Treatment and management of Salmonella prostatitis in a heartworm-positive intact male dog: a case report.

BACKGROUND: Salmonella spp. represent a significant zoonotic concern to pregnant owners as infection can cause septic abortions and post-partum illness. Enteric salmonellosis is well documented in canines however urinary salmonellosis is rarely described and Salmonella prostatitis has never been described in dogs. CASE PRESENTATION: This case report describes the diagnosis and management of a five-year-old, intact male Labrador Retriever mix dog that was diagnosed with Salmonella prostatitis among other comorbidities including heartworm infestation. Additionally, mitigation of zoonotic spread is emphasized as one of the owners was six months pregnant at the time of diagnosis. DISCUSSION: The pathogenesis of Salmonella prostatitis is unknown but explanations pertaining to enteric salmonellosis, such as the lifestyle and stress of living as a stray may have contributed and contamination from an enteric infection may have also been possible. Several recommendations were made to reduce the likelihood of zoonotic transmission including frequent hand washing, avoidance of the patient's mouth, change in location of where the patient was fed, the use of an isolated area outside for urination and defecation, and the use of dilute bleach to clean areas soiled by the patient's bodily fluids. Monitoring of the prostatic infection was facilitated with prostatic wash instead of urine culture. This decision was made as prostatic infections have been shown to intermittently shed bacteria into the urine, leading to possible false negative urine cultures and potential catastrophic zoonotic infection.

Molecular Detection of Salmonella enterica subsp. arizonae by Quantitative PCR.

Salmonella enterica subspecies arizonae (subspecies IIIa) is most frequently associated with reptiles but is also a bacterial pathogen of poultry, primarily of young turkeys where it induces septicemia, neurologic signs, and increased mortality. Arizonosis clinical cases in broiler chickens have recently been documented in the United States, driving the development of a rapid, molecular-based diagnostic for this subspecies. S. enterica subsp. arizonae is a genetically distinct subgroup of S. enterica, primarily diagnosed through culture followed by serotyping or biochemical identification, which are costly in both time and laboratory resources. Real-time/quantitative PCR offers rapid and sensitive detection of Salmonella sp. in laboratory and diagnostic samples; however, no such methodology exists to differentiate S. enterica subsp. arizonae from other Salmonella sp. In this study, we designed a quantitative PCR assay for S. enterica subsp. arizonae. The assay is able to differentiate S. enterica subsp. arizonae from other S. enterica subspecies, including S. enterica subsp. diarizonae (IIIb), and other non-Salmonella bacteria. Validation, including 56 different S. enterica subsp. arizonae serovars, demonstrated 100% sensitivity and 100% specificity. This assay provides a rapid diagnostic option for suspected cases of arizonosis in poultry.

Salmonella enterica Subspecies arizonae Detected from Bilateral Pleural Fluid in a Patient with Systemic Lupus Erythematosus and Malignant Lymphoma.

A 72-year-old woman was admitted to our hospital with bilateral pleural effusions. She had a 31-year history of systemic lupus erythematosus and had been treated with prednisolone and azathioprine. Pleural fluid culture revealed Salmonella enterica subsp. arizonae infection. This pathogen rarely infects humans but is commonly found in the gut flora of reptiles, especially snakes. Our patient had not come in contact with reptiles. Despite antibiotic therapies and negative pleural cultures, the pleural effusion persisted. Colon cancer was detected concomitantly, and she finally died. The autopsy revealed that the pleuritis was due to underlying diffuse large B cell lymphoma.

Pyelonephritis in Japan caused by Salmonella enterica subspecies arizonae.

Salmonella enterica subsp. arizonae is a bacteria commonly found in the gut of reptiles. In humans, infections caused by this organism are rare. Most cases originate from southwestern United States, where rattlesnake products are often used in traditional medicine. In Asia, only a few cases have been described. This case report documents a case involving a 64-year-old woman with pyelonephritis caused by S. arizonae in Japan. She had no history of contact with reptiles or foreign travel. The likely route of transmission is unclear. She was treated with cephalosporins for 14 days and the pyelonephritis appeared to be resolved; however recurrence occurred twice -after two weeks and then after one month. Prolonged antibiotic therapy with amoxicillin resolved the infection. This case demonstrates that pyelonephritis associated with S. arizonae can be found outside of the typical geographic region and may not be associated with typical animal hosts.

Tigecycline therapy for bacteremia and aortitis caused by Salmonella enterica serotype Choleraesuis: A case report.

Non-typhoid Salmonella species represent a significant cause of aortitis. Few antimicrobial agents can be used when the patient is allergic or intolerable to cephalosporins or fluoroquinolones. Here, we report a case of bacteremia and aortitis caused by Salmonella enterica serotype Choleraesuis. This patient was cured by initial parenteral tigecycline and subsequent oral ciprofloxacin without surgical intervention.

Los riesgos del empleo de reptiles como animales de compañía / Risk of use of reptiles as pets

En los últimos años se ha incrementado el número de familias que tienen animales exóticos como mascotas, que en ocasiones actúan como reservorio de subespecies poco habituales de patógenos gastrointestinales. Se presenta el caso de un niño con gastroenteritis aguda por Salmonella arizonae, una subespecie de la Salmonella enterica cuyo reservorio es principalmente los reptiles (AU)

In the last years the number of families who have exotic animals as pets has been increased, sometimes acting as a reservoir of rare subspecies of gastrointestinal pathogens. We present the case of a child with acute gastroenteritis caused by S. arizonae (Salmonella enterica subspecies), whose main reservoir are reptiles (AU)

Antimicrobial profile of Salmonella enterica serotype Choleraesuis from free-range swine in Kakamega fish market, western Kenya.

INTRODUCTION: Salmonella enterica subspecies enterica serovar Choleraesuis is a host-adapted, facultative, intracellular pathogen that causes swine paratyphoid. Its antimicrobial resistance presents a challenge to feed manufacturing industries. However, stopping antibiotics in animal feed would have economic implications for the industry. METHODOLOGY: Conventional microbial methods for isolation and identification of S. Choleraesuis were employed. The isolates were subjected to screening against 17 antimicrobial agents and genotyping of resistance markers by PCR. The data were then analyzed and presented in percentages. RESULTS: Phenotypically, 43 out of 95 isolates showed multidrug resistance. Among the 17 antibiotics tested, resistance was observed as follows: sulphonamides (45.2%), nalidixic acid (44.25%), tetracycline (42%), ampicillin (36.8%), erythromycin (34.7%), carbenicillin (31.5%), chrolamphenical (28.4%), gentamicin (27.3%), kanamycin (24.2%), spectinomycin (21%), sulfamethoxazole-trimethoprim (16.8%), streptomycin (12.6%), cephalothion (8.4%), ofloxacin (5.2%), ciprofloxacin (4.2%), and norfloxacin (4.2%). Fifty-two isolates were susceptible to the antimicrobial agents tested. A total of 3.1% of the isolates had the integron gene pattern combination of dfrA2-aadA2 (2100 bp), dfrA12 (2100 bp); 4.2% had dfrA12-aadA2-sulI (2100 bp); 2.1% had dfrA12-aadA2 (2100 bp); and 1% had dfrA2-aadA2-sulI (2100 bp), oxa1-aadA2 (1500 bp), dfrA12-aadA2-sulI, and blaPSE (2100 bp). CONCLUSIONS: The isolated S. Choleraesuis were resistant to more than 10% of the antimicrobial agents used in this study. Appropriate surveillance is warranted to gain more information about the epidemiology, as stopping antibiotics in animal feed would have economic implications for the industry.

Epidemiology of infections with enteric salmonellae in Switzerland with particular consideration of travelling activities.

QUESTIONS UNDER STUDY: To describe the current epidemiological situation of enteric salmonellosis in Switzerland and its development in the last two decades, particularly by determining the ratio between domestic and travel-associated cases. METHODS: Between 1 February 2011 and 31 January 2012, 14 medical laboratories continuously reported their isolations of enteric salmonellae to the Federal Office of Public Health (FOPH). Data on the travel history of salmonellosis patients was actively acquired from their treating physicians. These data were compared with the results of a case-control study on sporadic salmonellosis that was performed in 1993. RESULTS: It could be shown that, concomitantly with the pronounced decline in incidence of reported laboratory notifications of enteric salmonellae since the early 1990s, the travel-associated portion of isolates belonging to the most frequently isolated serovar Enteritidis has increased significantly (more than doubled). The three serovars that followed S. Enteritidis in frequency of isolation (Typhimurium, Bardo, monophasic 4,12:i:-) are predominantly of domestic origin. CONCLUSIONS: The significant increase in the percentage of travel-related S. Enteritidis infection, demonstrated by the comparison between the data from 2012 and 1993, might be a consequence of the reduction in domestic infections during this period. The fact that infections due to this serovar are now significantly more often travel-related than domestic clearly illustrates the success of the preventive measures taken. These consist of legal measures that were necessary to reduce the transmission of the pathogen in raw eggs, and sanitation measures taken by the producers that aimed to contain the chicken meat reservoir.

Diversity of pulsed-field gel electrophoresis pulsotypes, serovars, and antibiotic resistance among Salmonella isolates from wild amphibians and reptiles in the California Central Coast.

A survey of cold-blooded vertebrates and associated surface waters in a produce-growing region on the Central California Coast was done between May and September 2011 to determine the diversity of Salmonella. Samples from 460 amphibians and reptiles and 119 water samples were collected and cultured for Salmonella. Animals sampled were frogs (n=331), lizards (n=59), newts (n=5), salamanders (n=6), snakes (n=39), and toads (n=20). Salmonella was isolated from 37 individual animals, including frogs, lizards, snakes, and toads. Snakes were the most likely to contain Salmonella, with 59% testing positive followed by 15.3% of lizards, 5% of toads, and 1.2% of frogs. Fifteen water samples (12.6%) were positive. Twenty-two different serovars were identified, and the majority of isolates were S. enterica subsp. IIIb, with subsp. I, II, and IIIa also found. The serovar isolated most frequently was S. enterica subsp. IIIb 16:z10:e,n,x,z15, from snakes and frogs in five different locations. S. enterica subsp. I serovar Typhimurium and the monophasic I 6,8:d:- were isolated from water, and subspecies I Duisburg and its variants were found in animals and water. Some samples contained more than one type of Salmonella. Analysis of pulsed-field gel electrophoresis pulsotypes indicated that some strains persisted in animals and water collected from the same location. Sixty-six isolates displayed antibiotic resistance, with 27 isolates resistant to more than one antibiotic, including a subspecies IIIb isolate from snake having resistance to five different antibiotics. Twenty-three isolates were resistant to more than one class of antibiotic, and six isolates were resistant to three classes. While these subspecies of IIIa and IIIb cause fewer instances of human illness, they may serve as reservoirs of antibiotic resistance, determinants in the environment, and be sources of contamination of leafy greens associated with product recalls.

[Development of modified molecular beacon based real-time PCR assay for the rapid detection of Salmonella choleraesuis and Salmonella paratyphi C].

OBJECTIVE: To develop real-time PCR assay based on modified molecular beacon for simultaneous detection of S. choleraesuis and S. paratyphi C. The established method was applied to the rapid detection of S. choleraesuis in food and stool samples of food poisoning, and then was applied to the identification of Salmonella C. METHODS: Based on the sequences (CP000857.1) published in GenBank, Two sets of primers and modified molecular beacon were designed. The Real-time PCR assay for the simultaneous detection of S. paratyphi C and S. choleraesuis was developed with optimized PCR procedures and PCR components, while other 11 different bacterial species were as the control. Then the sensitivity and specificity of the assay were tested using 77 Samonella strains. The assay was applied to the detection of 70 food samples. RESULTS: The limit of detection achieved was 10 fg/reaction or 20 CUF/reaction, Only Salmonella paratyphi C and Salmonella choleraesuis strains generated fluorescent signals. No cross-reaction was observed with other 11 bacterium, the sensitivity and specificity were both 100%. No samples among 70 food samples were found Salmonella positive by both real-time PCR assay and traditional culture method. It could be finished within 2 hours from template preparation to detection and the overall test would be finished within one day. CONCLUSION: The real-time PCR assay was rapid, sensitive and specific. It could be applied to the rapid diagnosis of S. paratyphi C and S. choleraesuis in food and stool samples of food poisoning and the identification of Salmonella C to guarantee food safety.

Successful treatment of late Salmonella infections in total hip replacement - report of two cases.

BACKGROUND: Salmonella species can be rarely isolated from periprosthetic joint infections, however when present, are usually part of a severe septic clinical picture. CASE PRESENTATIONS: Two patients presented with late infected hip replacements to our institution. The first patient with multiple comorbidities had a confirmed Salmonella Enteridis infection with an abscess in the groin, with loosening of both components. He underwent a successful one stage cemented revision hip replacement, followed by 6 weeks of antibiotic therapy (ciprofloxacin). He had no recurrence or complications. The second patient was admitted in a septic condition with ARDS to the Intensive Care Unit 7 years following an uncemented total hip replacement. From an ultrasound guided hip aspirate Salmonella cholerae-suis was isolated. He underwent a successful a two-stage revision hip replacement. CONCLUSIONS: Successful treatment of such potentially life threatening infections is achievable using modern orthopaedic techniques and close collaboration with the infectious diseases specialists.

Molecular characterization of extended-spectrum cephalosporinase-producing Salmonella enterica serovar Choleraesuis isolates from patients in Thailand and Denmark.

The objective of this study was to characterize extended-spectrum cephalosporinase (ESC)-producing isolates of Salmonella enterica serovar Choleraesuis recovered from patients in Thailand and Denmark. Twenty-four blood culture isolates from 22 patients were included in the study, of which 23 isolates were recovered from 21 Thai patients during 2003, 2007, or 2008 and one isolate was recovered from a Danish traveler to Thailand. ESC production was confirmed in 13 out of the 24 isolates by MIC testing. Microarray and plasmid profiling (replicon typing and restriction fragment length polymorphism [RFLP]) were used to characterize the genetic mechanisms of antimicrobial resistance in the 13 ESC-producing isolates. Pulsed-field gel electrophoresis (PFGE) and MIC testing were used to compare the clonality between the 13 ESC-producing isolates and the 11 non-ESC-producing isolates. Based on susceptibility patterns, the ESC-producing isolates were more closely related than non-ESC-producing isolates. Microarray, PCR, plasmid profiling, and replicon typing revealed that the 13 ESC-producing isolates harbored either bla(CMY-2) containing incA/C or bla(CTX-M-14) containing incFIIA, incFrepB, and an unknown replicon located on plasmids ranging in size from 75 to 200 kb. The RFLP and replicon typing clustered the isolates into four distinct groups. PFGE revealed 16 unique patterns and five clusters; each cluster contained two or three of the 24 isolates. The isolate from the Danish patient was indistinguishable from two Thai clinical isolates by PFGE. This study revealed the emergence of the bla(CTX-M-14) gene among several clones of Salmonella serovar Choleraesuis. Numerous plasmids were identified containing up to two different ESC genes and four distinct replicons. A "travel-associated" spread was confirmed. Overall, a high degree of clonal diversity between isolates resistant and susceptible to cephalosporins was observed. The findings represent a serious threat to public health for the Thai people and tourists.

Rapid identification of Salmonella enterica subsp. arizonae and S. enterica subsp. diarizonae by real-time polymerase chain reaction.

Reptiles are popular as pets, leading to an increased risk of human infections due to uncommon Salmonella strains including the Arizona group (subspecies arizonae and diarizonae). We present a real-time Arizona-specific polymerase chain reaction demonstrating 100% specificity and 99.6% sensitivity, offering savings in time and labor over traditional identification methods.

Salmonella enterica subsp. arizonae bone and joints sepsis. A case report and literature review.

Osteoarticular infections caused by Salmonella enterica subsp. arizonae are rarely seen in humans but young children and immunocompromised adults are at particular risk of acquiring this bacteria. Reptiles and their by-products (e.g. meat preparations or medications) are particularly likely to harbor Salmonella. We report on a case of septic arthritis of the hip transmitted by a reptile in a 10-month-old child. We carry out a recall of the complex nomenclature of Salmonella, a review of the literature and provide information on the recommended precautions for reducing the risk of transmission of Salmonella from reptiles to humans.

Consumption of groundwater as an independent risk factor of Salmonella choleraesuis infection: a case-control study in Taiwan.

Infection with Salmonella enterica serovar Choleraesuis (S. Choleraesuis) in humans can be considered as an endemic disease in certain regions of Taiwan, and the number of cases has increased in recent years. The goal of the case-control study discussed in this article was to identify the possible demographic and environmental risk factors associated with S. Choleraesuis infection in Taiwan. During the period of December 2005 to March 2007, the case-control study was conducted in human patients with Salmonella infection from two medical centers. Structured questionnaires were applied to collect information of relevant risk factors after interviewing 13 culture-confirmed S. Choleraesuis cases and 84 controls with other Salmonella serotype infection. After evaluation by univariate and multivariate statistical models, the results suggested that consumption of groundwater could be an independent risk factor associated with S. Choleraesuis in Taiwan. Therefore, appropriate health education needs to be conducted especially in areas where groundwater is used.

Rapid multiplex PCR and real-time TaqMan PCR assays for detection of Salmonella enterica and the highly virulent serovars Choleraesuis and Paratyphi C.

Salmonella enterica is a human pathogen with over 2,500 serovars characterized. S. enterica serovars Choleraesuis and Paratyphi C are two globally distributed serovars. We have developed a rapid molecular-typing method to detect serovars Choleraesuis and Paratyphi C in food samples by using a comparative-genomics approach to identify regions unique to each serovar from the sequenced genomes. A Salmonella-specific primer pair based on oriC was designed as an internal control to establish accuracy, sensitivity, and reproducibility. Serovar-specific primer sets based on regions of difference between serovars Choleraesuis and Paratyphi C were designed for real-time PCR assays. Three primer sets were used to screen a collection of over 100 Salmonella strains, and both serovars Choleraesuis and Paratyphi C gave unique amplification patterns. To develop the technique for practical use, its sensitivity for detection of Salmonella spp. in a food matrix was determined by spiking experiments. The technique was also adapted for a real-time PCR rapid-detection assay for both serovars Choleraesuis and Paratyphi C that complements the current procedures for Salmonella sp. isolation and serotyping.

Endogenous endophthalmitis due to Salmonella choleraesuis in an HIV-positive patient.

PURPOSE: To report a case of endogenous endophthalmitis caused by the gram-negative bacterium Salmonella choleraesuis as a first sign of HIV infection in a patient from Thailand. METHOD: Case description and literature review. RESULTS: A 54-year-old male without systemic complaints developed non-painful panuveitis in his left eye accompanied by high intraocular pressure. On investigation, HIV serology was found positive, and aqueous and blood cultures revealed the bacterium Salmonella choleraesuis. Despite aggressive treatment with antibiotics, the affected eye did not improve, and his visual acuity decreased to no light perception. CONCLUSIONS: Endogenous endophthalmitis with the non-typhoidal Salmonellae can occur in the absence of systemic symptoms in an immunocompromised host.