Microbiology and pathogenesis of Yersinia infections
- Robert V Tauxe, MD, MPH
Robert V Tauxe, MD, MPH
- Division of Bacterial and Mycotic Diseases
- Centers for Disease Control and Prevention
The genus Yersinia includes 11 species, three of which are important human pathogens: Yersinia pestis, Yersinia enterocolitica, and Yersinia pseudotuberculosis . The yersinioses are zoonotic infections of domestic and wild animals; humans are considered incidental hosts that do not contribute to the natural disease cycle.
Y. enterocolitica and Y. pseudotuberculosis cause yersiniosis, a diarrheal illness. The microbiological characteristics, pathogenic determinants and laboratory isolation and characterization of Y. enterocolitica and Y. pseudotuberculosis will be reviewed here. The epidemiology, clinical manifestations and treatment of these infections are discussed separately. (See "Epidemiology of yersiniosis" and "Clinical manifestations and diagnosis of Yersinia infections".)
Y. pestis causes plague and is discussed separately. (See "Epidemiology, microbiology and pathogenesis of plague (Yersinia pestis infection)" and "Clinical manifestations, diagnosis, and treatment of plague (Yersinia pestis infection)".)
Members of the genus Yersinia are gram-negative coccobacilli; they are facultative anaerobes in the family Enterobacteriaceae . Like other Enterobacteriaceae, Y. pseudotuberculosis and Y. enterocolitica are bile tolerant and grow on MacConkey agar, they ferment glucose but not lactose, they are oxidase-negative, and reduce nitrate to nitrite.
Y. pseudotuberculosis and Y. enterocolitica are readily differentiated by biochemical tests. Y. enterocolitica ferments sucrose and Y. pseudotuberculosis does not, while Y. pseudotuberculosis ferments rhamnose and melibiose and Y. enterocolitica does not. Y. enterocolitica can be further subtyped into biotypes by a combination of phenotypic markers . They can also be serogrouped using antisera produced against cell surface lipopolysaccharide antigens, known classically as the O antigens [3,4]. For Y. enterocolitica, biogroup and serotype are correlated. The most common are serotype O:9 biotype 2, serotype O:3 biotype 4 and serotype O:8 biotype 1B . A similar serotyping system exists for Y. pseudotuberculosis. Both Y. enterocolitica and Y. pseudotuberculosis can be further subtyped using molecular methods such as pulsed field gel electrophoresis.
- Butler T. Plague and other Yersinia infections, Plenum Medical Books Co., New York 1983.
- Bottone EJ. Yersinia enterocolitica: the charisma continues. Clin Microbiol Rev 1997; 10:257.
- Wauters G, Kandolo K, Janssens M. Revised biogrouping scheme of Yersinia enterocolitica. Contrib Microbiol Immunol 1987; 9:14.
- Tsubokura M. Yersinioses other than plague. In: Laboratory Diagnosis of Infectious Diseases, Balows A, Hausler WJ Jr, Ohashi M, Turano A (Eds), Springer-Verlag, New York 1989. p.540.
- Lobato MJ, Landeras E, González-Hevia MA, Mendoza MC. Genetic heterogeneity of clinical strains of Yersinia enterocolitica traced by ribotyping and relationships between ribotypes, serotypes, and biotypes. J Clin Microbiol 1998; 36:3297.
- Carniel E, Mazigh D, Mollaret HH. Expression of iron-regulated proteins in Yersinia species and their relation to virulence. Infect Immun 1987; 55:277.
- Cherchi GB, Cossellu S, Pacifico L, et al. Incidence and outcome of Yersinia enterocolitica infection in thalassemic patients. Contrib Microbiol Immunol 1995; 13:16.
- Burnens AP, Frey A, Nicolet J. Association between clinical presentation, biogroups and virulence attributes of Yersinia enterocolitica strains in human diarrhoeal disease. Epidemiol Infect 1996; 116:27.
- Head CB, Whitty DA, Ratnam S. Comparative study of selective media for recovery of Yersinia enterocolitica. J Clin Microbiol 1982; 16:615.
- Khare R, Espy MJ, Cebelinski E, et al. Comparative evaluation of two commercial multiplex panels for detection of gastrointestinal pathogens by use of clinical stool specimens. J Clin Microbiol 2014; 52:3667.
- Buss SN, Leber A, Chapin K, et al. Multicenter evaluation of the BioFire FilmArray gastrointestinal panel for etiologic diagnosis of infectious gastroenteritis. J Clin Microbiol 2015; 53:915.
- Farmer JJ 3rd, Carter GP, Miller VL, et al. Pyrazinamidase, CR-MOX agar, salicin fermentation-esculin hydrolysis, and D-xylose fermentation for identifying pathogenic serotypes of Yersinia enterocolitica. J Clin Microbiol 1992; 30:2589.
- Riley G, Toma S. Detection of pathogenic Yersinia enterocolitica by using congo red-magnesium oxalate agar medium. J Clin Microbiol 1989; 27:213.
- Feng P. Identification of invasive Yersinia species using oligonucleotide probes. Mol Cell Probes 1992; 6:291.
- Bottone EJ, Sheehan DJ. Yersinia enterocolitica: guidelines for serologic diagnosis of human infections. Rev Infect Dis 1983; 5:898.
- Cornelis GR, Boland A, Boyd AP, et al. The virulence plasmid of Yersinia, an antihost genome. Microbiol Mol Biol Rev 1998; 62:1315.
- De Koning-Ward TF, Robins-Browne RM. Contribution of urease to acid tolerance in Yersinia enterocolitica. Infect Immun 1995; 63:3790.
- Carniel E. Chromosomal virulence factors of Yersinia: an update. Contrib Microbiol Immunol 1995; 13:218.
- Portnoy DA, Martinez RJ. Role of a plasmid in the pathogenicity of Yersinia species. Curr Top Microbiol Immunol 1985; 118:29.
- Cornelis GR. Yersinia type III secretion: send in the effectors. J Cell Biol 2002; 158:401.
- Boland A, Cornelis GR. Role of YopP in suppression of tumor necrosis factor alpha release by macrophages during Yersinia infection. Infect Immun 1998; 66:1878.
- Rakin A, Noelting C, Schubert S, Heesemann J. Common and specific characteristics of the high-pathogenicity island of Yersinia enterocolitica. Infect Immun 1999; 67:5265.
- Badger JL, Miller VL. Expression of invasin and motility are coordinately regulated in Yersinia enterocolitica. J Bacteriol 1998; 180:793.
- Takao T, Tominaga N, Yoshimura S, et al. Isolation, primary structure and synthesis of heat-stable enterotoxin produced by Yersinia enterocolitica. Eur J Biochem 1985; 152:199.
- Mikulskis AV, Delor I, Thi VH, Cornelis GR. Regulation of the Yersinia enterocolitica enterotoxin Yst gene. Influence of growth phase, temperature, osmolarity, pH and bacterial host factors. Mol Microbiol 1994; 14:905.
- Morris JG Jr, Prado V, Ferreccio C, et al. Yersinia enterocolitica isolated from two cohorts of young children in Santiago, Chile: incidence of and lack of correlation between illness and proposed virulence factors. J Clin Microbiol 1991; 29:2784.
- Aho K, Ahvonen P, Lassus A, et al. HL-A 27 in reactive arthritis. A study of Yersinia arthritis and Reiter's disease. Arthritis Rheum 1974; 17:521.
- Hermann E, Yu DT, Meyer zum Büschenfelde KH, Fleischer B. HLA-B27-restricted CD8 T cells derived from synovial fluids of patients with reactive arthritis and ankylosing spondylitis. Lancet 1993; 342:646.
- Laitinen O, Leirisalo M, Skylv G. Relation between HLA-B27 and clinical features in patients with yersinia arthritis. Arthritis Rheum 1977; 20:1121.