Yersinia spp.

Yersinia spp. are facultatively anaerobic rod-shaped bacteria, belonging to the Yersiniaceae family. The family includes a total of 18 species, three of which are human pathogens: the intestinal pathogens Y. enterocolitica and Y. pseudotuberculosis, as well as the pathogen which causes the plague Y. pestis . The latter has no relevance for endoscopy ^[1].

The pathogens Y. enterocolitica and Y. pseudotuberculosis trigger yersiniosis and are spread throughout the world ^[1][2]. In Europe, yersiniosis is the third most frequently reported foodborne infectious disease ^[3].

Diseases caused by the intestinal pathogenic Yersinia bacteria include^[2][3][4]:

• Gastroenteritis

• Enterocolitis (inflammation of the small and large intestine)

• Appendicitis (inflammation of the appendix)

• Pharyngitis, flu symptoms (uncommon)

The main source of infection for Y. enterocolitica and Y. pseudotuberculosis is contaminated animal products, particularly pork and pork products. Furthermore, other types of meat, raw or pasteurized milk and dairy products, as well as contaminated water, fish, fruit, vegetables and tofu have also been identified as reservoirs for Yersinia bacteria ^[1][5].

Relevance of pathogen in transmission in endoscopy

• Gastroenterology: Low

• Pulmonology: Not relevant

• Ear, nose, and throat: Not relevant

• Urology: Not relevant

Relevance for endoscope surveillance

• High concern organism

Transmission route

Transmission occurs via the fecal-oral route when contaminated food is ingested, e.g. raw or undercooked pork, raw milk or contaminated water ^[2][3].

Resistance to antibiotics

Various studies report that isolates of intestinal pathogenic Yersinia bacteria from raw milk show resistance to tetracyclines, cephalothin and ampicillin ^[6]. Investigations of Y. enterocolitica isolates from meat samples showed almost 90% resistance to ampicillin and cephalothin ^[7].