Microbiological and clinical characterization of extraintestinal Salmonella infection

A. V. Rakov¹, F. N. Shubin¹, V. A. Ivanis²;
¹Institute of Epidemiology and Microbiology SB RAMS, Vladivostok, RUSSIAN FEDERATION, ²Vladivostok State Medical University, Vladivostok, RUSSIAN FEDERATION.

Salmonella infection usually proceeds as gastroenteritis, having a brief duration, not demanding treatment of antibiotics, and has low mortality. Much less frequently Salmonella infection proceeds as extraintestinal salmonellosis appeared bacteremia-septicemia and focal infections. It is characterized by high severity and a plenty of lethal outcomes. The aim of this study was an evaluation of focal forms of extraintestinal salmonellosis cases in Primorye Region and the comparative analysis of plasmid characteristics of Salmonella enterica subsp. enterica serovar Enteritidis strains isolated from patients with extraintestinal salmonellosis and Salmonella gastroenteritis. Studying of Salmonella infection in Primorye Region in 1995-2002 has shown that the basic form of an infection was gastroenteritis caused by S. Enteritidis. Extraintestinal salmonellosis was revealed in two patients. At the first patient, 65 years, disease proceeded as Salmonella pleural empyema and has ended with recovery. From feces, pleural pus and blood of the patient it has been isolated S. Enteritidis with plasmid profile 57:3.5 kb. Strains of similar plasmid profile for corresponding half-year have been isolated at 9.6% of gastroenteritis patients, caused by S. Enteritidis, that is they did not dominate over the given period of time, and took only the third place in Salmonella gastroenteritis morbidity. The second patient, a child of 5 months has developed severe Salmonella sepsis and the purulent meningitis, ended with the death of the patient after 8 day of illness. From the patient�s cerebrospinal fluid, blood and feces demonstrate isolated S. Enteritidis with plasmid profile 57:2.1 kb. Strains with same plasmid profile in the corresponding half-year had first place in Salmonella gastroenteritis morbidity and have made 49.4 %. The relativity of pathogen strains isolated from patients of extraintestinal salmonellosis and gastroenteritis proves to be true in their uniformity of antibiotic pattern. S. Enteritidis strains of both plasmid profiles isolated in both forms of infection were sensitive to all tested antibiotics. Hence, the conducted studies have shown that extraintestinal salmonellosis was caused by S. Enteritidis demonstrating the leading importance in etiology of infections. At the same time, according to the received data, it is possible to conclude that extraintestinal salmonellosis can be caused by S. Enteritidis of different plasmid profiles, both dominating, and not dominating in a population of the pathogen. Our data agrees with the results received in Spain by �. Rodriguez et al. (1998). Extraintestinal salmonellosis was caused as by the dominating genomic group of S. Enteritidis, having the basic etiological importance in development of gastroenteritis, and the others genomic groups of the pathogen which is recognized at Salmonella gastroenteritis.