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Itoh N, Akazawa N, Yamaguchi M, Ishibana Y, Murakami H, Ohkusu K, Ohkusu M, Ishiwada N. Pyelonephritis with bacteremia caused by Salmonella Choleraesuis in a Japanese patient with carcinoma of unknown primary origin: A case report. J Infect Chemother 2024:S1341-321X(24)00101-6. [PMID: 38552839 DOI: 10.1016/j.jiac.2024.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/31/2024] [Accepted: 03/26/2024] [Indexed: 04/01/2024]
Abstract
Salmonella enterica subspecies enterica serovar Choleraesuis (S. Choleraesuis) is a nontyphoidal Salmonella pathogen that causes swine paratyphoids. S. Choleraesuis is a zoonotic pathogen transmitted to humans via contaminated food and causes sepsis. Here, we report a rare case of pyelonephritis caused by S. Choleraesuis in a Japanese patient with a carcinoma of unknown primary origin. On the day of admission, the patient was diagnosed with pyelonephritis associated with ureteral stent obstruction. He had no history of raw pork consumption or gastrointestinal symptoms. Gram-negative rods were isolated from urine and blood cultures, identified as Salmonella enterica subsp. enterica using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The serological typing results were O7: -: 1 and 5; however, the serotypes could not be determined. The isolate was identified as S. Choleraesuis using multilocus sequence typing, nucleotide sequence analysis of the fliC gene, and biochemical examination. Four days after a 14-day course of intravenous piperacillin-tazobactam (9 g/day), the patient showed relapse of the condition. Subsequently, the patient was treated with intravenous ceftriaxone (2 g/day) and oral amoxicillin (1000 mg/day) for 14 days each; recurrence was not observed. This novel case of pyelonephritis with bacteremia was caused by S. Choleraesuis in Japan. Conventional testing methods could not identify the serotypes; however, the case highlights the importance of adopting advanced diagnostic techniques based on molecular biology to ensure accurate pathogen identification.
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Affiliation(s)
- Naoya Itoh
- Division of Infectious Diseases, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan.
| | - Nana Akazawa
- Division of Infectious Diseases, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Makoto Yamaguchi
- Division of Infectious Diseases, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Yuichi Ishibana
- Division of Infectious Diseases, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Hiromi Murakami
- Division of Infectious Diseases, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Kiyofumi Ohkusu
- Department of Microbiology, Tokyo Medical University, 6-1-1 Shinjuku-ku, Shinjuku, Tokyo, 160-8402, Japan
| | - Misako Ohkusu
- Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, 260-8673, Japan
| | - Naruhiko Ishiwada
- Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, 260-8673, Japan
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2
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Mokraoui NR, Ganim R, Paez A. Chest wall abscess and costochondritis due to Salmonella enterica serotype Choleraesuis: a case report. J Med Case Rep 2023; 17:502. [PMID: 38053106 DOI: 10.1186/s13256-023-04229-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 10/26/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Salmonella enterica serotype Choleraesuis infections usually cause self-limited gastrointestinal diseases. Extra-abdominal infections are often secondary to bacteremia in immunocompromised individuals and are relatively rare in immunocompetent hosts. CASE PRESENTATION A 65-year-old Caucasian female initially presented to the thoracic surgery clinic due to a poorly healing wound on her chest. Her condition started after a mechanical fall hitting her chest with interval development of a tender lump that later spontaneously drained. A chest computed tomography scan with intravenous contrast demonstrated an abnormal infiltration with small foci of fluid and air consistent with a small abscess anterior to the left seventh costal cartilage. Aspirate culture of the abscess grew S. enterica serotype Choleraesuis susceptible to ampicillin and trimethoprim/sulfamethoxazole. The patient had no prior history of signs or symptoms of gastrointestinal infection. Blood cultures were negative. With a background of penicillin allergy, she was treated with trimethoprim/sulfamethoxazole, and later with ceftriaxone due to persistent drainage of the wound. Follow-up chest computed tomography scan with intravenous (IV) contrast showed continued abnormal findings previously seen in the computed tomography scan with the appearance of a sinus tract. The patient subsequently underwent surgical debridement and partial resection of the left seventh costochondral cartilage and excision of the fistula. She had an uneventful recovery and complete resolution of her condition. CONCLUSION We report a rare case of chest wall abscess with associated costochondritis due to S. enterica serotype Choleraesuis in a patient with no evidence of immunodeficiency nor history of bacteremia. Extraintestinal infections due to Salmonella without documented bacteremia have been previously reported in the literature. History of local trauma to the affected area might contribute to the seeding of infection. Diagnosis is often accomplished by clinical evaluation and culture of the affected area. Treatment often involves targeted antibiotic therapy but may require surgical intervention to achieve source control and cure.
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Affiliation(s)
- Nassim R Mokraoui
- Division of Infectious Diseases, UMass Chan Medical School-Baystate, Springfield, MA, 01199, USA.
| | - Rose Ganim
- Division of Thoracic Surgery, UMass Chan Medical School-Baystate, Springfield, MA, 01199, USA
| | - Armando Paez
- Division of Infectious Diseases, UMass Chan Medical School-Baystate, Springfield, MA, 01199, USA
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Soliani L, Rugna G, Prosperi A, Chiapponi C, Luppi A. Salmonella Infection in Pigs: Disease, Prevalence, and a Link between Swine and Human Health. Pathogens 2023; 12:1267. [PMID: 37887782 PMCID: PMC10610219 DOI: 10.3390/pathogens12101267] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/12/2023] [Accepted: 10/20/2023] [Indexed: 10/28/2023] Open
Abstract
Salmonella is one of the most spread foodborne pathogens worldwide, and Salmonella infections in humans still represent a global health burden. The main source of Salmonella infections in humans is represented by contaminated animal-derived foodstuffs, with pork products being one of the most important players. Salmonella infection in swine is critical not only because it is one of the main causes of economic losses in the pork industry, but also because pigs can be infected by several Salmonella serovars, potentially contaminating the pig meat production chain and thus posing a significant threat to public health globally. As of now, in Europe and in the United States, swine-related Salmonella serovars, e.g., Salmonella Typhimurium and its monophasic variant Salmonella enterica subsp. enterica 1,4,[5],12:i:-, are also frequently associated with human salmonellosis cases. Moreover, multiple outbreaks have been reported in the last few decades which were triggered by the consumption of Salmonella-contaminated pig meat. Throughout the years, changes and evolution across the pork industry may have acted as triggers for new issues and obstacles hindering Salmonella control along the food chain. Gathered evidence reinforces the importance of coordinating control measures and harmonizing monitoring programs for the efficient control of Salmonella in swine. This is necessary in order to manage outbreaks of clinical disease in pigs and also to protect pork consumers by controlling Salmonella subclinical carriage and shedding. This review provides an update on Salmonella infection in pigs, with insights on Salmonella ecology, focusing mainly on Salmonella Choleraesuis, S. Typhimurium, and S. 1,4,[5],12:i:-, and their correlation to human salmonellosis cases. An update on surveillance methods for epidemiological purposes of Salmonella infection in pigs and humans, in a "One Health" approach, will also be reported.
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Affiliation(s)
- Laura Soliani
- Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia-Romagna (IZSLER), 25124 Brescia, Italy; (G.R.); (A.P.); (C.C.); (A.L.)
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Papić B, Kušar D, Mićunović J, Vidrih Š, Pirš M, Ocepek M, Avberšek J. Genomic insights into Salmonella Choleraesuis var. Kunzendorf outbreak reveal possible interspecies transmission. Vet Microbiol 2021; 263:109282. [PMID: 34785475 DOI: 10.1016/j.vetmic.2021.109282] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 10/19/2022]
Abstract
Salmonella enterica serovar Choleraesuis is a host-adapted serovar that causes serious infections in domestic pigs and wild boars. Here, we investigated an outbreak of salmonellosis in domestic pigs in Slovenia, 2018-2019. To assess the outbreak, 18 isolates from domestic pigs, wild boars, wild boar meat and a human patient underwent whole-genome sequencing (WGS). All isolates were of sequence type (ST) 145 and harbored no antimicrobial resistance genes or AMR-associated mutations. A single transmission cluster (≤ 6 alleles) of spatially (< 100 km) and temporally linked isolates was observed, comprising isolates of pig (n = 9), wild boar (n = 2) and human (n = 1) origin, and suggesting possible interspecies transmission. In all outbreak-related animal cases, septicemic salmonellosis was observed, accompanied in some cases by enteric symptoms. All pig isolates were linked to a single intensive breeding farm that distributed growers to small family farms. The same transport vehicles were used to distribute growers to family farms and also to transport livestock between neighboring countries. Both isolates that originated from the imported wild boar meat were genetically distant (≥ 122 alleles) from the outbreak cluster. The present results indicate the importance of screening domestic pigs and proper disinfection of transport vehicles to control the spread of S. Choleraesuis.
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Affiliation(s)
- Bojan Papić
- University of Ljubljana, Veterinary Faculty, Institute of Microbiology and Parasitology, Gerbičeva 60, SI-1000 Ljubljana, Slovenia.
| | - Darja Kušar
- University of Ljubljana, Veterinary Faculty, Institute of Microbiology and Parasitology, Gerbičeva 60, SI-1000 Ljubljana, Slovenia
| | - Jasna Mićunović
- University of Ljubljana, Veterinary Faculty, Institute of Microbiology and Parasitology, Gerbičeva 60, SI-1000 Ljubljana, Slovenia
| | - Špela Vidrih
- University of Ljubljana, Veterinary Faculty, National Veterinary Institute, Gerbičeva 60, SI-1000 Ljubljana, Slovenia
| | - Mateja Pirš
- University of Ljubljana, Faculty of Medicine, Institute of Microbiology and Immunology, Zaloška 4, SI-1000 Ljubljana, Slovenia
| | - Matjaž Ocepek
- University of Ljubljana, Veterinary Faculty, Institute of Microbiology and Parasitology, Gerbičeva 60, SI-1000 Ljubljana, Slovenia
| | - Jana Avberšek
- University of Ljubljana, Veterinary Faculty, Institute of Microbiology and Parasitology, Gerbičeva 60, SI-1000 Ljubljana, Slovenia
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Martínez-Puchol S, Riveros M, Ruidias K, Granda A, Ruiz-Roldán L, Zapata-Cachay C, Ochoa TJ, Pons MJ, Ruiz J. Dissemination of a multidrug resistant CTX-M-65 producer Salmonella enterica serovar Infantis clone between marketed chicken meat and children. Int J Food Microbiol 2021; 344:109109. [PMID: 33677191 DOI: 10.1016/j.ijfoodmicro.2021.109109] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 02/03/2021] [Accepted: 02/15/2021] [Indexed: 02/07/2023]
Abstract
The objective of the present study was to characterize Salmonella enterica serovar Infantis isolated from chicken meat determining their clonal relationships with S. Infantis isolated from children with diarrhea. Fifteen meat-recovered S. Infantis were analyzed. Susceptibility levels to 14 antibacterial agents, the presence of ESBL and that of inducible plasmid-mediated AmpC (i-pAmpC) were determined by phenotypical methods. The presence of ESBL and pAmpC was confirmed by PCR, and detected ESBL-encoding genes were sequenced and their transferability tested by conjugation. The presence of gyrA mutations as well as Class 1 integrons was determined by PCR. Clonal relationships were established by REP-PCR and RAPD. In addition, 25 clinical isolates of S. Infantis were included in clonality studies. All meat-recovered S. Infantis were MDR, showing resistance to ampicillin, nitrofurans and quinolones, while none was resistant to azithromycin, ceftazidime or imipenem. ESBL (blaCTX-M-65) and i-pAmpC (blaDHA) were detected in 2 and 5 isolates respectively (in one case concomitantly), with blaCTX-M-65 being transferable through conjugation. In addition, 1 isolate presented a blaSHV gene. All isolates presented D87Y at GyrA, nalidixic acid active efflux pump and a Class 1 integron of ~1000 bp (aadA1). Clonal analysis showed that all isolates were related. Further they were identical to MDR blaCTX-M-65-producing S. Infantis isolates causing children diarrhea in Lima. The dissemination of MDR blaCTX-M-65-producing S. Infantis between marketed meat and children highlights a public health problem which needs be controlled at livestock level.
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Affiliation(s)
| | - Maribel Riveros
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Kenny Ruidias
- Universidad Nacional Federico Villarreal, Lima, Peru
| | - Ana Granda
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Lidia Ruiz-Roldán
- ISGlobal Hospital Clinic - Universitat de Barcelona, Barcelona, Spain
| | - Cristhian Zapata-Cachay
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Theresa J Ochoa
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru; University of Texas, Houston, TX, USA
| | - Maria J Pons
- ISGlobal Hospital Clinic - Universitat de Barcelona, Barcelona, Spain; Universidad Científica del Sur, Lima, Peru
| | - Joaquim Ruiz
- ISGlobal Hospital Clinic - Universitat de Barcelona, Barcelona, Spain; Universidad Científica del Sur, Lima, Peru.
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Rödel J, Edel B, Braun SD, Ehricht R, Simon S, Fruth A, Löffler B. Simple differentiation of Salmonella Typhi, Paratyphi and Choleraesuis from Salmonella species using the eazyplex TyphiTyper LAMP assay. J Med Microbiol 2020; 69:817-823. [DOI: 10.1099/jmm.0.001201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction. Identification of typhoidal
Salmonella
(TS) serovars and their discrimination from non-typhoidal
Salmonella
(NTS) is conventionally performed by seroagglutination. This method is labour-intensive, requires technical experience and can be inconclusive in some cases. Molecular assays may be reliable alternative diagnostic tools.
Aim. This study was designed to evaluate the eazyplex TyphiTyper based on loop-mediated isothermal amplification (LAMP) for fast identification of TS and S. Choleraesuis in culture.
Methodology. A total of 121
Salmonella
strains and 33 isolates of other
Enterobacterales
species were tested by the eazyplex TyphiTyper. Simulated and clinical blood cultures (BCs) were used to examine the performance of the assay for diagnosis of systemic infection. Sample preparation took about 5 min and the test running time was 20 min. Amplification was measured by real-time fluorescence detection.
Results. All TS and S. Choleraesuis strains were correctly identified. The most common NTS S. Typhimurium (n=34) and S. Enteritidis (n=15) were detected as
Salmonella
species without any false positive result for TS targets. Cross-reactions of NTS with TS were only rarely observed. Direct testing of positive BCs gave correct results. Sensitivities and specificities of the assay were as follows: 100 and 99.3 % for S. Typhi, 100 and 98.7 % for S. Paratyphi A, 100 and 97.3 % for S. Paratyphi B, 100 and 100 % for S. Paratyphi C, 100 and 100 % for S. Choleraesuis, and 100 and 100 % for
Salmonella
species, respectively.
Conclusion. The eazyplex TyphiTyper is very easy to perform and allows the rapid identification of TS and S. Choleraesuis isolates.
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Affiliation(s)
- Jürgen Rödel
- Institute of Medical Microbiology, Jena University Hospital, Jena, Germany
| | - Birgit Edel
- Institute of Medical Microbiology, Jena University Hospital, Jena, Germany
| | - Sascha D. Braun
- Leibniz Institute of Photonic Technology (IPHT), Jena, Germany
| | - Ralf Ehricht
- Institute of Physical Chemistry, Friedrich Schiller University of Jena, Jena, Germany
- Leibniz Institute of Photonic Technology (IPHT), Jena, Germany
| | - Sandra Simon
- Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and Other Enteric Bacterial Pathogens, Robert Koch Institute, Wernigerode, Germany
| | - Angelika Fruth
- Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and Other Enteric Bacterial Pathogens, Robert Koch Institute, Wernigerode, Germany
| | - Bettina Löffler
- Institute of Medical Microbiology, Jena University Hospital, Jena, Germany
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Salmonella neck abscess in a diabetic. IDCases 2019; 17:e00541. [PMID: 31384558 PMCID: PMC6667484 DOI: 10.1016/j.idcr.2019.e00541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 04/17/2019] [Accepted: 04/17/2019] [Indexed: 11/21/2022] Open
Abstract
Salmonella is known to cause invasive illness. However, head and neck abscesses are an unusual presentation of extra-intestinal infection with this organism. We describe a case of Salmonella neck abscess in a diabetic patient. An 18 year old diabetic male was admitted with increasing left sided neck pain and swelling approximately four weeks after gastrointestinal illness. Imaging revealed a left sided neck abscess. Surgical drainage was undertaken. Cultures grew non-typhoid Salmonella species. He was treated with intravenous antibiotics and did well clinically. Salmonella infection should be considered in the differential diagnosis of patients with immunocompromising conditions presenting with neck abscess of unclear etiology.
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