Boutiba-Ben Boubaker I, Ben Redjeb S
Service de Microbiologie, Hôpital Charles Nicolle de Tunis.
Tunis Med. 2001 Dec;79(12):642-6.
Anthrax, an acute infectious disease of historical importance, is once again regaining interest with its use as a biological weapon. It is caused by B. anthracis, a Gram positive spore forming rod usually surrounded by a capsule and producing toxin. It occurs most frequently as an epizootic or enzootic disease of herbivores that acquire spores form direct contact with contaminated soil. Spores can survive for many years in soil. Animal vaccination programs have reduced drastically the disease in developed countries. In humans, the disease is acquired following contact with anthrax infected animals or their products. 3 types of anthrax infection can occur: cutaneous, inhalational and gastro intestinal. Cutaneous anthrax is the most common observed form. When germination occurs, replicating bacteria release toxin leading to hemorrhage, edema, necrosis and death. Full virulence of B. anthracis requires the presence of both antiphagocytic capsule and 3 toxin components (protective antigen, lethal factor and edema factor). Most naturally occurring anthrax strains are sensitive to penicillin but resistant to third generation cephalosporins. Post exposure prophylaxis is indicated to prevent inhalational anthrax.
炭疽病是一种具有历史重要性的急性传染病,随着其被用作生物武器,再次引起了人们的关注。它由炭疽芽孢杆菌引起,这是一种革兰氏阳性、形成芽孢的杆菌,通常被荚膜包围并产生毒素。它最常作为食草动物的流行性或地方性疾病出现,食草动物通过直接接触受污染的土壤获得孢子。孢子可在土壤中存活多年。动物疫苗接种计划已在发达国家大幅减少了该病的发生。在人类中,该病是在接触感染炭疽的动物或其产品后感染的。可发生3种类型的炭疽感染:皮肤型、吸入型和胃肠型。皮肤炭疽是最常见的观察到的形式。当孢子萌发时,繁殖的细菌释放毒素,导致出血、水肿、坏死和死亡。炭疽芽孢杆菌的完全毒力需要同时存在抗吞噬荚膜和3种毒素成分(保护性抗原、致死因子和水肿因子)。大多数自然发生的炭疽菌株对青霉素敏感,但对第三代头孢菌素耐药。暴露后预防措施适用于预防吸入性炭疽。