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Singhal L, Sandhu D, Gupta V, Kour I. Salmonella Typhi: A Review of Antibiogram Journey in Developing Countries. Infect Disord Drug Targets 2024; 24:e230124225976. [PMID: 38265374 DOI: 10.2174/0118715265255339240102110929] [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: 06/13/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Typhoid fever poses a significant health challenge in low- and middleincome countries (LMiCs), impacting millions of individuals across various age groups. Its prevalence is particularly pronounced in South Asia. Factors contributing to its transmission in South Asia include rapid unplanned urbanization, urban-rural disparities, provision of poor water and sanitation facilities, and open defecation. The mortality rate of typhoid fever is up to 1%, and those who survive have a protracted period of poor health and carry an enormous financial burden. The treatment is further complicated by the emerging antibiotic resistance leaving few treatment options in hands. This issue has become more urgent due to the further emergence of extended drug-resistant (XDR) and multidrug-resistant (MDR) typhoid strains, as well as their subsequent global spread. Fluoroquinolone-resistant Salmonella spp. is currently classified by the World Health Organization (WHO) as a high (Priority 2) pathogen. As a result, establishing minimum inhibitory concentrations (MIC) according to the latest guidelines may prove effective in treating typhoid fever and minimizing the rising threat of drug resistance.
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Affiliation(s)
- Lipika Singhal
- Department of Microbiology, Government Medical College & Hospital, Chandigarh, 160030, India
| | - Diljot Sandhu
- Department of Microbiology, Government Medical College & Hospital, Chandigarh, 160030, India
| | - Varsha Gupta
- Department of Microbiology, Government Medical College & Hospital, Chandigarh, 160030, India
| | - Ivneet Kour
- Department of Microbiology, Government Medical College & Hospital, Chandigarh, 160030, India
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2
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Teklemariam AD, Al-Hindi RR, Albiheyri RS, Alharbi MG, Alghamdi MA, Filimban AAR, Al Mutiri AS, Al-Alyani AM, Alseghayer MS, Almaneea AM, Albar AH, Khormi MA, Bhunia AK. Human Salmonellosis: A Continuous Global Threat in the Farm-to-Fork Food Safety Continuum. Foods 2023; 12:foods12091756. [PMID: 37174295 PMCID: PMC10178548 DOI: 10.3390/foods12091756] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023] Open
Abstract
Salmonella is one of the most common zoonotic foodborne pathogens and a worldwide public health threat. Salmonella enterica is the most pathogenic among Salmonella species, comprising over 2500 serovars. It causes typhoid fever and gastroenteritis, and the serovars responsible for the later disease are known as non-typhoidal Salmonella (NTS). Salmonella transmission to humans happens along the farm-to-fork continuum via contaminated animal- and plant-derived foods, including poultry, eggs, fish, pork, beef, vegetables, fruits, nuts, and flour. Several virulence factors have been recognized to play a vital role in attaching, invading, and evading the host defense system. These factors include capsule, adhesion proteins, flagella, plasmids, and type III secretion systems that are encoded on the Salmonella pathogenicity islands. The increased global prevalence of NTS serovars in recent years indicates that the control approaches centered on alleviating the food animals' contamination along the food chain have been unsuccessful. Moreover, the emergence of antibiotic-resistant Salmonella variants suggests a potential food safety crisis. This review summarizes the current state of the knowledge on the nomenclature, microbiological features, virulence factors, and the mechanism of antimicrobial resistance of Salmonella. Furthermore, it provides insights into the pathogenesis and epidemiology of Salmonella infections. The recent outbreaks of salmonellosis reported in different clinical settings and geographical regions, including Africa, the Middle East and North Africa, Latin America, Europe, and the USA in the farm-to-fork continuum, are also highlighted.
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Affiliation(s)
- Addisu D Teklemariam
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Rashad R Al-Hindi
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Raed S Albiheyri
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Centre of Excellence in Bionanoscience Research, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Mona G Alharbi
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Mashail A Alghamdi
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Amani A R Filimban
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Abdullah S Al Mutiri
- Laboratory Department, Saudi Food and Drug Authority, Riyadh 12843, Saudi Arabia
| | - Abdullah M Al-Alyani
- Laboratory Department, Saudi Food and Drug Authority, Jeddah 22311, Saudi Arabia
| | - Mazen S Alseghayer
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Monitoring and Risk Assessment Department, Saudi Food and Drug Authority, Riyadh 13513, Saudi Arabia
| | - Abdulaziz M Almaneea
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Monitoring and Risk Assessment Department, Saudi Food and Drug Authority, Riyadh 13513, Saudi Arabia
| | - Abdulgader H Albar
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Department of Microbiology and Medical Parasitology, Faculty of Medicine, Jeddah University, Jeddah 23218, Saudi Arabia
| | - Mohsen A Khormi
- Department of Biological Sciences, Faculty of Sciences, Jazan University, Jazan 82817, Saudi Arabia
| | - Arun K Bhunia
- Molecular Food Microbiology Laboratory, Department of Food Science, Purdue University, West Lafayette, IN 47907, USA
- Purdue Institute of Inflammation, Immunology, and Infectious Disease, Purdue University, West Lafayette, IN 47907, USA
- Purdue University Interdisciplinary Life Science Program (PULSe), West Lafayette, IN 47907, USA
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN 47907, USA
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3
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Krzyżewska-Dudek E, Kotimaa J, Kapczyńska K, Rybka J, Meri S. Lipopolysaccharides and outer membrane proteins as main structures involved in complement evasion strategies of non-typhoidal Salmonella strains. Mol Immunol 2022; 150:67-77. [PMID: 35998438 DOI: 10.1016/j.molimm.2022.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/10/2022] [Accepted: 08/15/2022] [Indexed: 11/27/2022]
Abstract
Non-typhoidal Salmonella (NTS) infections pose a serious public health problem. In addition to the typical course of salmonellosis, an infection with Salmonella bacteria can often lead to parenteral infections and sepsis, which are particularly dangerous for children, the elderly and immunocompromised. Bacterial resistance to serum is a key virulence factor for the development of systemic infections. Salmonella, as an enterobacterial pathogen, has developed several mechanisms to escape and block the antibacterial effects of the complement system. In this review, we discuss the relevance of outer membrane polysaccharides to the complement evasion mechanisms of NTS strains. These include the influence of the overall length and density of the lipopolysaccharide molecules, modifications of the O-antigen lipopolysaccharide composition and the role of capsular polysaccharides in opsonization and protection of the outer membrane from the lytic action of complement. Additionally, we discuss specific outer membrane protein complement evasion mechanisms, such as recruitment of complement regulatory proteins, blocking assembly of late complement components to form the membrane attack complex and the proteolytic cleavage of complement proteins.
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Affiliation(s)
- E Krzyżewska-Dudek
- Department of Bacteriology and Immunology, Translational Immunology Research Program, University of Helsinki, and Diagnostic Center (HUSLAB), Helsinki University Hospital, 00290 Helsinki, Finland; Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wroclaw, Poland
| | - J Kotimaa
- Department of Bacteriology and Immunology, Translational Immunology Research Program, University of Helsinki, and Diagnostic Center (HUSLAB), Helsinki University Hospital, 00290 Helsinki, Finland
| | - K Kapczyńska
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wroclaw, Poland
| | - J Rybka
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wroclaw, Poland
| | - S Meri
- Department of Bacteriology and Immunology, Translational Immunology Research Program, University of Helsinki, and Diagnostic Center (HUSLAB), Helsinki University Hospital, 00290 Helsinki, Finland.
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4
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Murillo-Cerda FJ, Martínez-Reséndez MF. Typhoid encephalopathy as a neuropsychiatric manifestation of salmonellosis. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2021; 87:259-260. [PMID: 34794929 DOI: 10.1016/j.rgmxen.2021.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/19/2021] [Indexed: 11/29/2022]
Affiliation(s)
- F J Murillo-Cerda
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, Mexico.
| | - M F Martínez-Reséndez
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, Mexico
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5
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Karabasanavar N, Madhavaprasad C, Gopalakrishna S, Hiremath J, Patil G, Barbuddhe S. Prevalence of
Salmonella
serotypes
S
. Enteritidis and
S
. Typhimurium in poultry and poultry products. J Food Saf 2020. [DOI: 10.1111/jfs.12852] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Nagappa Karabasanavar
- Department of Veterinary Public Health & Epidemiology Veterinary College Shivamogga Karnataka India
| | | | - Shilpa Gopalakrishna
- Department of Veterinary Public Health & Epidemiology Veterinary College Shivamogga Karnataka India
| | - Jagadish Hiremath
- ICAR‐National Institute of Veterinary Epidemiology and Disease Informatics Bengaluru Karnataka India
| | - Girish Patil
- ICAR‐National Research Center on Meat Hyderabad Telangana Sate India
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6
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Kim GH, Lee JH, Kim SH. Salmonella Encephalopathy Treated with Early Use of Intravenous Immunoglobulin and Dexamethasone. ANNALS OF CHILD NEUROLOGY 2020. [DOI: 10.26815/acn.2020.00010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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7
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Mellon G, Eme AL, Rohaut B, Brossier F, Epelboin L, Caumes E. Encephalitis in a traveller with typhoid fever: efficacy of corticosteroids. J Travel Med 2017; 24:4339101. [PMID: 29088483 DOI: 10.1093/jtm/tax063] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 08/16/2017] [Indexed: 11/14/2022]
Abstract
Typhoid fever is a bacterial infection caused by Salmonella typhi or S. paratyphi, recognized as a classical cause of fever in returning travellers. However, neuropsychiatric presentations are rarely reported in travellers diagnosed in western countries, whereas they are more commonly described in patients treated in endemic areas. We describe such a case and discuss the pathophysiologic mechanisms of this complication.
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Affiliation(s)
- Guillaume Mellon
- Department of Infectious Diseases and Tropical Medicine, Assistance Publique-Hôpitaux de Paris, Pitié Salpétrière Hospital, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - Anne-Line Eme
- Department of Infectious Diseases and Tropical Medicine, Assistance Publique-Hôpitaux de Paris, Pitié Salpétrière Hospital, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - Benjamin Rohaut
- Department of Neurology, Assistance Publique-Hôpitaux de Paris, Pitié Salpétrière Hospital, 47-83 Boulevard de l'Hôpital, 75013 Paris, France.,Sorbonne Universités, UPMC, Medical School Paris 6 University, Paris, France
| | - Florence Brossier
- Department of Microbiology, Assistance Publique-Hôpitaux de Paris, Pitié Salpétrière Hospital, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - Loïc Epelboin
- Department of Infectious Diseases and Tropical Medicine, Assistance Publique-Hôpitaux de Paris, Pitié Salpétrière Hospital, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - Eric Caumes
- Department of Infectious Diseases and Tropical Medicine, Assistance Publique-Hôpitaux de Paris, Pitié Salpétrière Hospital, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
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8
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Eng SK, Pusparajah P, Ab Mutalib NS, Ser HL, Chan KG, Lee LH. Salmonella: A review on pathogenesis, epidemiology and antibiotic resistance. FRONTIERS IN LIFE SCIENCE 2015. [DOI: 10.1080/21553769.2015.1051243] [Citation(s) in RCA: 131] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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9
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Noda M. [Studies on the mode of action of bacterial AB5 toxins]. Nihon Saikingaku Zasshi 2013; 68:299-311. [PMID: 23985936 DOI: 10.3412/jsb.68.299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Bacterial AB5 toxins are proteins, produced by pathogenic bacteria including of Vibrio cholerae, Shigella dysenteriae, and enterohaemorrhagic Escherichia coli, which are usually released into the extracellular medium and cause disease by killing or altering the metabolism of target eukaryotic cells. The toxins are usually composed of one A subunit (a toxic domain) and five B subunits (a receptor-binding domain). This article overviews the characteristics and mode of actions of AB5 toxins including cholera toxin, Shiga-like toxin, and subtilase cytotoxin, and highlights current topics related to the roles of the effectors in promoting bacterial infection.
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Affiliation(s)
- Masatoshi Noda
- Department of Molecular Infectiology, Chiba University Graduate School of Medicine, Japan
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10
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Sánchez-Vargas FM, Abu-El-Haija MA, Gómez-Duarte OG. Salmonella infections: an update on epidemiology, management, and prevention. Travel Med Infect Dis 2011; 9:263-77. [PMID: 22118951 DOI: 10.1016/j.tmaid.2011.11.001] [Citation(s) in RCA: 149] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2011] [Revised: 09/30/2011] [Accepted: 11/03/2011] [Indexed: 01/01/2023]
Abstract
Salmonella species are a group of Gram-negative enterobacteria and known human pathogens in developing as well as industrialized countries. Despite significant advances in sanitation, provision of potable water, and highly controlled food chain surveillance, transmission of Salmonella spp. continues to affect communities, preferentially children, worldwide. This review summarizes updated concepts on typhoidal and non-typhoidal Salmonella infections, starting with a historical perspective that implicates typhoid Salmonella as a significant human pathogen since ancient times. We describe the epidemiology of this pathogen with emphasis on the most recent non-typhoidal Salmonella outbreaks in industrialized countries and continued outbreaks of typhoid Salmonella in underserved countries. An overview of clinical aspects of typhoid and non-typhoid infections in developing and industrialized countries, respectively, is provided, followed by a description on current treatment concepts and challenges treating multidrug-resistant Salmonella infections. We conclude with prevention recommendations, and recent research studies on vaccine prevention.
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11
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Ichikawa K, Kajitani A, Tsutsumi A, Takeshita S. Salmonella encephalopathy successfully treated with high-dose methylpredonisolone therapy. Brain Dev 2009; 31:782-4. [PMID: 19216041 DOI: 10.1016/j.braindev.2008.12.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2008] [Revised: 12/20/2008] [Accepted: 12/27/2008] [Indexed: 12/26/2022]
Abstract
We present a 7-year-old boy diagnosed as having salmonella encephalopathy. He developed severe consciousness disturbance following enterocolitis. Electroencephalography showed diffuse and high-voltage slow activity but MR images of the brain were normal. Examination of inflammatory cytokines in serum and cerebrospinal fluid revealed high levels of interleukin-6, -8, and -10, and interferon gamma. Salmonella typhimurium was detected in a stool specimen. He was diagnosed as having salmonella-associated encephalopathy that had features of septic encephalopathy and quickly responded to high-dose methylpredonisolone therapy. High-dose methylpredonisolone was considered to be an effective treatment for hypercytokine-mediated S. encephalopathy.
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Affiliation(s)
- Kazushi Ichikawa
- Department of Pediatrics, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024, Japan.
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12
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13
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Proinflammatory cytokines in cerebrospinal fluid from patients with nontyphoidal Salmonella encephalopathy. Pediatr Infect Dis J 2008; 27:558-9. [PMID: 18434936 DOI: 10.1097/inf.0b013e318166356c] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Nontyphoidal Salmonella (NTS) encephalopathy is characterized by rapidly progressive brain dysfunction that develops after NTS enteritis. The mechanism of central nervous system involvement remains unclear. We examined cerebrospinal fluids from 7 patients for cytokines and found elevated interleukin-6, interleukin-8, and monocyte chemotactic protein-1 concentrations in all the patients, suggesting that the proinflammatory cytokines are involved in the pathogenesis of NTS encephalopathy.
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14
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Gefen R, Eshel G, Abu-Kishk I, Lahat E, Youngster I, Rosenbloom E, Kozer E. Hemorrhagic shock and encephalopathy syndrome: clinical course and neurological outcome. J Child Neurol 2008; 23:589-92. [PMID: 18160555 DOI: 10.1177/0883073807309790] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The syndrome of hemorrhagic shock and encephalopathy is associated with an acute onset of diarrhea, followed by shock, disseminated intravascular coagulopathy, multiorgan failure, and encephalopathy. The etiology of this syndrome is unknown, and despite intensive treatment, the outcome is often fatal or associated with severe neurological sequelae. Two infants aged 6 and 9 months were admitted with this syndrome within a 24-hour time interval. The authors hereby present the clinical course and a prospective evaluation of the neurological outcome. A review of the literature regarding this infrequent syndrome is presented.
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Affiliation(s)
- Roni Gefen
- Pediatric Division, Assaf Harofeh Medical Center, Zerifin 70300, Israel.
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15
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McCuddin ZP, Carlson SA, Sharma VK. Experimental reproduction of bovine Salmonella encephalopathy using a norepinephrine-based stress model. Vet J 2007; 175:82-8. [PMID: 17324598 DOI: 10.1016/j.tvjl.2006.12.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2006] [Revised: 12/12/2006] [Accepted: 12/14/2006] [Indexed: 11/16/2022]
Abstract
Neurological disease represents a sporadic but serious manifestation of bovine salmonellosis that is thought to be related to systemic infection. Salmonella enterica serovar Dublin (S. Dublin) is the serovar most associated with systemic infection in cattle, although reports of neurological disease associated with S. Dublin or any other serovar are rare and usually anecdotal. This study reports the involvement of three strains of S. enterica, serovars Saintpaul, Montevideo, and Enteritidis, in Salmonella encephalopathies. Encephalopathies were reproduced in calves using a norepinephrine-based stress model. Neurological signs were not observed in calves infected with control strains of S. enterica, including S. Dublin, or in calves infected with clinical strains in the absence of norepinephrine. Therefore, norepinephrine may play a role in Salmonella encephalopathies.
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Affiliation(s)
- Z P McCuddin
- Pre-harvest Food Safety and Enteric Disease Research Unit, National Animal Disease Center, Agricultural Research Service, USDA, Ames, IA 50010, USA
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16
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Clark IA, Budd AC, Alleva LM, Cowden WB. Human malarial disease: a consequence of inflammatory cytokine release. Malar J 2006; 5:85. [PMID: 17029647 PMCID: PMC1629020 DOI: 10.1186/1475-2875-5-85] [Citation(s) in RCA: 201] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2006] [Accepted: 10/10/2006] [Indexed: 12/24/2022] Open
Abstract
Malaria causes an acute systemic human disease that bears many similarities, both clinically and mechanistically, to those caused by bacteria, rickettsia, and viruses. Over the past few decades, a literature has emerged that argues for most of the pathology seen in all of these infectious diseases being explained by activation of the inflammatory system, with the balance between the pro and anti-inflammatory cytokines being tipped towards the onset of systemic inflammation. Although not often expressed in energy terms, there is, when reduced to biochemical essentials, wide agreement that infection with falciparum malaria is often fatal because mitochondria are unable to generate enough ATP to maintain normal cellular function. Most, however, would contend that this largely occurs because sequestered parasitized red cells prevent sufficient oxygen getting to where it is needed. This review considers the evidence that an equally or more important way ATP deficiency arises in malaria, as well as these other infectious diseases, is an inability of mitochondria, through the effects of inflammatory cytokines on their function, to utilise available oxygen. This activity of these cytokines, plus their capacity to control the pathways through which oxygen supply to mitochondria are restricted (particularly through directing sequestration and driving anaemia), combine to make falciparum malaria primarily an inflammatory cytokine-driven disease.
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Affiliation(s)
- Ian A Clark
- School of Biochemistry and Molecular Biology, Australian National University, Canberra, ACT 0200, Australia
| | - Alison C Budd
- School of Biochemistry and Molecular Biology, Australian National University, Canberra, ACT 0200, Australia
| | - Lisa M Alleva
- School of Biochemistry and Molecular Biology, Australian National University, Canberra, ACT 0200, Australia
| | - William B Cowden
- John Curtin School of Medical Research, Australian National University, Canberra, ACT 0200, Australia
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17
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El-Khoury M, Naoushi H, Sawaya R, Aoun E, Nassar NT, Sharara AI. Reversible Encephalopathy Secondary to Paratyphoid Infection and Concomitant Acute Hepatitis A. South Med J 2005; 98:723-5. [PMID: 16108242 DOI: 10.1097/01.smj.0000168134.80038.25] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Reversible encephalopathy has been described in association with typhoid fever as well as nontyphoidal salmonella infections. A diagnostic dilemma as to the cause of encephalopathy may arise when there is coexistent acute viral hepatitis and suspicion of fulminant liver failure. The authors report a patient who presented with acute icteric hepatitis A infection and a concomitant febrile illness due to Salmonella paratyphi associated with progressive encephalopathy and coma. The young man developed high-grade fever and coma. Concomitant infection with S. paratyphi was diagnosed and the patient's encephalopathy resolved rapidly with antibiotic therapy. This is the first report of a putative association of S. paratyphi infection and reversible encephalopathy. Salmonella and hepatitis A virus infection are both transmitted via the fecal-oral route, and awareness of this association is important in the management of such patients.
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Affiliation(s)
- Marc El-Khoury
- Department of Internal Medicine, Divisions of Infectious Diseases, Neurology and Gastroenterology, American University of Beirut Medical Center, Beirut, Lebanon
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Onoe S, Nishigaki T. EEG spectral analysis in children with febrile delirium. Brain Dev 2004; 26:513-8. [PMID: 15533652 DOI: 10.1016/j.braindev.2004.02.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2003] [Revised: 02/02/2004] [Accepted: 02/02/2004] [Indexed: 11/28/2022]
Abstract
UNLABELLED Febrile delirium is defined as an acute and transient confusional state with high fever. There are very few reports on febrile delirium, although fever is one of the commonest symptoms in children. We previously found a posterior slowing in the electroencephalogram (EEG) of delirious patients with fever. The purpose of this study is to evaluate the features of occipital slow waves by spectral analysis and to find a parameter associated with clinical improvement. METHODS Digital EEG tracings were investigated by Fourier analysis in 20 patients aged from 2 to 13 years. The fast Fourier transform (FFT) was computed for 20 s tracing from the P3-A1 and P4-A2 derivations. The spectral analysis of EEG was repeated in 7 patients. The tracings of 34 control subjects were also analyzed by FFT. EEG of a febrile, nine-year-old girl without delirium was also studied. RESULTS Febrile delirium was seen during the first three days of fever. The episodes lasted up to 10 min. Four patients showed febrile delirium again after admission but they became conscious a few minutes later. The relative power in the delta frequency band was increased in 65% of patients with preservation of the occipital alpha rhythm. In addition, repeated febrile delirium did not cause worsening of the posterior slowing. The duration of abnormal EEG was only a few days and the decrease of relative power in the delta frequency band was the best parameter of clinical improvement. Posterior slowing was also found in a febrile patient without delirium. CONCLUSION Febrile delirious children showed the characteristic clinical and spectral analytical features and the numerical data of EEG facilitate the comparison of the serial findings.
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Affiliation(s)
- Sachiko Onoe
- Department of Pediatrics, Osaka Police Hospital, 10-31 Kitayama-cho, Tennouji-ku, Osaka 543-0035, Japan
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19
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Minami K, Yanagawa T, Okuda M, Suzuki H, Tamura A, Izumi G, Yoshikawa N. Cerebrospinal Fluid Cytokines in Salmonella Urbana Encephalopathy. TOHOKU J EXP MED 2004; 203:129-32. [PMID: 15212148 DOI: 10.1620/tjem.203.129] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We present a case report of encephalopathy associated with Salmonella urbana infection in a child. A 5-year-old boy was admitted to our clinic with convulsions and coma. Cerebrospinal fluid (CSF) interleukin-6 (IL-6) and IL-8 were elevated at onset and were decreased within normal limit on the fifth day. Residual neurological deficits included severe mental deficits and spastic tetraplegia. High levels of CSF proinflammatory cytokines might be related to central nervous system (CNS) disease activity. Although encephalopathy is a rare complication of non-typhi Salmonella infection, it should be borne in mind as an occasionally serious and potentially lethal disease.
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Affiliation(s)
- Koichi Minami
- Department of Pediatrics, Wakayama Medical University School of Medicine, Wakayama 641-0012, Japan.
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