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Salmonella Lecture

Salmonella is a Gram-negative bacterium that causes various clinical syndromes, including enteritis and enteric fever (typhoid and paratyphoid). Transmission occurs via the fecal-oral route, with significant complications arising from infections, particularly in developing countries. Diagnosis involves blood cultures and serological tests, while treatment includes antibiotics and vaccination for prevention.

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4 views21 pages

Salmonella Lecture

Salmonella is a Gram-negative bacterium that causes various clinical syndromes, including enteritis and enteric fever (typhoid and paratyphoid). Transmission occurs via the fecal-oral route, with significant complications arising from infections, particularly in developing countries. Diagnosis involves blood cultures and serological tests, while treatment includes antibiotics and vaccination for prevention.

Uploaded by

val.carolina.2004
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd
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Typhoid/ Enteric fever

Dr. Jyotsna Agarwal


Professor, Dept. Microbiology
KGMU

1
Salmonella
• Salmonella is Gram-
negative, rod-shaped
• Facultative anaerobe in
family Enterobacteriaceae
• Motile, Non lactose
fermenting
• Over 2400 serotypes

2
 Faeco-oral transmission
 Refrigeration does not kill bacteria, Heat
at 600C destroys

3
Clinical Syndromes of Salmonella
Salmonellosis = Generic term for disease

 Enteritis (acute gastroenteritis)


 Enteric fever (prototype is typhoid fever and
less severe paratyphoid fever)
 Septicemia (particularly S. choleraesuis, S. typhi,
and S. paratyphi)
 Asymptomatic carriage (gall bladder is the
reservoir for Salmonella typhi)

4
Enteritis( Food Poisoning)
 Most common form of salmonellosis with
foodborne outbreaks and sporadic disease
 High infectious dose (108 CFU)
 Poultry, eggs, etc. are sources of infection
 6-48h incubation period
 Nausea, vomiting, nonbloody diarrhea, fever,
cramps, myalgia and headache common
 Many species of salmonella can cause this (eg. S.
typhimurium) except S. typhi

5
Pathogenesis
 Bacteria penetrates intestinal cell
in ileocaecal region
 Inflammatory response to bacterial
multiplication in the cell
 Prostaglandins secreted
 Increase in C-AMP

6
Clinical Syndromes- Enteric fever

 S. typhi causes typhoid fever


S. paratyphi A, B and C cause milder form of
enteric fever called paratyphoid fever
 Infectious dose large = 106 CFU
 Fecal-oral route of transmission
 Person-to-person spread by chronic carrier
 Fecally-contaminated food or water
 Food handlers contaminate food
 10-14 day incubation period

7
 Virtually non existent in developed
world
 In developing countries endemic
 Typhoid more common than
paratyphoid

8
Pathogenesis of Enteric fever

M cells on Peyers patches

Invade intestinal lining cells


bloodstream (primary bacteremia)

Phagocytosis
Transported (R E system), continue to
replicate

9
Pathogenesis contd…
 Second week: re-enter bloodstream
(secondary bacteremia) endotoxemia

 Second to third week: gallbladder, secreted


in bile, re-infect intestinal tract

10
 Complications: Intestinal
haemorrhage, perforation,
cholecystitis
 Less commonly: Bronchopneumonia,
arthritis, osteomyelitis

11
Epidemiology & Clinical Syndromes

Asymptomatic Carriage
 Chronic carriage in 1-5% of cases following S.
typhi or S. paratyphi infection (Temporary
carrier>12 months shedding)
 Gall bladder usually the reservoir

 Chronic carriage with other Salmonella spp.


occurs in <<1% of cases and does not play a
role in human disease transmission

12
Early 1900- Mary Mallon

13
Virulence factor
•Encapsulation , antigenic mimicry, masking
•Evasion or incapacitation of phagocytosis
• Mechanisms enabling an invading
microorganism to resist being ingested and lysed
by lysosomes
intracellular survival and multiplication
•Endotoxin

14
Diagnosis of Typhoid Fever
 Clinical:
 For Lab diagnosis, specimen & diagnostic tests
according to duration of fever:

1. Blood for Culture


2. WIDAL
3. Stool culture
4. Urine culture

15
Blood Culture
 In blood culture bottle
 Repeated cultures may be required
 Subculture on MacConkey medium (NLF colony)

 Clot culture- put clot in blood culture bottle, lyse it


with streptokinase in B/C bottle
 Use serum for WIDAL

16
 Selective media for subculture from blood
culture bottle: MacConkey, Wilson Blair,
Tellurite blood agar

 Enrichment broth for culture of stool/urine:


Selenite F broth, Tetrathionate broth

17
Serological test- WIDAL
 For detecting antibody
 Agglutination test
1. Endemic titre
2. Paired sera

 For carriers - antibody against Vi antigen


 Rapid test- Typhi dot

18
Treatment, prevention & control of
salmonella infections
Enteritis:
 Antibiotics not recommended for enteritis
because prolong duration
 Control by proper preparation of poultry & eggs

Enteric fever:
 Antibiotics- Chloramphenicol, cipriflox,
Ceftriaxone
 Identify & treat carriers of S. typhi & S. paratyphi
 Vaccination can reduce risk of disease for
travellers in endemic areas
19
Salmonella vaccines
 TAB: Salmonella typhi, paratyphi A &B, killed
whole cell
 Oral Ty21-A: Live attenuated, Salmonella
typhi vaccine
 Vi capsular polysaccharide vaccine

20
Summary- Enteric fever
 S. typhi / S. paratyphi
 Mode of spread /Pathogenesis
 Clinical features / Complications
 Laboratory diagnosis
 Treatment/vaccines

21

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