Yersinia enterocolitica is a gram-negative bacillus with significant pleomorphism that can be spherical, rod-shaped, or spiral[1]. It is a facultative anaerobic bacterium capable of growing in both aerobic and anaerobic conditions[2]. Y. enterocolitica is widely distributed in nature, including soil, water, plants, and animal intestines, and is a zoonotic pathogen capable of infecting a variety of hosts, including humans, pigs, dogs, cats, cattle, sheep, and wild animals[3]. To date, six biotypes (1A, 1B, 2, 3, 4, and 5) and more than 70 serotypes have been identified. Among them, the biotype 1B strain is considered highly virulent and lethal in mice, while the biotype 1A strain is considered non-toxic due to the lack of virulence plasmid pYV. Biotypes 2, 3, 4, and 5 are low-virulence[4]. Although the European Centre for Disease Prevention and Control has defined Y. enterocolitica biotype 1A as non-pathogenic and not reportable, all biotypes, including 1A, have been isolated from clinical samples[5]. Virulence assays using Galleria mellonella suggest that all Y. enterocolitica are pathogenic[6].
In 2021, yersiniosis was the third most commonly reported zoonosis in the European Union, with the primary agent being Y. enterocolitica[7]. Primary Y. enterocolitica infections affect the gastrointestinal tract, causing symptoms of diarrhea, fever, stomach cramps, vomiting, and blood in stools. Whilst Y. enterocolitica infections are generally self-limiting, secondary complications include sepsis[8], focal infections[9], ileitis, appendicitis, and reactive arthritis.
Y. enterocolitica produces β-lactamases and is therefore naturally resistant to AMP, amoxicillin, and first-generation cephalosporins[10]. In addition, plasmids are also important for virulence in Y. enterocolitica. In Y. enterocolitica type O, only a few (mainly O:3, O:5,27, O:8, and O:9) carry 70 kb virulence plasmids that are pathogenic and are causative agents of yersiniosis in animals and humans[11]. Y. enterocolitica cell surface structures that play a significant role in virulence have been subject to many investigations. These include outer membrane (OM) glycolipids such as lipopolysaccharide and enterobacterial common antigen and several cell surface adhesion proteins present only in virulent Y. enterocolitica, i.e., Inv, YadA, and Ail. While the yadA gene is located on the Yersinia virulence plasmid the Ail, Inv, LPS, and ECA are chromosomally encoded. These structures ensure the correct architecture of the OM, and provide adhesive properties as well as resistance to antimicrobial peptides and to host innate immune response mechanisms[12].
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