Yersinia is a gram positive rod shaped bacteria belonging to the family Enterobacteriaceae that mostly causes enterocolitis, terminal iletis, acute diarrhea, mesenteric lymphadenitis, psediappendicitis and sepsis. Yersinia is a food borne bacteria that enters in the human body through unhygienic, canned and stale food. Pigs are the major animal reservoir of Yersinia but strains are also found in rodents, sheep, cattle, dogs, rabbits, cats and horses. The bacteria enter into the human beings through these animals.
Clinical signs for diagnosis of Yersinia infection include low grade fever, diarrhea, abdominal pain and vomiting. The patient sometimes also develops erythmanodosum which results in painful red or purple lesions on the patient’s legs. These lesions are visible after 2 to 20 days post the onset of fever and abdominal pain. Yersinia usually occurs in children and is second most common cause of bacterial gastrointestinal infection. Yersinia infections affect men three times more than women but post-infectious complications of arthritis and nodosum are more common in women.
Diagnostic tests which are performed to confirm Yersinia infection include:
- Stool culture: Most frequently used and reliable test to confirm the infection and it gives positive results within 2 weeks of onset of disease
- Enzyme-linked immunosorbant assays (ELISA)
- Tube agglutination
- Computed tomography (CT) scan
- Sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE)
- Joint aspiration in cases of arthropathy associated with Yersinia.
Other than these diagnostic measures, researchers have developed various new and innovative techniques which include:
- Polymerase chain reaction (PCR) methods that is sensitive, efficient and accurate for identifying Yersinia.
- Monoclonal antibodies that identify serogroup-specific protein epitopes of Yersina strains which are grown at specific temperature. These monoclonal antibodies do not react with Yersinia. This technique has great potential to be used as major serotypic diagnostic method in future.
For confirming the Yersinia infection in patient, doctors sometimes perform laboratory diagnosis after serological tests to support the associated syndromes due to following reasons:
- As this infection is caused by bacteria, this should not affect sterile fluids therefore the acquisition of culture from sources such as blood, peritoneal fluid, cerebrospinal fluid, synovial fluid or organ based biopsy (skin or intestinal tissue) is confirmatory.
- Histological examination of specific tissue such as mesenteric lymph node may result in both microbiologic and pathologic evidence of the organism.
For curing Yersinia infection, patient needs to take good care of their nutrition and hydration during the treatment. Treatment of the infection includes administration of cephalosporins, tetracyclines, trimethoprim-sulfamethoxasole (TMP-SMZ), Fluoroquinolones and aminoglycosides. If the condition worsens and patient is diagnosed with complications such as peritoneal findings, acute abdominal presentations or uncommon intussusceptions, gastroenterologists perform exploratory laparotomy. The Centers of Disease Control and Prevention (CDC) have taken the responsibility to monitor the frequency of Yersinia enterocolitica infection with the help of foodborne disease active surveillance network called FoodNet. In addition CDC also conducts awareness programs and investigations to control this infection.
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North America currently leads the Yersinia diagnostics market due to relatively high incidence rate of Yersinia infection and presence of sophisticated healthcare infrastructure coupled with initiatives undertaken by the domestic governments. The European market is for Yersinia diagnostics is mainly driven by the high prevalence of disease in Scandinavian countries. On the other hand, high presence of untapped opportunities in the emerging economies of Asia-Pacific and high prevalence of Yersinia infection in Japan are some of the key factors responsible for growth in Asia-Pacific. The major players in the Yersinia diagnostics market include Abbott Laboratories, Bio-Rad Laboratories, Becton Dickinson, Gen Probe, Danaher Corporation, Hologic Roche and Affymetrix, Inc.
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