Les diarrhées d'origine bactérienne le cas de Yersinia enterocolitica

Yersinia enterocolitica is a common cause of acute enteritis in temperate and cold countries worldwide, including France. The infection occurs most often as sporadic cases or small family outbreaks. Y. enterocolitica is transmitted by the fecal-oral route and has mainly an animal reservoir (pigs, cattle). Clinical symptoms such as diarrhea, fever and abdominal pain are often self-limiting and predominate in young children. More invasive forms (abscesses, septicemia) occur in elderly patients, with underlying conditions (hypersideremia, cirrhosis, diabetes). Secondary complications such as reactive arthritis or erythema nodosum are not uncommon. Because of its peculiar growth characteristics (slower growth than other enterobacteria), Y. enterocolitica is hardly isolated from a polymicrobial sample (stools). The use of enrichment procedures and selective media helps improving the isolation rate. Since the species Y. enterocolitica is composed of both pathogenic (biotypes 1 B, 2, 3, 4 et 5) and non-pathogenic (biotype 1A) isolates, it is of key importance to further characterize all isolated strains (biotyping), in order to determine their involvement in the observed clinical symptoms. Serotyping (0 antigen) is also used to subdivide the species. In France, the most commonly isolated strains belong to bioserotype 4/0:3, followed by bioserotype 2/0:9. In the absence of bacterial isolation, alternative diagnostic tools such as PCR or serology might be of some help. Y. enterocolitica is usually resistant to penicillins and to first and second generation cephalosporins. In conclusion, although Y. enterocolitica is a common cause of intestinal disease in France, the infection is largely underdiagnosed because the bacterium is not actively and systematically searched for.