SALMONELLAINFECTION：沙门氏菌感染.pptVIP

SALMONELLA INFECTION Abdelaziz Elamin, MD, PhD, FRCPCH College of Medicine Sultan Qaboos University * * INTRODUCTION Discovered in 1880 named after Daniel Salmon, the pathologist who first isolated the organism from porcine intestine. Salmonella is a motile, gram-negative, rod-shaped bacteria, which is a leading cause of bacterial food-borne diseases. Of the 2000 strains recognized, human infection are caused mainly by 5 serotypes, typhi, paratyphi, typhimurium, choleraesuis enteritidis. Infection follows ingestion of contaminated food or water. Meat, poultry, eggs diary products are frequent sources. TRANSMISSION Pets, domestic animals and infected human are potential reservoirs. Person to person animal to human transmission is recognized. In healthy humans a dose of about one million bacteria is necessary to produce symptoms. PATHOPHYSIOLOGY After ingestion salmonella must survive the stomach acidic PH colonize small intestine. Another portal of entry is invasion of lymphoid tissue in the GIT (peyer patches) multiplication within macrophages leading to bacteremia. Salmonella then attach to penetrate the gut mucosa resulting in diarrhea from direct mucosal damage by action of exotoxins. Salmonella typically produces 3 distinct syndromes: food poisoning, typhoid fever asymptomatic carrier state. Salmonella gastroenteritis manifest as vomiting diarrhea within 6-48 hours after ingestion of food or drink contaminated with bacteria. SALMONELLOSIS It is self-limiting, treatment is by water salts replacement. Antibiotics are not usually needed. MORTALITY MORBIDITY Whereas mortality caused by typhoid fever is rare in western countries, it is associated with significant mortality morbidity in tropical countries (10-30%). Dehydration is the most common complication of typhoid fever, but serious intestinal extra-intestinal complications may occur. Infection with nontyphoidal salmonella produces self-limiting gastroenteritis and food poisoning. TY