Salmonella

Enterobacteriaceae 3
 Salmonella can cause

3. Enteric fever
4. Gastroenteritis
5. Septicemia with or without focal
suppuration
6. Carrier state
 Salmonella typhi—typhoid fever
Eberth-Gaffky bacillus/Eberthella typhi

Practically salmonella has been divided

into
6. The enteric fever group-
typhoid,paratyphoid bacilli
7. The food poisoning group
 Gram –ve,rods,motile except S gallinarum-
pullorum which is always nonmotile
Aerobic and facultative anerobic
Grows readily on simple media
MacConkey and DCC media- colourless
Wilson and Blair bismuth sulphite medium-jet
black colonies
Selenite F &tetrathionate broth are commnly
employed as enrichment media
 S typhi- anerogenic
MR+,VP-ve,C+
Typhi- donot grow in Simmon’s citrate
medium as they need tryptophan as the
gowth factor
Antigenic structure-
5. Flagellar antigen-H
6. Somatic antigen O
7. Surface antigen-Vi
 H antigen- heat labile-strongly
immunogenic,induces antibody formation in
high titres
O antigen-phospholipid-Protein-Polysacharide
complx—also called Boivin antigen---heat
stable
Vi antigen- analogue to K antigen in the
coliforms-surface Polysacharide antigen
enveloping the o antigen—heat labile—tend to
loss in serial subculture
Vi polysacharide acts as a virulence factor by
inhibiting phogocytosis-resisting complement
activation and bacterial lysis
Poorly immunogenic
 Purified Vi vaccine
Total absence of vi antibody in a proven case
of typhoid fever indicates poor Prgns
Antibody disappears early in convalescence
Its persistance indicates dvlpmnt of carrier
state.
 Antigenic variation

1. H-O
2. V-W-loss of Vi by sub culture-now
agglutinable with O antiserum (W form)
3. S-R-by loss of O antigen & virulence
4. O antigen
 H-O variation
Associated with loss of flagella
Phase Variation-flagellar antigens two types
3. Phase 1 –specific for species
4. Phase 2 –group specific
5. Diphasic-both-
S.typhi –monophasic
Phase 1 can b converted to 2 by Craigie’s
method
 Pathogenicity

Enteric Fever-
2. Typhoid fever- S. typhi
3. Paratyphoid fever – S.paratyphi A,B,C
 D/s course
IP-7-14 days
Gradual onset-headache,malaise,anorexia-
caoted tongue-abdominal discomfort-
constipation/diarrhoea
Step ladder pyrexia-typical-
Hepato splenomegaly
Rose spots-in skin which blanch on pressure
Complications-perforation,he,circulatory collpase
Relapse may occur in convalescence-higher if
treated early with chloramphenicol
 Paratyphoid is milder form
Leads to frank septicemia with suppurative
complications
Infection with Alkaligens faecalis- similar c/f
Epidemiology-
Carriers-3w-3m-Convalescent
3m-1yr-temporary
More than 1yr-c/c
 Lab d/g
Isolation and demonstration of antibodies
,bacilli demonstration
Blood culture-diagnostic maximum at first
week,rapidly –ve on treating with
antibiotics
 Cultures should be declared –ve only after
incubation period of 10 days
May use Casteneda’s method-
Feces culture-salmonella are shed in the feces
thruout the course of disease,even in carriers
Imp, if antibiotics hav started-as they r slowly
eliminated from gut than from blood
Feces—MacConkey-/DCA/WB
Clot culture-blood- allowed to clot—serum is
used for widal—clot to bile broth—high rate of
isolation as bactericidal action of serum is less
Urine culture-,Bile culture,rose spots,csf,sputum
–less imp
Widal reaction
In H- +ve –loose,cotton woolly clumps
O +ve –disc like pattern at the bottom of
the tube
Result-
Ab appear by end of first week- ifearly –
ve—titre inc steadly till 3/4th week and it
decline after
Test more samples
1/100 or more for O & 1/200 or more for
H is sigfig
Ab-may be due to proir
d/s,immunisation,carriers
 H agglutinins persist longer than O
If immunised with TAB, Ab against both ,in
natural infection only causative org.
t/ted case –poor Ab titre
Other serological methods-ELISA,CIE
Staphylococcal co-agglutination test-in early
phase of d/s-S.aureus-/Cowan 1 strain-which
contains Protein A is stabilised by
formaldehyde and coated with S typhi
antibody---1%---with serum –visible
agglutination in 2 min
Not paositive after first week
 D/g of carriers
Islation from faeces,bile,urine cultures
Widal is no value in endemic states
Demo of Vi agglutinins is imp
Sewer-swab technique-Gauze pads in
sewers and drains -cultured
 Px
TAB vaccine-with S,typhi,S.paratyphi A & B
Typhi-1000 million
A & B- 750 million each/ml---killed by heating
at 50-60C—preserved in phenol
In india- divalant Typhoid-paratyphoid A is
given
Two doses—0.5ml s/c at an intervel of 4-6
weeks
0.1ml I/D
Newer vaccines
8. Typhoral-live oral vaccine
9. Typhin-Vi---injectable
 T/t
Chloramphenicol,tetracycline,
streptomycin
Ampicilline, Aox,cotrimoxazole
 Salmonella Gastroenteritis
Enterocolitis/food poisoning
-zoonotic-source of infection –animal products

Caused by any salmonella except typhi

Short IP-24 hrs-diarrhoea, vomiting, abdominal
pain,fever---loose stools
Subsides in 2-4 days
T/t –if uncomplicated-symptomatic- antibiotics
not neede