Non-typhoidal salmonella bacteraemia among HIV-infected Malawian adults: high mortality and frequent recrudescence

Gordon, Melita A.; Banda, Hastings; Gondwe, Macpherson; Gordon, Stephen B.; Boeree, Martin J.; Walsh, Amanda L.; Corkill, J. E.; Hart, C. A.; Gilks, Charles F.; Molyneux, Malcolm E.

doi:10.1097/00002030-200208160-00009

Cited by 251 publications

(211 citation statements)

References 34 publications

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“…An equilibrium is most likely established between host and pathogen whereby opsonizing antibody gives the host the advantage, whereas in the absence of antibody, T helper 1 cytokines (11, 12), or functional oxidative burst mechanism (8, 9), intracellular Salmonellae survive. Only small numbers of bacteria need avoid cell killing in this intracellular niche to establish latent infection that can subsequently reactivate leading to recrudescence of invasive disease, as commonly observed in HIV-infected African adults (14) and subjects with defective T helper 1 immunity (11).…”

Section: Discussionmentioning

confidence: 99%

“…Further evidence for the importance of cellular immunity in protecting against Salmonella in man is shown by the high frequency of severe Salmonella infections in individuals with defects in the IL-12/23-IFN-γ axis (11,12), IFN-γ from CD4 + lymphocytes and NK cells being important for activating macrophages to produce an oxidative burst. Both in Africa and worldwide, individuals with HIV/AIDS, especially those with low CD4 + lymphocyte counts (13), are particularly vulnerable to fatal NTS infection (1,(14)(15)(16).…”

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confidence: 99%

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Importance of antibody and complement for oxidative burst and killing of invasive nontyphoidalSalmonellaby blood cells in Africans

Gondwe

Molyneux

Goodall

et al. 2010

Proc. Natl. Acad. Sci. U.S.A.

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133

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Bacteremia caused by nontyphoidal strains of Salmonella is endemic among African children. Case-fatality rates are high and antibiotic resistance increasing, but no vaccine is currently available. T cells are important for clearance of Salmonella infection within macrophages, but in Africa, invasive Salmonella disease usually manifests in the blood and affects children between 4 months and 2 y of age, when anti- Salmonella antibody is absent. We have previously found a role for complement-fixing bactericidal antibody in protecting these children. Here we show that opsonic activity of antibody and complement is required for oxidative burst and killing of Salmonella by blood cells in Africans. Induction of neutrophil oxidative burst correlated with anti- Salmonella IgG and IgM titers and C3 deposition on bacteria and was significantly lower in African children younger than 2 y compared with older children. Preopsonizing Salmonella with immune serum overcame this deficit, indicating a requirement for antibody and/or complement. Using different opsonization procedures, both antibody and complement were found to be necessary for optimal oxidative burst, phagocytosis and killing of nontyphoidal Salmonella by peripheral blood cells in Africans. Although most strains of African nontyphoidal Salmonella can be killed with antibody and complement alone, phagocytes in the presence of specific antibody and complement can kill strains resistant to killing by immune serum. These findings increase the likelihood that an antibody-inducing vaccine will protect against invasive nontyphoidal Salmonella disease in African children.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Importance of antibody and complement for oxidative burst and killing of invasive nontyphoidalSalmonellaby blood cells in Africans

Gondwe

Molyneux

Goodall

et al. 2010

Proc. Natl. Acad. Sci. U.S.A.

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121

133

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“…Yet, although humans deficient in these host defenses show enhanced susceptibility to nontyphoidal Salmonella infections, they do not appear to be appreciably more susceptible to S. Typhi (de Jong et al 1998;Winkelstein et al 2000;Ottenhoff et al 2002). Similarly, mice lacking CD4 þ T cells are highly susceptible to S. Typhimurium, as are humans with low CD4 þ T-cell counts owing to HIV infection (Fischl et al 1986;Hess et al 1996;Gordon et al 2002), but HIV infection does not confer an increased susceptibility to typhoid fever (Gordon 2008). To render mice susceptible to an S. Typhi challenge, hog gastric mucin must be coadministered to incapacitate host phagocytes, or massive bacterial inocula must be given (Collins and Carter 1978;Hone et al 1991).…”

Section: Humanized Micementioning

confidence: 99%

Host Specificity of Bacterial Pathogens

Bäumler

Fang

2013

Cold Spring Harbor Perspectives in Medicine

173

134

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“…The most frequent serovar in HIV infection is S. Enteritidis. Recently, GORDON et al (2002) has shown high mortality (47%) and frequent recrudescence (43%) with non-typhi Salmonella bacteraemia among HIV-infected Malawian adults.…”

Section: Human Infections Associated Withmentioning

confidence: 99%

Salmonella enterica subsp houtenae serogroup O:16 in a HIV positive patient: case report

Lourenço

Reis

Valls

et al. 2004

Rev. Inst. Med. trop. S. Paulo

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SUMMARYWe described a case of salmonellosis in a 33-year old HIV-infected patient. The patient presented oral and esophageal candidiasis, intense epigastric and retrosternal pain. During the physical examination he was hypochloraemic, acyanotic, hypohydrated, anicteric and afebrile. Admittance laboratorial tests indicated: red cells 3.6 millions/mm 3 ; hemoglobin, 10.1 g/dL; leukocyte count, 3,000/mm 3 , with 1% of eosinophils, 14% of non-segmented and 53% of segmented neutrophils and 31% of lymphocytes. The blood culture was positive for Salmonella enterica subsp houtenae serogroup O:16. This is probably the first human report of bacteremia due to Salmonella enterica subsp houtenae in Brazil associated to HIV-infected patient.

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Non-typhoidal salmonella bacteraemia among HIV-infected Malawian adults: high mortality and frequent recrudescence

Cited by 251 publications

References 34 publications

Importance of antibody and complement for oxidative burst and killing of invasive nontyphoidalSalmonellaby blood cells in Africans

Importance of antibody and complement for oxidative burst and killing of invasive nontyphoidalSalmonellaby blood cells in Africans

Host Specificity of Bacterial Pathogens

Salmonella enterica subsp houtenae serogroup O:16 in a HIV positive patient: case report

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