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22 - Typhoid, paratyphoid and non-typhoid Salmonella infections

from Section 5 - Bacterial infections

Published online by Cambridge University Press:  05 March 2013

By
Nicholas Feasey  and
Melita Gordon
Edited by
David Mabey ,
Geoffrey Gill ,
Eldryd Parry ,
Martin W. Weber  and
Christopher J. M. Whitty
David Mabey
Affiliation:
London School of Hygiene and Tropical Medicine
Geoffrey Gill
Affiliation:
University of Liverpool
Eldryd Parry
Affiliation:
Tropical Health Education Trust
Martin W. Weber
Affiliation:
World Health Organization, Jakarta
Christopher J. M. Whitty
Affiliation:
London School of Hygiene and Tropical Medicine
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Summary

The problem in Africa

Salmonella infections are among the commonest bacterial isolates from blood cultures throughout Africa. WHO estimates that 12.5 million cases of typhoid fever occur annually world-wide. Most cases are in Asia, but typhoid remains endemic in some areas of Africa, and epidemics are also reported. Invasive non-typhoid salmonella (NTS) infections, a long-standing and common cause of illness and death in African infants and children, have further increased among children and significantly increased among adults as a result of the HIV epidemic.

Whenever an African patient has few signs, yet is ill with a fever, invasive Salmonella infection (either typhoid or non-typhoid) is high on the list of differential diagnoses. Host factors (age, nutrition, malaria, HIV) and local environmental factors will determine whether typhoidal or non-typhoidal disease is most likely. The management of Salmonella sepsis has been complicated by the recent emergence of multidrug resistance.

The organism

Salmonellae are Gram-negative, motile, facultatively anaerobic bacilli, which produce acid on glucose fermentation, reduce nitrates and do not ferment lactose. They can be grown easily on a variety of media. Use of a selective agar, such as XLD or MacConkeys, may be useful if attempting to differentiate them from other organisms, for example, when culturing faeces.

Type
Chapter
Information
Principles of Medicine in Africa , pp. 308 - 315
Publisher: Cambridge University Press
Print publication year: 2013

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References

Anglaret, X, Chene, G, Attia, A. et al. (1999). Early chemoprophylaxis with trimethoprim-sulphamethoxazole for HIV-1 infected adults in Abidjan, Cote d'Ivoire: a randomised trial. Lancet; 353: 1463–8.CrossRefGoogle ScholarPubMed
Cohen, JI, Bartlett, JA, Corey, GR (1987). Extra-intestinal manifestations of Salmonella infections. Medicine; 66: 349–88.CrossRefGoogle ScholarPubMed
Dougle, ML, Hendriks, ER, Sanders, EJ, Dorigo-Zetsma, JW (1997). Laboratory investigations in the diagnosis of septicaemia and malaria. E Afr Med J; 74: 353–6.Google Scholar
Dryden, M, Gabb, R, Wright, S (1996). Empirical treatment of severe acute community-acquired gastroenteritis with ciprofloxacin. Clin Infect Dis; 22: 1019–25.CrossRefGoogle ScholarPubMed
Effa, EE, Bukwira, H (2008). Azithromycin for treating uncomplicated typhoid and paratyphoid fever Cochrane Database of systematic reviews, issue 4, art. No. CD006083. .
Feasey, NA, Archer, BN, Heyderman, RS, et al. (2010). Typhoid fever and invasive nontyphoid salmonellosis, Malawi and South Africa. Emerg Infect Dis; 16: 1448–51.CrossRefGoogle ScholarPubMed
Feasey, NA, Dougan, G, Kingsley, RA, Heyderman, RS, Gordon, MA. (2012). Invasive NTS disease in Africa – an emerging and neglected disease, Lancet, (11)61752–2.Google Scholar
Fraser, A, Goldberg, E, Acosta, C et al. (2009). Vaccines for preventing typhoid fever. Cochrane dayabase of systemic reviews 2007, Art no: CD001261.
Gendrel, D, Kombila, M, Beaudoin-Leblevec, G, Richard-Lenoble, D. (1993). Nontyphoidal Salmonella septicaemia in Gabonese children infected with Schistosoma intercalatum. Clin Infect Dis; 18: 103–5.CrossRefGoogle Scholar
Gilks, CF, Brindle, RJ, Otieno, LS et al. (1990). Life-threatening bacteraemia in HIV-1 seropositive adults admitted to hospital in Nairobi, Kenya. Lancet; 336: 545–9.CrossRefGoogle ScholarPubMed
Gordon, MA, Walsh, AL, Chaponda, M et al. (2001). Bacteraemia and mortality among adult medical admissions in Malawi – predominance of non-typhi salmonellae and Streptococcus pneumoniae. J Infect; 42: 44–9.CrossRefGoogle ScholarPubMed
Gordon, MA, Banda, HT, Gondwe, M. et al. (2002). Non-typhoidal salmonella bacteraemia among HIV-infected Malawian adults: high mortality and frequent recrudescence. AIDS; 16:1633–41.CrossRefGoogle ScholarPubMed
Gordon, MA, Graham, SM, Walsh, AL et al. (2008). Epidemics of invasive Salmonella Enteritidis serovar Enteritidis and S. Typhimurium infections among adults and children, associated with multidrug resistance in Malawi. Clin Infect Dis; 46: 963–9.CrossRefGoogle ScholarPubMed
Gordon, MA, Kankwatira, MA, Mwafulirwa, G et al. (2010). Invasive non-typhoid Salmonella establish systemic intracellular infection in HIV-infected adults; an emerging disease pathogenesis. Clin Infect. Dis; 50: 953–62.CrossRefGoogle ScholarPubMed
Gruenewald, R, Blum, S, Chan, J (1992). Relationship between human immunodeficiency virus infection and Salmonellosis in 20- to 59-year-old residents of New York City. Clin Infect Dis; 18: 358–63.CrossRefGoogle Scholar
Hoffman, S, Punjabi, NH, Kumala, S (1984). Reduction of mortality in chloramphenicol-treated severe typhoid by high dose dexamethasone. N Engl J Med; 310: 82–8.CrossRefGoogle ScholarPubMed
Hohmann, EL (2001). Nontyphoidal salmonellosis. Clin Infect Dis; 32: 263–9.Google ScholarPubMed
Hotez, PJ, Kamath, A (2009). Neglected tropical diseases in Sub-Saharan Africa: review of their prevalence, distribution, and disease burden. PLoS Negl Trop Dis 3(8): e412.CrossRefGoogle ScholarPubMed
Kariuki, S, Revathi, G, Kariuki, N et al. (2006). Invasive multidrug-resistant non-typhoidal Salmonella infections in Africa: zoonotic or anthroponotic transmission?J Med Microbiol 55: 585–91.CrossRefGoogle ScholarPubMed
Kariuki, S. (2008). Typhoid fever in sub-Saharan Africa: Challenges of diagnosis and management of infections. J Infect Developing Countries. .CrossRef
Kingsley, RA, Msefula, CL, Thomson, NR et al. (2009). Epidemic multiple drug resistant Salmonella Typhimurium causing invasive disease in Sub-Saharan Africa have a distinctive genotype. Genomic Res; 19: 2279–87.CrossRefGoogle Scholar
Mackenzie, G, Ceesay, SJ, Hill, PCV et al. (2010). A decline in the incidence of invasive non-typhoidal Salmonella infection in the Gambia temporally associated with a decline in malaria transmission. PLoS ONE 5(5) e10569.CrossRefGoogle Scholar
McGowan, JE, Chesney, PJ, Crossley, K, LaForce, FM (1992). Guidelines for the use of systemic glucocorticoids in the management of selected infections. J Infect Dis; 165: 1–13.CrossRefGoogle ScholarPubMed
Nadjm, B, Amos, B, Mtove, GT et al. (2010). WHO guidelines for antimicrobial treatment in children admitted to hospital in an area of intense Plasmodium falciparum transmission: prospective study. BMJ; 340; c1350.CrossRefGoogle Scholar
Osuntokun, BO, Bademosi, O, Ogunremik, Wright SG (1972). Neuropsychiatric manifestations of typhoid fever in 959 patientsArch Neurol; 27: 7–13.CrossRefGoogle ScholarPubMed
Parry, CM, Hien, TT, Dougan, G et al. (2002). Typhoid Fever. New Engl J Med 347:1770–82.CrossRefGoogle ScholarPubMed
Peters, RPH, Zijlstra, EE, Schijffelen, MJ et al. (2004). A prospective study of bloodstream infections as a cause of fever in Malawi – clinical predictors and implications for management. Trop Med Int Health 9: 928–34.CrossRefGoogle ScholarPubMed
Sirinavin, S. and Garner, P (2000). Antibiotics for treating salmonella gut infections. Cochrane Database Syst Rev CD001167.
Sperber, SJ, Schleupner, CJ (1987). Salmonellosis during infection with Human Immunodeficiency Virus. Rev Infect Dis; 9: 925–34.CrossRefGoogle ScholarPubMed
Thaver, D, Zaidi, AKM, Critchley, J et al. (2009). A comparison of fluoroquinolones versus other antibiotics for treating enteric fever: meta-analysis. BMJ 228: 1865–76.CrossRefGoogle Scholar
WHO position paper on typhoid vaccines (2008) Wkly Epidemiol Rec. 83: 49–59.
Wiktor, SZ, Sassan-Morokro, M, Grant, AD et al. (1999). Efficacy of trimethoprim-sulphamethoxazole prophylaxis to decrease morbidity and mortality in HIV-1 infected patients with tuberculosis in Abidjan, Cote d'Ivoire: a randomised controlled trial. Lancet; 353: 1469–75.CrossRefGoogle ScholarPubMed

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