Salmonella enterica Subspecies diarizonae Maxillary Sinusitis in a Snake Handler: First Report

Horvath, Lukas; Kraft, Marcel; Fostiropoulos, Karolos; Falkowski, Anna L.; Tarr, Philip E.

doi:10.1093/ofid/ofw066

Cited by 19 publications

(25 citation statements)

References 11 publications

(14 reference statements)

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“…The case reports from the last twenty years which identify and confirm snakes or lizards as a source of human Salmonella infection are presented in Table 2 . Studies were from Switzerland [ 33 ], Germany [ 34 ], USA [ 6 , 35 , 36 , 37 , 38 ], Australia [ 39 ], UK [ 7 , 40 , 41 , 42 , 43 ], France [ 44 ], The Netherlands [ 8 ], and Canada [ 13 ]. The most commonly-identified lizard or snakes were bearded dragons [ 34 , 35 , 40 , 45 ] and iguanas [ 6 , 13 , 36 , 37 , 42 , 43 ]; although other species included corn snakes [ 37 , 44 ], a water dragon [ 41 ], a boa constrictor [ 38 ], and a gecko [ 7 ].…”

Section: Resultsmentioning

confidence: 99%

“…A common observation made in the case reports was that patients and the parents of patients were not aware of the risk associated with handling lizards and reported poor hand hygiene practices after handling of snakes and lizards and cleaning of enclosures. It was noted in a case involving a 29 years old male from Switzerland that the patient did no wash or disinfect his hands after handling snakes, feeding them, or cleaning their terrarium [ 33 ].…”

Section: Resultsmentioning

confidence: 99%

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A Review of Salmonella and Squamates (Lizards, Snakes and Amphisbians): Implications for Public Health

2017

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Globally, there has been an increase in squamates (particularly lizards and snakes) being kept as pets. Additionally, urban spread has resulted in greater human encroachment and interaction with the natural habitat of wild squamates. A potential consequence of increasing human interaction with squamates is the increased potential for disease transfer. This review collates the literature describing clinical salmonellosis cases that were definitively linked to a squamate through testing of the animal and population-based studies which investigate the risk of salmonellosis linked to pet squamates. It was demonstrated that although squamate-acquired salmonellosis accounted for a small percentage of total cases, children under five were at greatest risk, with the clinical manifestations tending to be more severe. In many cases, it was noted that the patient was unaware of the risks associated with keeping squamates and did not practice proper hand hygiene after handling the animals or cleaning cages. This highlights the need for more education focused on informing the general public of ways to reduce the risk of salmonellosis from pet squamates. There is also the need for future research into the role of wild squamates in the spread of human salmonellosis, both directly and indirectly through cross contamination.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A Review of Salmonella and Squamates (Lizards, Snakes and Amphisbians): Implications for Public Health

2017

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“…Finally, from the Proteobacteria phylum, the genus Salmonella was a profound colonizer of our in vitro model. Salmonella is less commonly described in the human sinonasal cavities, except for rare cases of reptile-associated maxillary sinusitis (60). It has been suggested that species can (transiently) occupy the respiratory tract through microaspiration from the oral cavity (16,61), where the presence of Salmonella species has been reported.…”

Section: Discussionmentioning

confidence: 99%

Dual and Triple Epithelial Coculture Model Systems with Donor-Derived Microbiota and THP-1 Macrophages To Mimic Host-Microbe Interactions in the Human Sinonasal Cavities

Rudder

Calatayud

Lebeer

et al. 2020

mSphere

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The epithelium of the human sinonasal cavities is colonized by a diverse microbial community, modulating epithelial development and immune priming and playing a role in respiratory disease. Here, we present a novel in vitro approach enabling a 3-day coculture of differentiated Calu-3 respiratory epithelial cells with a donor-derived bacterial community, a commensal species (Lactobacillus sakei), or a pathobiont (Staphylococcus aureus). We also assessed how the incorporation of macrophage-like cells could have a steering effect on both epithelial cells and the microbial community. Inoculation of donor-derived microbiota in our experimental setup did not pose cytotoxic stress on the epithelial cell layers, as demonstrated by unaltered cytokine and lactate dehydrogenase release compared to a sterile control. Epithelial integrity of the differentiated Calu-3 cells was maintained as well, with no differences in transepithelial electrical resistance observed between coculture with donor-derived microbiota and a sterile control. Transition of nasal microbiota from in vivo to in vitro conditions maintained phylogenetic richness, and yet a decrease in phylogenetic and phenotypic diversity was noted. Additional inclusion and coculture of THP-1-derived macrophages did not alter phylogenetic diversity, and yet donor-independent shifts toward higher Moraxella and Mycoplasma abundance were observed, while phenotypic diversity was also increased. Our results demonstrate that coculture of differentiated airway epithelial cells with a healthy donor-derived nasal community is a viable strategy to mimic host-microbe interactions in the human upper respiratory tract. Importantly, including an immune component allowed us to study host-microbe interactions in the upper respiratory tract more in depth. IMPORTANCE Despite the relevance of the resident microbiota in sinonasal health and disease and the need for cross talk between immune and epithelial cells in the upper respiratory tract, these parameters have not been combined in a single in vitro model system. We have developed a coculture system of differentiated respiratory epithelium and natural nasal microbiota and incorporated an immune component. As indicated by absence of cytotoxicity and stable cytokine profiles and epithelial integrity, nasal microbiota from human origin appeared to be well tolerated by host cells, while microbial community composition remained representative for that of the human (sino)nasal cavity. Importantly, the introduction of macrophage-like cells enabled us to obtain a differential readout from the epithelial cells dependent on the donor microbial background to which the cells were exposed. We conclude that both model systems offer the means to investigate host-microbe interactions in the upper respiratory tract in a more representative way.

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“…This subspecies, as well as S. enterica spp. houtenae were identified in 16% of the reptiles and considered to have a moderate zoonotic potential as most human cases occur in immunosuppressed individuals or children (Table 3) [21,[51][52][53][54]. In total almost 1/3 of the reptiles were identified as carriers of highly or moderately zoonotic Salmonella serovars.…”

Section: Zoonotic Potential Of Identified Salmonella Serovarsmentioning

confidence: 99%

Prevalence of Salmonella serovars isolated from reptiles in Norwegian zoos

et al. 2020

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Background: Reptiles are known to be asymptomatic carriers of Salmonella spp. in their gastrointestinal mucosa and a variety of Salmonella serovars including exotic serovars mainly associated with reptiles as well as human pathogenic serovars have been isolated. There are many case reports of reptile-associated Salmonella infections worldwide, including one case in Norway in 2000. In August 2017, there was a legislative change in Norway that allowed more permissive reptile ownership and legalized the keeping of 19 different reptile species by private persons. There has been a concern that this new legislation will lead to an increase in reptile-associated salmonellosis in Norway, however knowledge is lacking on the occurrence of Salmonella spp. in Norwegian reptiles. The aim of this study was therefore to investigate the prevalence of Salmonella spp. in captive reptile species in Norway, identify the serovars and evaluate their zoonotic potential. Thus, cloacal swabs were taken from 53 snakes, 15 lizards and 35 chelonians from three Norwegian zoos, and assessed for the presence of Salmonella spp. by culture, biochemical testing and serotyping. Results: In total, 43% of the reptiles were shedding Salmonella spp., with a prevalence of 62%, 67% and 3% in snakes, lizards and chelonians, respectively. A total of 26 different serovars were found, including Salmonella enterica spp. enterica (40%) and S. enterica spp. arizonae (4%), both of which are considered to have a high zoonotic potential. S. enterica spp. diarizonae, salamae and houtenae were also identified, however these serovars are considered to have a lower zoonotic potential. Conclusions: The current study demonstrates that captive Norwegian reptiles are carriers of potentially zoonotic Salmonella spp. Given the increasing popularity of reptiles as pets and the legislative change, reptile-associated salmonellosis could become an increasingly important public health concern in Norway. Adequate public information about the risk of Salmonella infection as well as preventive measures to avoid Salmonella transmission from reptiles to humans is needed. The risk of Salmonella infection is considered low when recommended precautions are taken and good hygiene exhibited.

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Salmonella enterica Subspecies diarizonae Maxillary Sinusitis in a Snake Handler: First Report

Cited by 19 publications

References 11 publications

A Review of Salmonella and Squamates (Lizards, Snakes and Amphisbians): Implications for Public Health

A Review of Salmonella and Squamates (Lizards, Snakes and Amphisbians): Implications for Public Health

Dual and Triple Epithelial Coculture Model Systems with Donor-Derived Microbiota and THP-1 Macrophages To Mimic Host-Microbe Interactions in the Human Sinonasal Cavities

Prevalence of Salmonella serovars isolated from reptiles in Norwegian zoos

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