Extraintestinal infections caused by nontyphoidal Salmonella from a tertiary care center in India

Abstract

BACKGROUND: Infection with Salmonella has become an increasing problem worldwide. Recently, nontyphoid Salmonella (NTS) has become a global concern causing threat to the health of human. It causes gastrointestinal infection which may be self-limiting, but invasive infections may be fatal, requiring appropriate therapy. This study was done to analyze the spectrum of NTS infections causing extraintestinal infections and its susceptibility pattern from a tertiary care center in India. MATERIALS AND METHODS: The medical records of 27 patients whose cultures were positive for NTS between the years 2013–2016 were included in this retrospective study. The relevant demographic, clinical, and laboratory data were analyzed. RESULTS: Among the 27 patients, predominant patients were in the age group of 20–30 years. The male to female ratio is 1.7:1. Salmonella typhimurium was the predominant NTS isolated among 15/27 (55.5%), followed by Salmonella enteritidis 4/27 (14.8%). 18/27 (66.6%) of NTS were isolated from blood. Nalidixic acid was sensitive in 2/15 of S. typhimurium, 2/4 of S. enteritidis and 1/3 of Salmonella weltevreden, while others are nalidixic acid-resistant implying resistance to quinolones. They were sensitive to other antibiotics reported. CONCLUSION: This study highlights the spectrum of NTS causing extraintestinal infections which is an emerging infection occurring mostly in immunosuppressed individuals. There should be a high degree of clinical suspicion which would help in the early diagnosis and management of patients.

Extended Spectrum Beta-lactamase producing Salmonella Lindenberg gastroenteritis

“…Previous Indian report [14] on S. Lindenberg had been from invasive infections, nevertheless, here we report, for the first time a case of S. Lindenberg gastroenteritis. S. Lindenberg differs from S. Typhimurium in having C2 serogroup O antigens, nevertheless they possess similar H antigens, i:1,2 could lead to the misreporting of the serovar.…”

Non-typhoidal Salmonella infections across India: emergence of a neglected group of enteric pathogens

“…In the literature on NTS infection in India, several authors have published their findings on NTS infection at different time points. 3 , 28 , 29 , 30 , 31 , 32 The prior studies have focused mainly on particular geographic areas of the country and consequently have not provided a clear picture of prevalence of NTS infection across India. Therefore, the present research was aimed at studying the distribution of NTS over diverse geographical locations across India, to assess the NTS disease burden throughout the country.…”

“…14 , 37 The highly prevalent serovar S. enterica serovar Typhimurium has already been reported to be an invasive NTS serovar globally. 6 The serovar Lindenberg was first reported to be isolated from a human blood sample in 2018 3 in India. In this study, one isolate each of S. enterica serovar Typhimurium and S. enterica serovar Lindenberg was obtained from human CSF; this important finding indicates the invasive nature of these bacteria, thus raising concerns regarding possible threats to community health.…”

“…The global annual disease burden of salmonella infections has been reported to be 3.4 million. 1 , 2 , 3 …”

Emerging Threat of Salmonella typhimurium in Extraintestinal Infections: Cases from a Tertiary Care Hospital in North India

“…Salmonella encompasses a total of 2500 serovars including the typhoidal and NTS [2]. Unlike typhoidal salmonella which is strictly restricted to humans, NTS can be transferred from animal-to-human and from human-tohuman.…”