Yersinia

Yersinia was reported in an EPA sewage sludge compost study in 1988

Black Plague -- Yersinia pestis causes the bubonic, pneumonic, and septicemic plagues . Human
contraction of bubonic plague is usually through flea bites. Once inside the body, Y. pestis
releases a toxin which inhibits electron transport chain function. Swelling of the lymph nodes, skin
blotches, and dilerium are sometimes observed within a few days of infection. Untreated infections
usually result in death within a week of initial infection.

Plague is an endemic disease of rodents in the western United States, with occasional spread into
human and non-rodent populations via enzootic or amplification hosts.

Yersinia enterocolitica (1976) is a gram-negative organism that only recently has become
known to infect man. Although the number of infections with Yersiniia entercolitica has increased
during the last few years, most  reports came from Europe, Africa, Australia, and Japan. During the
past year, Yersinia infections have been discovered in Canada  and in the United States.

Most diseases caused by Yersinia entercolitica are relatively benign; however, we have recently
observed one case that presented as a severe abscess of the lung. This case is unique in that it is
not only the first report of pulmonary disease with this organism, but also demonstrates the
potential aggressiveness of this organism in areas outside the gastrointestinal tract. Our purpose
is to report this unusual occurrence and to acquaint the physician with this organism and some of
its manifestations.

CLINICAL MANIFESTATIONS: Yersinia enterocolitica and Yersinia pseudotuberculosis cause
several age-specific syndromes and a variety of uncommon presentations. The most common
manifestation of infection with Y enterocolitica is enterocolitis with fever and diarrhea; stool often
contains leukocytes, blood, and mucus. This syndrome occurs most often in young children. A
pseudoappendicitis syndrome (fever, abdominal pain, tenderness in the right lower quadrant of the
abdomen, and leukocytosis) occurs primarily in older children and young adults. Focal infections,
abscess formation (such as hepatic and splenic), and bacteremia occur most often in patients with
predisposing conditions, such as excessive iron storage. Other manifestations of infection are
uncommon and include pharyngitis, meningitis, osteomyelitis, pyomyositis, conjunctivitis,
pneumonia, acute proliferative glomerulonephritis, peritonitis, and primary cutaneous

Of 187 newborns admitted to a 33-bed, level III neonatal intensive care unit between January 1,
1985 and June 23, 1985, 33 developed necrotlzlng enterocolitis during their hospital stay. Twenty
of the 33 newborns (61%) had onset of symptoms between April 1 and June 23, suggesting
clustering during this period. A case-control study, with matching on birth weIght class, approximate
date of admission to the unit and approximate duration of stay, failed to reveal any association of
the syndrome with type or timing of feeding, perinatal hypoxic events, as determined by apgar
scores and labor history, or specific microbial organisms. By contrast, however, transfusion of
packed red blood cells was highly and significantly associated with the syndrome (odds ratio =
15.1, 95% confidence interval = 2.59–92.51). In addition, therapy with caffeine, with theoph ylline,
and with furosemide were moderately associated with the syndrome, although not significantly so.
During this outbreak period, the Incidence of necrotizing enterocolitis by birth weight was 30.6% in
infants less than 1,500 gm, 10.8% in infants 1,500–2,500 gm, and 11.9% in infants 2,500 gm or
more. These findings confirm the importance of low birth weight as a risk factor for development of
the syndrome and suggest that Insults to volume homeostasis, such as transfusion and use of
diuretics, need to be considered as possible mechanisms whereby necrotizing enterocolitis is
Initiated.

The authors report (1993) a rare case of Yersinia enterocolitica necrotizing pneumonia in an
immunocompromised patient, who responded with resolution of the infection after 6 weeks of
therapy with a third-generation cephalosporin but subsequently expired from the underlying
lymphoma. In the few cases of Y. enterocolitica pulmonary infections that have been reported, the
prognosis for cure of the infection is excellent with appropriate antibiotic therapy. Y. enterocolitica
is likely to be recognized more frequently as a cause of serious infection in the growing
immunosuppressed population. Early recognition and appropriate therapy can improve survival
significantly.

The Cytotoxic Necrotizing Factors (2007)  from Yersinia pseudotuberculosis and from
Escherichia coli Bind to Different Cellular Receptors but Take the Same Route to the Cytosol

Eight pathogenic strains (O:1, O:2, O:4, O:13, O:15, O:20, O:21, and O:34) of Y enterocolitica
were obtained from the Centers for Disease Control and Prevention (CDC), Atlanta, GA. These
specimens were received as
freeze-dried organisms, which subsequently were rehydrated with
phosphate-buffered saline (PBS) before culture.

Yer·sin·ia/ (yer-sin´e-ah) a genus of nonmotile, ovoid or rod-shaped, nonencapsulated, gram-
negative bacteria (family Enterobacteriaceae); Y. enterocoli´tica is a ubiquitous species that
causes acute gastroenteritis and mesenteric lymphadenitis in children and arthritis, septicemia,
and erythema nodosum in adults; Y. pes´tis causes plague in humans and rodents, transmitted
from rats to humans by the rat flea, and from person to person by the human body louse; Y.
pseudotuberculo´sis causes disease in rodents and mesenteric lymphadenitis in humans.
http://medical-dictionary.thefreedictionary.com/YERSINIA

Yersinia genus: Y. enterocolitica and Y. pestis. Y. enterocolitica is the most often encountered
species of Yersinia in the lab. This bacterium is an invasive pathogen which can penetrate the gut
lining and enter the lymphatic system and the blood. Infection, which is usually through ingestion of
contaminated foods, can cause a severe intestinal inflammation called yersiniosis. Release of its
enterotoxin can cause severe pain similar to that found in patients with appendicitis.

Yersinia enterocolitica (1984) Now that its role as a human pathogen is firmly established,
reports documenting Yersinia enterocolitica infections are increasing worldwide. The organism has
been encountered both sporadically and epidemically (3). Y. enterocolitica causes a diarrheal
illness in children (10), and its association with Reiter's syndrome in adults is well known (6, 13),
but only a handful of cases of primary soft tissue infection have been described.

Contributor’s Comment: The mule deer had bilateral ocular infection due to Yersinia pestis. In
addition to these changes there were acute necrotizing inflammatory lesions in lung, adrenals,
lymph node, and liver with intralesional bacteria, and disseminated intravascular coagulation

Plague is unusual in big game animals and ungulates are generally considered resistant to the
disease. There is a published report of plague in a free-ranging mule deer in Wyoming,1 an
unpublished, laboratory-confirmed case in a mule deer in Montana,2 and bilateral plague-
associated necrotizing panophthalmitis in a blacktailed deer in California.3 Ocular plague has been
seen in Colorado (Dr. M. Miller, Colorado Division of Wildlife, unpublished observations).