Summary auto-generated
This study examined faecal specimens from 3,784 patients over one year to determine carriage rates of Yersinia species in a UK population. Yersinia was isolated from 3.5% of patients, exceeding isolation rates for Salmonella (2.5%), Campylobacter (2.8%), and Shigella (0.34%). The predominant isolates were Yersinia enterocolitica biotype 1 (53%) and Yersinia frederikseni (39%), with serotypes O5,27 and O6,30 most common. Notably, serotype O3—the recognised pathogenic strain—was not isolated. Yersinia excretion showed strong association with the 1-14 year age group, though most isolates required cold enrichment (only 5% detected by direct culture). Among patients aged 15 years or older with no other pathogen detected, 88% exhibited gastrointestinal symptoms. Ten patients provided serum samples, but no antibody responses to Yersinia were demonstrated. The authors suggest that non-O3 serotypes and Y. frederikseni, previously not considered pathogenic, may have clinical significance given their high prevalence in symptomatic patients.
Key findings
- Yersinia carriage rate of 3.5% exceeded rates for other major enteric pathogens in this UK population
- Y. enterocolitica biotype 1 and Y. frederikseni were dominant, not the pathogenic serotype O3
- Yersinia excretion was strongly associated with the 1-14 year age group
- Cold enrichment in buffered peptone water at 4°C was essential, recovering 95% of isolates missed by direct culture
- Nearly 90% of Yersinia-positive patients aged 15+ years exhibited gastrointestinal symptoms, suggesting potential clinical significance of non-pathogenic biotypes
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Abstract
Examination of faecal specimens for the presence of Yersinia spp. during a 1-year period yielded isolations from 3.5% of patients. Salmonella spp., Campylobacter spp. and Shigella spp. were isolated from 2.5%, 2.8% and 0.34% of patients respectively. Most isolates belonged to Y. enterocolitica biotype 1 (53%) and Y. frederikseni (39%). The most frequently encountered serotypable strains were serotypes O 5.27 and O 6.30. Serotype O 3, the commonly recognised pathogenic strain, was not isolated in this survey. A strong association between Yersinia excretion and the age group 1-14 years was demonstrated. Although biotype-1 strains and Y. frederikseni have not previously been thought to be pathogenic, clinical significance could be attributed to the presence of Yersinia spp. in almost 90% of patients aged 15 years or more, and in over 50% of patients in the younger age groups.