Permanent Carriers of Nontyphosa Salmonellae

Musher, Daniel M.

doi:10.1001/archinte.1973.03650120071013

Cited by 51 publications

(17 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a previous study, a significant proportion of patients with recurrence or carriage of NTS infection had an underlying disease (31). However, we were unable to determine if the patients whose isolates were analyzed in this study had any underlying diseases.…”

Section: Resultsmentioning

confidence: 82%

Genomic Variability of Serial Human Isolates of Salmonella enterica Serovar Typhimurium Associated with Prolonged Carriage

et al. 2015

View full text Add to dashboard Cite

c Salmonella enterica serovar Typhimurium is an important foodborne human pathogen that often causes self-limiting but severe gastroenteritis. Prolonged excretion of S. Typhimurium after the infection can lead to secondary transmissions. However, little is known about within-host genomic variation in bacteria associated with asymptomatic shedding. Genomes of 35 longitudinal isolates of S. Typhimurium recovered from 11 patients (children and adults) with culture-confirmed gastroenteritis were sequenced. There were three or four isolates obtained from each patient. Single nucleotide polymorphisms (SNPs) were analyzed in these isolates, which were recovered between 1 and 279 days after the initial diagnosis. Limited genomic variation (5 SNPs or fewer) was associated with short-and long-term carriage of S. Typhimurium. None of the isolates was shown to be due to reinfection. SNPs occurred randomly, and the majority of the SNPs were nonsynonymous. Two nonsense mutations were observed. A nonsense mutation in flhC rendered the isolate nonmotile, whereas the significance of a nonsense mutation in yihV is unknown. The estimated mutation rate is 1.49 ؋ 10 ؊6 substitution per site per year. S. Typhimurium isolates excreted in stools following acute gastroenteritis in children and adults demonstrated limited genomic variability over time, regardless of the duration of carriage. These findings have important implications for the detection of possible transmission events suspected by public health genomic surveillance of S. Typhimurium infections. Nontyphoid Salmonella (NTS) infections generally result in a short-term, self-limiting gastroenteritis. However, NTS can be excreted continually and asymptomatically in stools for many weeks, even after the initial diarrheal episode has been resolved. Children are the more common carriers, especially children under the age of 3 years (1, 2). Fecal shedding of NTS after an intestinal infection can last for up to 4 weeks in adults and 7 weeks in children (3). In a very small proportion of cases, carriage can last for a year after the initial onset of the disease (3). Carriers excrete large numbers of bacteria in their feces and can facilitate the transmission of Salmonella to other hosts by contaminating water and food sources. The persistence of fecal shedding in asymptomatic patients can have a duration similar to that for patients with clinical disease (4). Antibiotic treatment of NTS disease is rarely indicated, as it does not assist in clearance of infection but may increase the duration of asymptomatic shedding (4).Salmonella enterica serovar Typhimurium is one of the leading causes of NTS gastroenteritis in humans in Australia and other countries. Salmonellosis is a notifiable disease in all Australian states and territories. In the state of New South Wales (NSW), the notification rate has been around 50 cases per 100,000 population (5). Sequencing of S. Typhimurium genomes or analyses of tandem repeats within the genome have increasingly been employed for tracking community ou...

show abstract

Section: Resultsmentioning

confidence: 82%

Genomic Variability of Serial Human Isolates of Salmonella enterica Serovar Typhimurium Associated with Prolonged Carriage

et al. 2015

View full text Add to dashboard Cite

show abstract

“…A meta-analysis showed that antibiotic therapy does not appear to reduce the length of illness in immunocompetent adults and increases the period during which Salmonella was detected in stool ( 144 ). Th is however would not necessarily be an argument against antibiotic use as short-term carriage appears to be of limited clinical signifi cance to those who are aff ected ( 145 ).…”

Section: Th E Evidence Does Not Support Empiric Anti-microbial Therapymentioning

confidence: 99%

“…Th is may result in the development of C. diffi cile -associated diarrhea or colitis ( 132,145 ). A recent publication reported patients who developed C. diffi cile colitis following treatment with ciprofl oxacin ( 146 ).…”

Section: Th E Evidence Does Not Support Empiric Anti-microbial Therapymentioning

confidence: 99%

ACG Clinical Guideline: Diagnosis, Treatment, and Prevention of Acute Diarrheal Infections in Adults

Riddle

DuPont

Connor

2016

American Journal of Gastroenterology

319

250

View full text Add to dashboard Cite

Acute diarrheal infections are a common health problem globally and among both individuals in the United States and traveling to developing world countries. Multiple modalities including antibiotic and non-antibiotic therapies have been used to address these common infections. Information on treatment, prevention, diagnostics, and the consequences of acute diarrhea infection has emerged and helps to inform clinical management. In this ACG Clinical Guideline, the authors present an evidence-based approach to diagnosis, prevention, and treatment of acute diarrhea infection in both US-based and travel settings. Am J Gastroenterol 2016; 111:602-622; doi: 10.1038/ajg.2016 A follow-up survey where 3,568 respondents (median age 51) were asked at random about illness in the previous 7 days or previous month found that recall bias had an important eff ect on estimates of acute gastrointestinal illness ( 10 ). Using a 7-day exposure window, the estimated incidence of acute diarrhea was 1.6 episodes per person-year, compared with 0.9 episodes per person-year if asked about illness within the preceding month. Other population-based studies from Canada and western European countries using varied methodologies estimate annual incidence between 0.1 to 3.5 episodes per person-year ( 11 18. Antibiotic chemoprophylaxis has moderate to good effectiveness and may be considered in high-risk groups for short-term use. (Strong recommendation, high level of evidence) TD, traveler's diarrhea.

show abstract

“…Cholecystectomy fails when the bacilli also reside elsewhere in the body. 104 Y. enterocolitica caused dysentery in sixteen of twenty-one persons in neighbourhood families. Two died.…”

Section: Bacillary Infectionsmentioning

confidence: 99%

Infectious diseases: fortieth and final annual review of significant publications

Reimann

1975

Postgraduate Medical Journal

View full text Add to dashboard Cite

According to recent comment, the importance of infections and the interest in them have reached a nadir.1 But, by reviewing these Reviews published annually since 1935, infectious diseases actually have increased in importance, if not in interest. For example, the death rate from infections is about the same now as it was in 1935, but depends upon different causal microbes. Some diseases have almost disappeared only to be replaced by others. Great advances in the knowledge of viral infections, microbic biology and immunology; the multiplicity of vaccines and antimicrobic drugs, their proper use and limited value; the unceasing resurgence of epidemics; the rising incidence of iatrogenic and nosocomial infections; and the recognition of exotic diseases imported from persistent endemic areas are largely beyond the grasp of generalist physicians and surgeons. They require specialized knowledge and undiminished interest.

show abstract

Permanent Carriers of Nontyphosa Salmonellae

Cited by 51 publications

References 18 publications

Genomic Variability of Serial Human Isolates of Salmonella enterica Serovar Typhimurium Associated with Prolonged Carriage

Genomic Variability of Serial Human Isolates of Salmonella enterica Serovar Typhimurium Associated with Prolonged Carriage

ACG Clinical Guideline: Diagnosis, Treatment, and Prevention of Acute Diarrheal Infections in Adults

Infectious diseases: fortieth and final annual review of significant publications

Contact Info

Product

Resources

About