What is Clostridiosis in Children?
Clostridiosis is an acute infectious disease in humans and animals that is caused by clostridia.
Clostridiosis is classified according to the mechanism of occurrence into traumatic and enteric. Enteral include: clostridiosis difficile, clostridiosis perfringens, botulism. Traumatic include gas gangrene and tetanus. Clostridiosis difficile and Clostridiosis perfringens will be considered below.
Clostridiosis perfringens is an acute disease of an infectious nature with an enteric route of infection, which is manifested by gastroenteritis or enterocolitis syndrome and infectious toxicosis, and in more rare cases, necrotic enteritis or sepsis.
Clostridiosis difficile is an acute disease of an infectious nature (also an enteric route of infection), which is caused by antibiotic-induced strains of clostridia difficile and is manifested by diarrhea syndrome with the development of pseudomembranous colitis and infectious toxicosis.
Causes of Clostridiosis in Children
The clostridium genus unites strains of anaerobes of more than 100 species, they are divided into 5 groups. Most of them do not cause disease in humans, they are gastrointestinal saprophytes or “live” in the ground, and reproduction occurs in the root system of plants.
A person can become infected only with some representatives of clostridia of the 2nd and 4th groups, which lead to enteric clostridiosis, as well as a causative agent of tetanus and pathogens of gas gangrene. These bacteria produce specific active exotoxins.
Clostridia “live” in the natural environment in the intestines of animals and humans. They can be there for a long time and multiply, but they do not lead to diseases. With feces, clostridia fall into the external environment, mainly into the ground. There they can “live” a long time in the form of disputes.
Clostridia perfringens has long been considered the causative agent of only gas gangrene. But in the middle of the last century, our connection between these bacteria and foodborne toxic infections.
Clostridia perfringens are short polymorphic bacilli that do not have flagella. They can form subterminal spores. Relate to strict anaerobes. They are divided into six types depending on the ability to produce exotoxins and enzymes: A, B, C, D, E, F.
Most often, children’s intestinal clostridiosis is provoked by type A perfringens clostridia, in more rare cases, types C and F.
Pathogenesis during Clostridiosis in Children
Clostridiosis perfringens enters the body in the digestive tract (gastrointestinal tract) along with contaminated food. Then they follow into the small intestine, multiply there, leading to the development of the inflammatory process. Through the epithelial layer of the intestine of the child, they enter the nearby tissues and blood. So the disease goes into a severe septic form (but not in all cases).
Clostridia perfringens produce exoenterotoxins having cytolytic and necrotic properties, which determines the main symptoms that manifest during the disease.
In the intestines, many organs and systems (even in the central nervous system), Clostridia exotoxins perfringens lead to functional and structural changes. Toxicosis and exsicosis may develop. Local inflammatory process in the intestines of the child leads to diarrhea.
Pathomorphology of clostridiosis perfringens. During illness, maximum structural changes occur in the small or large (less often) intestine. The dead fix the swelling of the intestinal mucosa, its hyperemia, multiple hemorrhages, stasis, in rare cases, and necrosis.
Clostridiosis difficile begins only during or after the use of broad-spectrum antibiotics, in particular cefamizine, ampicillin, lincomycin and clindamycin. This is due to the suppression of the natural intestinal flora by antibiotics, as a result of which clostridia difficile can colonize the intestine, multiplying there and forming toxins.
Some antibiotics lead to enterotoxin formation in bacteria. In addition, the normal intestinal flora in children and adults produces beta-lactamase, an enzyme that destroys the beta-lactam ring of beta-lactams, thereby inhibiting the action of the antibiotic in the intestine.