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THU0440 Yersinia Enterocolitica Biotype 1A Infection can Trigger Reactive Arthritis
  1. R. Tuompo1,
  2. T. Hannu2,
  3. A. Siitonen3,
  4. M. Leirisalo-Repo1
  1. 1Department of Medicine, Division of Rheumat, Helsinki University Central Hospital
  2. 2Hjelt Institute, Department of Public Health, University of Helsinki
  3. 3Bacteriology Unit, National Institute of Health and Welfare, Helsinki, Finland

Abstract

Background Yersinia enterocolitica (YE) is a well-known trigger of reactive arthritis (ReA) [1]. Studies of YE-related ReA have concentrated on the traditionally pathogenic serotypes O:3 and O:9 (biotypes 4 and 2, respectively) [2, 3]. Biotype 1A is generally considered non-pathogenic [4]. However, biotype 1A has been isolated from stools of diarrheic patients, and the potential pathogenicity of biotype 1A has been discussed in the literature [5, 6].

Objectives To study the capability of YE biotype 1A to induce ReA and other reactive musculoskeletal (MS) symptoms.

Methods 406 questionnaires were sent to cases with positive stool culture of YE. Analysis of self-reported MS symptoms was supplemented with a clinical examination of subjects with recent MS symptoms.

Results Of the 295 subjects, who returned the questionnaire, 120 reported MS symptoms, of which 114 were included to the final analysis. Among these 114 patients, 77 (68%) had YE biotype 1A, 16 (14%) had YE biotype 4, and one (0.9%) had biotype 2 infection; the remaining 20 (17%) patients had different YE-like strains or had a non-biotypable strain in the stool specimens. Of the subjects, 18% (21/114) fulfilled the criteria for ReA, and a further 12% (14/114) had other reactive MS symptoms (tendinitis or enthesitis). The incidence of ReA was 6% in cases with YE biotype 1 A and 5.4% in cases with biotypes 4 or 2.

Conclusions YE biotype 1A can be a causative agent for ReA. Therefore, it should be included among pathogens searched at the diagnostic work up of the aetiology of ReA.

References

  1. Leirisalo-Repo M. Reactive arthritis. Scand J Rheumatol 2005;34:251-9.

  2. Leirisalo M, Skylv G, Kousa M, et al. Followup study on patients with Reiter’s disease and reactive arthritis, with special reference to HLA-B27. Arthritis Rheum 1982;25:249-9.

  3. Schiellerup P, Krogfelt KA, Locht H. A comparison of self-reported joint symptoms following infection with different enteric pathogens: effect of HLA-B27.J Rheumatol. 2008;35:480-7.

  4. Bottone EJ. Yersinia enterocolitica: the charisma continues. Clin Microbiol Rev 1997;10:257-76.

  5. Tennant SM, Grant TH, Robins-Browne RM. Pathogenicity of Yersinia enterocolitica biotype 1A. FEMS Immunol Med Microbiol 2003;38:127-37.

  6. Bhagat N, Virdi JS. The enigma of Yersinia enterocolitica biovar 1A. Crit Rev Microbiol 2010;37:1-15.

Disclosure of Interest None Declared

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