor of bifidobacteria and lactobacilli. The norm is 0 (zero). Its presence in the intestines clearly indicates a violation of the microflora. Helps with skin problems and allergic reactions. In general, having this wand will not bring you anything good.

1. BACTEROIDS. Separate test results may include a list of bacteroids. It is a mistake to attribute them to harmful bacteria. In fact, everything is quite simple - their quantitative indicator is not related to the performance of the body. In newborns, they are practically absent, then gradually populate the intestines. Their role in the body has not been fully studied, but without them normal digestion is impossible.
2. ENTEROCOCCI — It is these microorganisms that are present even in a healthy intestine. When the body operates optimally, the percentage of enterococci does not exceed 25% (10 7).

   Otherwise, we can state a violation of the microflora. At the same time, they are causative agents of genitourinary infections. It is believed that not exceeding their values ​​relative to the norm - good indicator and don't worry.

3. PATHOGENIC MICROBES OF THE INESTINAL FAMILY(Pathogenic Enterobacteriaceae) are exclusively harmful bacteria. Here and Salmonella(lat. Salmonella), And Shigella(lat. Shigella). They are causative agents of infectious diseases salmonellosis, dysentery, typhoid fever and others. The norm is the absence of these microbes at all. If they are present, then there may be a sluggish or manifest infectious infection. It is these microbes that are often first on the list of dysbacteriosis test results.
4. Non-fermenting bacteria - regulators of everything digestive process. Food fibers are fermented and prepared for absorption useful substances(acids, proteins, amino acids, etc.) The absence of these bacteria indicates that your intestines have room for improvement. Food is not fully digested. He recommends eating sprouted wheat and bran.
5. EPIDERMAL (SAPROPHYTIC) STAPHYLOCOCCUS– also refers to representatives of the opportunistic environment. But by analogy with enterococci, these microorganisms can calmly coexist in healthy body. Their optimal percentage point is 25% or 10 to the 4th power.
6. CLOSTRIDIIA ( Clostridium)— bacteria that are also present in small quantities in our intestines. With their help, processes associated with the formation of alcohols and acids occur. themselves are harmless, they can only complement the pathogenic flora when it grows above normal.
7. Staphylococcus aureus These bacteria are nothing more than environmental microbes. For example, they can be found on the skin or mucous membranes of our body. Even the smallest part of staphylococci can lead to exacerbations in the intestines. It is not surprising that medicine has long developed a standard: there should be no staphylococci in the test form. Even a small amount of them can cause diarrhea, vomiting, and abdominal pain.
   
   
   

   Important feature intestines is that Staphylococcus aureus will never appear on their own. They depend entirely on the number of positive microorganisms and representatives of bifidobacteria. Beneficial microflora(bifidobacteria and lactobacilli) is able to suppress aggression from staphylococcus. But if it does enter the intestines, the body will undergo allergic reactions, purulence and itching of the skin. A person may have serious problems with gastrointestinal tract. In this case, it is better to consult a doctor immediately.

8. YEAST-LIKE MUSHROOMS CANDIDA (Candida) Fungi Candida albicans

   Candida fungi - live in the human intestines, in quantities less than 10 to the 4th degree. The number may increase if the patient is actively taking antibiotics. An increase in fungi with a general decrease in normal microflora leads to the development of thrush, usually in women, or stomatitis (in children). The disease affects the mucous membranes of the human body: mouth and genitourinary system. Candidiasis is the general name for diseases associated with the active growth and activity of these fungi (thrush, stomatitis, etc.).

   There are cases when tests do not reveal a decrease in microflora, but an increase in fungal microorganisms is observed. This practice indicates that the concentration of fungi does not appear inside the body, but in external environment. First of all, we are talking about skin, for example, near anus(anus). Treatment is prescribed, during which problem areas of the skin are treated with anti-fungal ointment.

Other microorganisms are analyzed only in extremely rare cases. The most prominent pathogen of this group is considered to be Pseudomonas aerugenosa.

Sometimes in the analysis form you can find an interesting term: abs. But it doesn’t mean anything terrible. With this writing medical workers note the absence of any microflora element. Also in the analysis form you can find the phrase “not detected”, which is understandable to all of us.

As practice shows, diagnostics consists of deciphering information from 15 to 20 types of bacteria. This is not so much, considering that our body consists of 400 types of microbes. Human feces submitted for analysis are carefully examined for the presence of bifidobacteria and pathogens of various diseases (staphylococci, proteas, etc.).

Dysbacteriosis is a decrease quantitative indicator bifidobacteria and a simultaneous increase pathogenic microorganisms intestines.

Norms of intestinal microflora

Example 1 - The composition of the intestinal microflora is normal

• Normal microflora:
• Escherichia coli - 10 to 6 degrees (10*6) or 10 to 7 degrees (10*7)
• Spore anaerobes - 10*3 and 10*5
• Lactobacilli - 10 to 6 degrees and higher
• Bifidobacteria - 10 to 7 degrees and higher

• Pathogenic and conditionally pathogenic microflora:

Example 2 - The composition of the intestinal microflora is normal


Example 3 - Composition of normal intestinal microflora in children

Analysis of stool for dysbacteriosis. How to do all this?

1. The first thing to remember is the incompatibility of antibiotics with stool sampling for culture. It is recommended to wait at least 12 hours after completing the course of medication, and only then prepare tests. Stool collection is carried out naturally, without additional stimulation of the intestines. You should not give enemas or use barium - the material for research will be unsuitable. Before collecting stool for analysis, you must empty your bladder. Defecation should occur naturally, preferably not into the toilet, but into a vessel or potty. Urine should not get into the stool. The faeces collection area is being treated disinfectants and washed with boiled water.

1. The hospital usually gives you a resealable container with a spoon. You need to place material in it to diagnose dysbacteriosis. After you collect the stool in a container, you must immediately deliver it to the laboratory. The maximum time allowed for this is 3 hours. If you don’t have time, then place the container with stool in a cold environment (but not in the refrigerator).

1. Mandatory conditions for collecting and storing feces for analysis:

• It is prohibited to store tests for more than 5 hours;
• the container must be tightly closed;
• defecation should be carried out on the day of the stool examination, and not the day before.

If the conditions are not met, you may encounter distorted data laboratory research. In this case, the picture of the disease will be incomplete, and the doctor’s assumptions will not be confirmed. You will have to submit feces for culture a second time.

Video “Examination of stool for dysbacteriosis”

Analysis for dysbacteriosis: negative aspects

If you turn to the medical literature, you can find polar opinions on the analysis of dysbacteriosis. And in order to have an idea not only of the advantages, but also of the disadvantages of this method, let us consider negative sides. In any case, the doctor is responsible for your treatment, and it is he who decides how to take tests.

Disadvantages of testing for dysbacteriosis:

1. ambiguity in the interpretation of the result– complex accounting of bacteria found in tests of a sick and healthy person, cases of insufficient confirmation of dysbacteriosis, evaluation of tests;
2. When diagnosing, there is no accounting for bacteroids and obligate anaerobes– microorganisms are the main core of the intestinal flora, and feces only copy the state of the intestinal wall, and do not always give a complete picture of the disease or its absence;
3. despite the fact that pathogenic bacteria highlighted in special group, ordinary microflora can also cause a painful situation (oversaturation of bacteria or lack thereof);
4. records are kept from the microflora of the large intestine, and microorganisms small intestine are not analyzed - it is the latter bacteria that determine one or another defect of the gastrointestinal tract.

Negative aspects, by the way, mentioned by the doctors themselves, show the ambiguity in the interpretation of the analysis for dysbacteriosis. The contradictions concern, first of all, high cost research. To the number unfavorable factors also include the likelihood of erroneous analyses. But professional doctors They can easily distinguish low-quality material from reliable information. After receiving a microbiological diagnosis, the specialist deals with clinical content. His competence consists of prescribing a course of treatment for the patient.

In conclusion, I would like to note one more important nuance: dysbiosis is a phenomenon based on intestinal problems. Secondly and thirdly, it concerns the microflora itself. Therefore, the courses of antibiotics and live bacteria that are praised these days cannot always correct the situation. It is not the intestinal microflora that should be treated, but the intestine itself. The basis will be numerous symptoms of the disease. Ultimately, by eliminating the troubles of the intestinal environment, it is possible to achieve normalization of the microflora.

When clostridia enter the human body, a disease called clostridiosis develops. According to the mechanism of occurrence, this disease can be classified into enteral and traumatic. Among the first are botulism, clostridium perfringens and difficile. Types of traumatic clostridiosis include tetanus and gas gangrene. Our article will consider two types of enteral clostridia, when clostridia can be detected in feces, namely perfringens and difficile.

What is clostridia?

Before we describe what clostridia is, it is worth talking about the diseases we describe. Thus, clostridiosis difficile is acute infectious disease with enteral route of infection. It is provoked by antibiotic-induced strains of this infection. The disease manifests itself as infectious toxicosis and diarrhea, followed by the development of pseudomembranous colitis.

Clostridiosis perfringens is also an infectious disease with enteral infection, in which a syndrome of enterocolitis, gastroenteritis, sepsis, necrotic enteritis and infectious toxicosis is observed.

The genus Clostridia includes more than 100 species of anaerobic bacteria, which are divided into 5 groups. Most of them do not pose a threat to humans and are normally part of the intestinal microflora or live in the soil and reproduce in the plant root system.

Important! Only clostridia from the second and fourth groups can cause illness in humans. They cause enteric clostridiosis, gas gangrene and tetanus. These microorganisms can produce exotoxins that are dangerous to humans.

Clostridia perfringens are polymorphic short rods without flagella. These strict anaerobes are divided into six subspecies based on their ability to produce enzymes and exotoxins.

Causes of clostridiosis

The natural habitat for many clostridia is the intestines of animals and humans. From there, gastrointestinal bacteria with feces fall into the soil where they can long time remain in the form of a dispute.

Important! Most often, Clostridia perfringens of variety “A” is found in the coprogram of children, less often these are representatives of the “C” and “F” groups.

If clostridia are found in the feces of a child after antibiotic therapy, then these are difficile bacteria. This is especially often observed after the use of broad-spectrum antibiotics: ampicillin, cephamizine, clindamycin and lincomycin. These antibiotics suppress the natural flora of the gastrointestinal tract, which is why pathogenic bacteria can actively multiply in the intestines and produce toxins.

Infection with Clostridia perfringens occurs by eating contaminated foods. Once in the intestines, bacteria begin to multiply and provoke inflammatory process. Even if clostridium causes mild inflammation, the bacterium penetrates the intestinal epithelium into the blood and nearby tissues. This contributes to the development of a severe septic form of the disease (but not necessarily).

The causes of diarrhea, toxicosis, structural and functional changes in organs are associated with the production of exotoxins by clostridia. Most often in adults and children structural changes diagnosed in the small and large intestine.

Symptoms of clostridiosis

Depending on how much clostridia enters the body, incubation period the disease lasts 6-24 hours. The disease begins acutely with the appearance of the following symptoms:

• vomit;
• symptoms of general intoxication (decreased appetite, lethargy, anxiety, refusal to eat);
• gastrointestinal dysfunction;
• temperature increase.

In adults, clostridiosis perfringens causes frequent stool liquid consistency (enterocolitis or enteritis). If we talk about how long such symptoms persist, then in the mature population the disease is very mild and ends with recovery on the 4th day.

In children, the intestinal form of clostridiosis perfringens can be much more severe. It usually develops as enteritis or necrotizing colitis. Most often, this course of the disease is observed in the following groups:

1. In children who were treated with broad-spectrum antibiotics;
2. In weakened children with prolonged gastrointestinal dysfunction;
3. With long-term dysbacteriosis.

The first symptoms of the disease are very similar to acute gastroenteritis:

• vomiting blood;
• abdominal pain;
• foamy, watery and profuse stools (up to 20 times a day);
• feces mixed with mucus and blood;
• weakness and weakness;
• dizziness.

As symptoms progress further, the child begins to become dehydrated and loses arterial pressure, the spleen and liver enlarge, intestinal paresis occurs.

Attention! In the absence of treatment and progression of the disease, it is possible death due to disruption of activity of cardio-vascular system. Infants and weakened children may develop sepsis.

As for the intestinal form of clostridiosis difficile, its symptoms are usually similar to pseudomembranous colitis. Less commonly, they resemble diarrhea syndrome or necrotizing enterocolitis. Symptoms of pseudomembranous colitis are as follows:

• the skin acquires a pale gray tint;
• a venous network is visible on the abdomen;
• loose, watery stool mixed with blood and mucus;
• sometimes there is purulent stool mixed with blood;
• intestinal bleeding can cause death.

Treatment and diagnosis of clostridiosis

To make a diagnosis, it is important to take into account epidemiological data and the results of clinical and laboratory studies. Since these symptoms can also occur in other diseases, laboratory diagnostics are performed:

1. Express methods such as ELISA and RNGA are used. Using these methods, enterotoxins can be detected in the stool of infants and adults, and enterotoxigenicity can be assessed in isolated bacterial strains.
2. In the CBC there is a rod-nuclear shift and moderate leukocytosis.
3. To diagnose clostridiosis difficile, it is important to obtain a history of treatment with broad-spectrum antibiotics.

Treatment of intestinal forms of clostridiosis perfringens is the same as for other intestinal diseases. bacterial infections. Typically, etiotropic therapy is prescribed taking into account the sensitivity of the isolated bacterial strains to antibiotics. Experts recommend treating this form of the disease with azithromycin, 3rd generation cephalosporins or amoxiclav.

As a rule, it is carried out complex treatment clostridia. It is recommended to take drugs to normalize the intestinal microflora and bacterial drugs, for example, Bifidumbacterin or Bifokol. The latter remedies will prevent colonization of the intestines by pathogenic clostridia.

Important! In especially severe cases (provided that the type of causative agent of the disease has been established), administration of antitoxic serum enterally or intramuscularly is indicated.

To treat the intestinal form of clostridiosis difficile, the following therapy is carried out:

• parenteral administration of metronidazole, cephalosporins or aminoglycosides;
• treatment with Vancomycin and its analogues (for severe and moderate forms, indicated course treatment for 5-7 days, the dosage of the drug depends on age);
• after antibiotic therapy, bacterial drugs are prescribed (Linex, Lactobacterin, Bifidumbacterin, etc.);
• Enzyme enzymes may also be prescribed during treatment medicines(Festal, Creon, Mezim, etc.);
• B vitamins must be prescribed;
• pathogenetic and symptomatic therapy is carried out;
• if indicated, it is performed infusion therapy(this will help detoxify, normalize water balance and provide parenteral nutrition);
• sometimes antihistamines are prescribed;
• for the treatment of particularly severe forms, antitoxic serums and corticosteroids are prescribed.

Which doctors should you contact if you have clostridial infections?

If you suspect clostridiosis and have corresponding symptoms, you should contact a gastroenterologist or infectious disease specialist. If you are very sick Small child, then they call an ambulance, because at this age dehydration occurs very quickly, which can lead to death.

If you don’t know exactly which doctor to go to, you can contact a therapist or pediatrician, and he, in turn, will refer you to a highly specialized specialist. In any case, with pronounced symptoms and in serious condition You need to urgently go to the hospital of a medical institution.