Difference between revisions of "Salmonella"

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*Clinical outcome depends on number of bacteria ingested, virulence of serotype, susceptibility of host
 
*Clinical outcome depends on number of bacteria ingested, virulence of serotype, susceptibility of host
 
*Young and debilitated animals susceptible
 
*Young and debilitated animals susceptible
*''S.'' Tymphimurium infects many species; causes severe diarrhoea; non-invasive; causes of food poisoning in humans, e.g. from infected poultry
+
*''Salmonella'' serotypes:
*''S. enteritidis'': non species-specific; losses in young birds; causes food poisoning in humans
+
**''S.'' Tymphimurium infects many species; causes severe diarrhoea; non-invasive; causes of food poisoning in humans, e.g. from infected poultry
*''S.'' Dublin: invasive serovar; infects cattle
+
**''S. enteritidis'': non species-specific; losses in young birds; causes food poisoning in humans
*''S.'' Cholerae-Suis: primarily infects pigs; also causes severe human disease
+
**''S.'' Dublin: invasive serovar; infects cattle
*''S.'' Pullorum: infects poultry; egg-transmitted; causes bacillary white diarrhoea, known as pullorum disease
+
**''S.'' Cholerae-Suis: primarily infects pigs; also causes severe human disease
*''S.'' Gallinarum: infectes older birds; known as howl typhoid
+
**''S.'' Pullorum: infects poultry; egg-transmitted; causes bacillary white diarrhoea, known as pullorum disease
*''S.'' Pullorum and ''S.'' Gallinarum now rare in UK due to eradication programs including the Pullorum test (whole blood slide agglutination to detect antibody to both ''S.'' Pullorum and ''S'' Gallinarum
+
**''S.'' Gallinarum: infectes older birds; known as howl typhoid
*''S.'' Abortis-ovis: infects sheep
+
**''S.'' Pullorum and ''S.'' Gallinarum now rare in UK due to eradication programs including the Pullorum test (whole blood slide agglutination to detect antibody to both ''S.'' Pullorum and ''S'' Gallinarum
*''S.'' Abortus-equi: infects horses outside of the UK
+
**''S.'' Abortis-ovis: infects sheep
*''S.'' Typhi, ''S.'' Paratyphi: infect humans
+
**''S.'' Abortus-equi: infects horses outside of the UK
 +
**''S.'' Typhi, ''S.'' Paratyphi: infect humans
 
*Most human infections contracted from animals, especially poulty and cattle
 
*Most human infections contracted from animals, especially poulty and cattle
*Enteric and septicaemic forms of salmonellosis
+
*Enteric salmonellosis:
 +
**Enterocolitis occurs in most farm animal species affecting all ages
 +
**[[Intestines - Ulcerative Enteritis|ulcerative enteritis]]
 +
**Fever, depression, anorexia, foul-smelling diarrhoea containing blood, mucus and epithelial casts
 +
**Dehydration and weight loss
 +
**Abortion
 +
**Fatal within days in severely young animals
 +
**Milder syndrome where endemic on farms, possibly due to acquired immunity
 +
**Chronic enterocolitis can occur in surviving pigs, cattle, horses, causing intermittent fever, soft faeces and gradual weight loss
 +
*Septicaemic salmonellosis:
 +
**Most common in calves, neonatal foals, pigs under one month
 +
**Sudden onset fever, depression, recumbency
 +
**Die within 48 hours if not treated
 +
**Persistent diarrhoea, meningitis, arthritis or pneumonia may occur in surviving animals
 +
**Can cause in [[Bones - inflammatory#Osteomyelitis|Osteomyelitis]]
 +
**Found in [[Joints - inflammatory#In Horses|arthritis of horses]]
 +
**Can cause haemorrhagic disease by [[General Pathology - Haemostasis#Secondary Thrombocytopenic Disease|secondary thrombocytopenic disease]]
 
*Bovine [[Intestines - Fibrinous/ Haemorrhagic Enteritis#Salmonellosis|Salmonellosis]]:
 
*Bovine [[Intestines - Fibrinous/ Haemorrhagic Enteritis#Salmonellosis|Salmonellosis]]:
 
**Syndrome of fever and diarrhoea (with dysentery), often fatal, in calves and adult cattle
 
**Syndrome of fever and diarrhoea (with dysentery), often fatal, in calves and adult cattle
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**An important zoonosis and reportable
 
**An important zoonosis and reportable
 
**Carrier animals important for spread
 
**Carrier animals important for spread
*A cause of [[Intestines - Ulcerative Enteritis|ulcerative enteritis]] in the pig.
+
 
*Can cause haemorrhagic disease by [[General Pathology - Haemostasis#Secondary Thrombocytopenic Disease|secondary thrombocytopenic disease]].
 
*''Salmonella'' in [[Bones - inflammatory#Osteomyelitis|Osteomyelitis]]
 
* In [[Joints - inflammatory#In Horses|arthritis of horses]]
 
  
 
===Diagnosis===
 
===Diagnosis===

Revision as of 10:23, 17 February 2008

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Overview

  • Important member of the enterobacteria
  • Cause disease in humans and animals worldwide
  • Reservior of infection in poulty, pigs, rodents, cattle, dogs
  • Bacteria may be present in water, soil, animal feed, raw meat
  • Cause enteritis and systemic infection (septicaemia and abortion)
  • Salmonella may be carried sub-clinically
  • Some human strains cause enteric fever (S. Typhi causes typhoid), also gastroenteritis, septicaemia or bacteraemia

Characteristics

  • Gram negative bacilli
  • Facultative intracellular pathogens
  • Non-lactose fermentor, oxidase negative
  • Do not produce urease or indole from tryptophan
  • Utilise citrate as a carbon source
  • Reduce nitrates to nitrites
  • Grow on MacConkey
  • Ferment glucose to produce acid and gas
  • Usually produce hydrogen sulphide
  • Most motile with flagellae (H antigen)
  • H antigen can be in phase 1 or phase 2, depending on a genetic switch allowing for one of the H antigen genes to be transcribed at any one time

Classification

  • Single species, Salmonella enterica
  • Over 2400 pathogenic serotypes or serovars identified
  • Grouped into 9 groups according to Somatic, O antigen (lipopolysaccharide) by the Kauffmann-White scheme - determined by slide agglutination of the bacteria with specific antisera
  • Categorised into serovars depending on and H (Flagellar) antigen, e.g. Salmonella enterica subspecies enterica serovar Tymphimurium; must also determine phase of H antigen (isolates must be in phase 1 to be typed)
  • Most animal and human isolates in Groups B to E

Pathogenicity

  • Faecal-oral transmission
  • Infection frequently transmitted from faeces of rodents and birds
  • Young, immunocompromised animals particularly susceptible
  • Comparitively large dose required for infection due to gastric acid, normal intestinal flora and local immunity
  • Enterocolitis:
    • Acute enteritis
    • Bacteria adhere to intestinal epithelial cells in the ileum and colon, probably via fimbrae, O antigen and flagellar H antigen
    • Multiply in and destroy epithelial cells
    • Cytotoxin may cause epithelial cell damage by inhibiting protein synthesis and causing calcium escape from cells
    • Enterotoxin may induce fluid secretion into intestinal lumen
    • Degeneration of microvilli
  • Systemic disease:
    • Bacteria invade and replicate in host cells and resist phagocytosis and destruction by complement
    • Bacteria internalised by intestinal epithelial cells by inducing ruffling of cell membranes and uptake into vesicles
    • The organisms replicate within the vesicles and are released from the cells
    • Stimulate immune response on reaching the lamina propria
    • Acute inflammation, possibly with ulceration; prostaglandin and cytokine production by epithelial cells; enterotoxin production damaging mucosa
    • Phagocytosis of bacteria by neutrophils and macrophages
    • Bacteria either destroyed by the phagocytic cells or survive and multiply in the cells to cause systemic disease
    • Resistance to phagocytosis and destruction by complement allows spread within the body - bacteraemia and septicaemia
    • LPS O antigens prevent damage to bacterial cell wall by complement
    • LPS also causes endotoxaemia, and may contribute to local inflammatory response damaging intestinal cells to cause diarrhoea
    • Endotoxic shock during septicaemic salmonellosis due to LPS
    • Intracellular carriage if bacteria no completely removed
    • Invasive potential of certain strains e.e Salmonella Dublin associated with carriage of a large plasmid, encoding genes to allow intracellular survival in macrophages and also to allow iron acquisition
    • Salmonellae are facultative intracellular organisms, allowing them to move from the gut in macrophages and cause a bacteraemia and lesions throughout the body
    • Possession of Pathogenicity Islands associated with virulence
  • Carriage:
    • Salmonellae can persist in the gut or gall bladder
    • Excreted in faeces after clinical signs disappeared - active carriage
    • Bacteria can survive intracellularly, avoiding the immune system and antimicrobials
    • May have latent carriage and intermittent excretion in faeces
    • Stresses e.g. transportaion, illness, parturition, overcrowding promote excretion in carrier animals and may cause clinical signs to be shown
    • Tortoises, terrapins, snakes and other reptiles ofter carry Salmonellae
    • Asymptomatic carriage allows faecal spread of infection


Clinical infections

  • Zoonotic
  • Outbreaks from contaminated imported meat and bone meal
  • Some serotypes are host-specific, some infect a wide range of species
  • Healthy adult carnivores are resistant to salmonellosis
  • Clinical outcome depends on number of bacteria ingested, virulence of serotype, susceptibility of host
  • Young and debilitated animals susceptible
  • Salmonella serotypes:
    • S. Tymphimurium infects many species; causes severe diarrhoea; non-invasive; causes of food poisoning in humans, e.g. from infected poultry
    • S. enteritidis: non species-specific; losses in young birds; causes food poisoning in humans
    • S. Dublin: invasive serovar; infects cattle
    • S. Cholerae-Suis: primarily infects pigs; also causes severe human disease
    • S. Pullorum: infects poultry; egg-transmitted; causes bacillary white diarrhoea, known as pullorum disease
    • S. Gallinarum: infectes older birds; known as howl typhoid
    • S. Pullorum and S. Gallinarum now rare in UK due to eradication programs including the Pullorum test (whole blood slide agglutination to detect antibody to both S. Pullorum and S Gallinarum
    • S. Abortis-ovis: infects sheep
    • S. Abortus-equi: infects horses outside of the UK
    • S. Typhi, S. Paratyphi: infect humans
  • Most human infections contracted from animals, especially poulty and cattle
  • Enteric salmonellosis:
    • Enterocolitis occurs in most farm animal species affecting all ages
    • ulcerative enteritis
    • Fever, depression, anorexia, foul-smelling diarrhoea containing blood, mucus and epithelial casts
    • Dehydration and weight loss
    • Abortion
    • Fatal within days in severely young animals
    • Milder syndrome where endemic on farms, possibly due to acquired immunity
    • Chronic enterocolitis can occur in surviving pigs, cattle, horses, causing intermittent fever, soft faeces and gradual weight loss
  • Septicaemic salmonellosis:
    • Most common in calves, neonatal foals, pigs under one month
    • Sudden onset fever, depression, recumbency
    • Die within 48 hours if not treated
    • Persistent diarrhoea, meningitis, arthritis or pneumonia may occur in surviving animals
    • Can cause in Osteomyelitis
    • Found in arthritis of horses
    • Can cause haemorrhagic disease by secondary thrombocytopenic disease
  • Bovine Salmonellosis:
    • Syndrome of fever and diarrhoea (with dysentery), often fatal, in calves and adult cattle
    • May cause abortion of pregnant cattle in absence of other signs
    • Septicaemia in neonates; accute enteritis in older calves
    • Caused by infection with various Salmonella serotypes, e.g. S. Dublin and S. Typhimurium
    • Chronic infections with S. Dublin in calves cause dry gangrene and bone lesions
    • An important zoonosis and reportable
    • Carrier animals important for spread


Diagnosis

Treatment

Control