Salmonella entericaSerotype Choleraesuis: Epidemiology, Pathogenesis, Clinical Disease, and Treatment

Abstract

SUMMARY Nontyphoid Salmonella strains are important causes of reportable food-borne infection. Among more than 2,000 serotypes, Salmonella enterica serotype Choleraesuis shows the highest predilection to cause systemic infections in humans. The most feared complication of serotype Cholearesuis bacteremia in adults is the development of mycotic aneurysm, which previously was almost uniformally fatal. The advances in diagnostic techniques, surgical care, and antimicrobial therapy have greatly improved the survival of these patients. However, the recent emergence of serotype Choleraesuis that is resistant to ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, and, notably, fluoroquinolone antibiotics has aroused concern about the use of these agents for the empirical treatment of systemic infection caused by this organism. In view of the serious implications of the situation, the chain of transmission and mechanism of resistance should be carefully studied to reduce the spread of infection and threat to human health. To date, there are no vaccines available to prevent serotype Choleraesuis infections in humans. The availability, in the near future, of the genome sequence of serotype Cholearesuis will facilitate the development of effective vaccines as well as the discovery of new targets for novel antimicrobial agents.

First case report of blood and urine cultures positive bacteraemia by Salmonella enterica serotype Choleraesuis from India

“…Choleraesuis is a swine-adapted serotype of S. enterica that causes swine paratyphoid and is highly pathogenic to humans. S. Choleraesuis is of particular concern in Taiwan, where it is the second most common serotype to cause human infections (after S. Typhimurium) (Chen et al, 2007;Chiu et al, 2004). It is usually associated with bacteraemia and extraintestinal focal infections, including mycotic aneurysms, osteomyelitis and pleuropulmonary infections in both children and adults, with little or no involvement of the gastrointestinal tract (Chen et al, 2007;Chiu et al, 2004;Jean et al, 2006).…”

“…It primarily has four different clinical manifestations: enteric fever, gastroenteritis, bacteraemia and an asymptomatic carrier state (Coburn et al, 2007). Although systemic infections such as enteric fever caused by serovars Typhi and Paratyphi are common in developing countries such as India (Ochiai et al, 2008), invasive salmonellosis caused by non-typhoidal Salmonella (NTS) species has been more frequently reported from sub-Saharan African countries (Gordon et al, 2008;Mtove et al, 2010) and south-eastern Asian countries such as Taiwan (Chen et al, 2007;Chiu et al, 2004;Jean et al, 2006).While a longer duration of fever and younger age (school age) are associated with typhoid fever, invasive NTS infections are more common in patients with malaria, anaemia, jaundice, hypoglycaemia, malnutrition, HIV infection and other immunosuppressive conditions (Chen et al, 2007;Chiu et al, 2004;Gordon et al, 2008;Mtove et al, 2010).…”

“…Among more than 2500 serotypes of Salmonella enterica, certain serotypes such as Typhimurium and Enteritidis have a broad host range, and some animal-adapted serotypes such as Choleraesuis (swine) and Dublin (cattle) show a much higher predilection for causing invasive disease in humans (Chiu et al, 2004;Coburn et al, 2007). Although there have been occasional reports of NTS septicemia from India (Patil et al, 2006;Randhawa et al, 2006), this is the first report of S. enterica serovar Choleraesuis (S. Choleraesuis) bacteraemia from India where the organism was simultaneously isolated from the blood and urine samples of a hospitalized, middle-aged, febrile patient in Kolkata.…”

Comparative Diagnosis of Typhoid Fever by Polymerase Chain Reaction and Widal Test in Southern Districts (Bannu, Lakki Marwat and D.I.KHAN) of Khyber Pakhtunkhwa, Pakistan

“…DNA probe hybridization methods can detect S. Typhi, but their sensitivity is poor because they cannot detect fewer than 500 bacteria/m [10][11][12][13]. This problem of sensitivity could be circumvented by using the PCR, which can detect very small amounts of DNA by enzymatic amplification with absolute specificity within several hours.…”

“…Some of the common signs and symptoms of typhoid include high fever (39-40°C), profuse sweating, headache, muscular pain, abdominal bloating, discomfort, nausea, vomiting, loss of appetite, diarrhea or constipation, fatigue, exhaustion, gastroenteritis, abdominal pain and enteric [5][6][7][8][9][10][11][12].…”