Salmonella is a genus of rod-shaped, Gram-negative,
non-spore-forming, predominantly motile enterobacteria with diameters around
0.7 to 1.5 µm, lengths from 2 to 5 µm, and flagella which grade in all
directions (i.e. peritrichous). They are chemoorganotrophs, obtaining their
energy from oxidation and reduction reactions using organic sources, and are
facultative anaerobes. Most species produce hydrogen sulfide, which can readily
be detected by growing them on media containing ferrous sulfate, such as TSI.
Most isolates exist in two phases: a motile phase I and a nonmotile phase II.
Cultures that are
nonmotile upon primary culture may be switched to the motile
phase using a Cragie tube.
Salmonella is closely related to the Escherichia genus
and are found worldwide in cold- and warm-blooded animals (including humans),
and in the environment. They cause illnesses like typhoid fever, paratyphoid
fever, and the foodborne illness.
Salmonella is typically pronounced with the initial
letter "L," although it is named for pathologist Daniel Elmer Salmon.
Salmonella infections are zoonotic and can be transferred
between humans and nonhuman animals. Many infections are due to ingestion of
contaminated food. A distinction is made between enteritis Salmonella and
typhoid/paratyphoid Salmonella, where the latter — because of a special
virulence factor and a capsule protein (virulence antigen) — can cause serious
illness, such as Salmonella enterica subsp. enterica serovar Typhi. Salmonella
typhi. is adapted to humans and does not occur in animals.
This is a group consisting of potentially all other
serotypes (over a thousand) of the Salmonella bacterium, most of which have
never been found in humans. These are encountered in various Salmonella
species, most having never been linked to a specific host, and can also infect
humans. It is therefore a zoonotic disease. The organism enters through the
digestive tract and must be ingested in large numbers to cause disease in
healthy adults. Gastric acidity is responsible for the destruction of the
majority of ingested bacteria. The infection usually occurs as a result of
massive ingestion of foods in which the bacteria are highly concentrated
similarly to a culture medium. However, infants and young children are much
more susceptible to infection, easily achieved by ingesting a small number of
bacteria. It has been shown that, in infants, the contamination could be
through inhalation of bacteria-laden dust. After a short incubation period of a
few hours to one day, the germ multiplies in the intestinal lumen causing an
intestinal inflammation with diarrhea that is often muco-purulent and bloody.
In infants, dehydration can cause a state of severe toxicosis. The symptoms are
usually mild. There is normally no sepsis, but it can occur exceptionally as a
complication in weakened elderly patients (Hodgkin's disease, eg.).
Extraintestinal localizations are possible, especially Salmonella meningitis in
children, osteitis, etc. Enteritis Salmonella (e.g., Salmonella enterica subsp.
enterica serovar enteritidis) can cause diarrhoea, which usually does not
require antibiotic treatment. However, in people at risk such as infants, small
children, the elderly, Salmonella infections can become very serious, leading
to complications. If these are not treated, HIV patients and those with
suppressed immunity can become seriously ill. Children with sickle cell anaemia
who are infected with Salmonella may develop osteomyelitis.
Salmonella can survive for weeks outside a living body.
They have been found in dried excrement after more than 2.5 years. Salmonella
are not destroyed by freezing. Ultraviolet radiation and heat accelerate their
demise; they perish after being heated to 55 °C (131 °F) for one hour, or to 60
°C (140 °F) for half an hour. To protect against Salmonella infection, it is
recommended that food be heated for at least ten minutes at 75 °C (167 °F) so
that the centre of the food reaches this temperature.
The AvrA toxin injected by the type three secretion
system of Salmonella typhimurium works to inhibit the innate immune system by
virtue of its serine/threonine acetyltransferase activity and requires binding
to eukaryotic target cell phytic acid (IP6). This leaves the host more
susceptible to infection. In a 2011 paper, Yale University School of Medicine
researchers described in detail how Salmonella is able to make these proteins
line up in just the right sequence to invade host cells. "These mechanisms
present us with novel targets that might form the basis for the development of
an entirely new class of anti-microbials," said Professor Dr. Jorge Galan,
senior author of the paper and the Lucille P. Markey Professor of Microbial
Pathogenesis and chair of the Section of Microbial Pathogenesis at Yale. In the
new National Institutes of Health (NIH)-funded study, Galan and colleagues
(Maria Lara-Tejero, Junya Kato, Samuel Wagner, and Xiaoyun Liu) identify what
they call a bacterial sorting platform, which attracts needed proteins and
lines them up in a specific order. If the proteins do not line up properly,
Salmonella, as well as many other bacterial pathogens, cannot
"inject" them into host cells to commandeer host cell functions, the lab
has found. Understanding how this machine works raises the possibility that new
therapies can be developed which disable this protein delivery machine and
therefore thwart the ability of the bacterium to become pathogenic. The process
would not kill the bacteria as most antibiotics do, but would cripple its
ability to do harm. In theory, this means that bacteria such as Salmonella
might not develop resistance to new therapies as quickly as they usually do to
conventional antibiotics.
The genus Salmonella was named after Daniel Elmer Salmon,
an American veterinary pathologist. While Theobald Smith was the actual
discoverer of the type bacterium (Salmonella enterica var. choleraesuis) in
1885, Dr. Salmon was the administrator of the USDA research program, and thus the
organism was named after him. Smith and Salmon had been searching for the cause
of common hog cholera and proposed this organism as the causal agent. Later
research, however, would show that this organism (now known as Salmonella
enterica) rarely causes enteric symptoms in pigs, and was thus not the agent
they were seeking (which was eventually shown to be a virus). However, related
bacteria in the genus Salmonella were eventually shown to cause other important
infectious diseases.
Salmonella nomenclature is complicated. Initially, each
Salmonella species was named according to clinical considerations, e.g.,
Salmonella typhi-murium (mouse typhoid fever), S. cholerae-suis (hog cholera).
After it was recognized that host specificity did not exist for many species,
new strains (or serovar, short for serological variants) received species names
according to the location at which the new strain was isolated. Later,
molecular findings led to the hypothesis that Salmonella consisted of only one
species, S. enterica, and the serovar were classified into six groups, two of
which are medically relevant. But as this now formalized nomenclature is not in
harmony with the traditional usage familiar to specialists in microbiology and
infectologists, the traditional nomenclature is common. Currently, there are
two recognized species: S. enterica and S. bongori, with six main subspecies:
enterica (I), salamae (II), arizonae (IIIa), diarizonae (IIIb), houtenae (IV),
and indica (VI). Historically, serotype (V) was bongori, which is now
considered its own species. The serovar classification of Salmonella is based
on the Kauffman-White classification scheme that permits serological varieties
to be differentiated from each other. Newer methods for Salmonella typing and
subtyping include genome-based methods such as pulsed field gel electrophoresis
(PFGE), Multiple Loci VNTR Analysis (MLVA), Multilocus sequence typing (MLST)
and (multiplex-) PCR-based methods.
Serovar Typhimurium has considerable diversity and may be
very old. The majority of the isolates belong to a single clonal complex.
Isolates are divided into phage types, but some phage types do not have a
single origin as determined using mutational changes. Phage type DT104 is
heterogeneous and represented in multiple sequence types, with its
multidrug-resistant variant being the most successful and causing epidemics in
many parts of the world.
Serovar Typhi is relatively young compared to
Typhimurium, and probably originated approximately 30,000-50,000 years ago.
Sources of infection
Infected food,
often gaining an unusual color, odor, or chewiness, that is then introduced
into the stream of commerce;
Poor kitchen
hygiene, especially problematic in institutional kitchens and restaurants
because this can lead to a significant outbreak;
Excretions from
either sick or infected but apparently clinically healthy people and animals
(especially endangered are caregivers and animals);
Polluted
surface water and standing water (such as in shower hoses or unused water
dispensers);
Unhygienically
thawed fowl (the meltwater contains many bacteria);
An association
with reptiles (pet tortoises, snakes, and frogs, but primarily aquatic turtles)
is well described.
Salmonella bacteria can survive several weeks in a dry
environment and several months in water; thus, they are frequently found in
polluted water, contamination from the excrement of carrier animals being
particularly important. Aquatic vertebrates, notably birds and reptiles, are
important vectors of Salmonella. Poultry, cattle, and sheep frequently being
agents of contamination, salmonella can be found in food, especially in milk,
meats and sometimes in eggs which have cracks.
About 142,000 (reported) Americans are infected each year
with Salmonella enteritidis from chicken eggs, and about 30 die. The shell of
the egg may be contaminated with Salmonella by faeces or environment, or its
interior (yolk) may be contaminated by penetration of the bacteria through the
porous shell or from a hen whose infected ovaries contaminate the egg during
egg formation. Nevertheless, such interior egg yolk contamination is
theoretically unlikely. Even under natural conditions, the rate of infection
was found to be very small (0.6% in a study of naturally-contaminated eggs and
3.0% among artificially- and heavily-infected hens). A recent analysis of death
certificates in the United States identified a total of 1,316
Salmonella-related deaths between the years 1990 to 2006. These were
predominately among older adults and those who were immunocompromised.
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