Enterotoksini

Enterotoksini are protein exotoxins produced by certain bacteria that target the gastrointestinal tract, causing gastroenteritis. They typically stimulate fluid and electrolyte secretion into the intestinal lumen or activate neural and immune pathways, leading to symptoms such as vomiting and watery diarrhea. Some enterotoxins are heat-stable and can resist cooking and gastric conditions, while others are heat-labile and more easily inactivated by heat.

Prominent examples include toxins produced by Staphylococcus aureus, Bacillus cereus, Escherichia coli, Clostridium perfringens, and Vibrio cholerae. Staphylococcal enterotoxins often act as superantigens and can provoke rapid vomiting and diarrhea after ingestion of contaminated foods. Bacillus cereus can cause an emetic syndrome via cereulide and a diarrheal form via other enterotoxins. Enterotoxigenic E. coli (ETEC) strains produce heat-labile (LT) and heat-stable (ST) enterotoxins that induce watery diarrhea, commonly in travelers. Clostridium perfringens produces enterotoxin that may cause diarrhea after ingestion of improperly cooked meat or poultry. Vibrio cholerae produces cholera toxin, a potent enterotoxin responsible for profuse, watery diarrhea and severe dehydration.

Clinical presentation typically includes abrupt onset of nausea, vomiting, abdominal cramps, and watery diarrhea, with dehydration being a primary concern in more severe cases. Onset times vary: preformed toxins can cause symptoms within hours, while toxins produced after ingestion may have longer incubation periods.

Diagnosis relies on clinical presentation supported by laboratory detection of the toxin in suspected foods or patient stool, along with identification of the causative organism when appropriate. Treatment is mainly supportive, emphasizing rehydration and electrolyte management; antibiotics are not routinely required for toxin-mediated disease. Prevention hinges on proper food handling, pasteurization, cooking, and safe storage to reduce toxin formation.