Salmonella

Salmonella is a genus of rod-shaped, Gram-negative, non-spore-forming, predominantly motile enterobacteria with diameters around 0.7 to 1.5 µm, lengths from 2 to 5 µm, and flagella which grade in all directions (i.e. peritrichous). They are chemoorganotrophs, obtaining their energy from oxidation and reduction reactions using organic sources, and are facultative anaerobes. Most species produce hydrogen sulfide, which can readily be detected by growing them on media containing ferrous sulfate, such as TSI. Most isolates exist in two phases: a motile phase I and a nonmotile phase II. Cultures that are nonmotile upon primary culture may be switched to the motile phase using a Cragie tube.

Salmonella is closely related to the Escherichia genus and are found worldwide in cold- and warm-blooded animals (including humans), and in the environment. They cause illnesses like typhoid fever, paratyphoid fever, and foodborne illness.

Salmonella is typically pronounced with the initial letter "L," although it is named for pathologist Daniel Elmer Salmon.

Salmonella as disease-causing agents
Salmonella infections are zoonotic and can be transferred between humans and nonhuman animals. Many infections are due to ingestion of contaminated food. A distinction is made between enteritis Salmonella and typhoid/paratyphoid Salmonella, where the latter — because of a special virulence factor and a capsule protein (virulence antigen) — can cause serious illness, such as ''Salmonella enterica subsp. enterica'' serovar Typhi. Salmonella typhi. is adapted to humans and does not occur in animals.

Enteritis Salmonellosis or Food Poisoning Salmonella
This is a group consisting of potentially all other serotypes (over a thousand) of the Salmonella bacterium, most of which have never been found in humans. These are encountered in various Salmonella species, most having never been linked to a specific host, and can also infect humans. It is therefore a zoonotic disease. The organism enters through the digestive tract and must be ingested in large numbers to cause disease in healthy adults. Gastric acidity is responsible for the destruction of the majority of ingested bacteria. The infection usually occurs as a result of massive ingestion of foods in which the bacteria are highly concentrated similarly to a culture medium. However, infants and young children are much more susceptible to infection, easily achieved by ingesting a small number of bacteria. It has been shown that, in infants, the contamination could be through inhalation of bacteria-laden dust. After a short incubation period of a few hours to one day, the germ multiplies in the intestinal lumen causing an intestinal inflammation with diarrhea that is often muco-purulent and bloody. In infants, dehydration can cause a state of severe toxicosis. The symptoms are usually mild. There is normally no sepsis, but it can occur exceptionally as a complication in weakened elderly patients (Hodgkin's disease, eg.). Extraintestinal localizations are possible, especially Salmonella meningitis in children, osteitis, etc. Enteritis Salmonella (e.g., Salmonella enterica subsp. enterica serovar enteritidis) can cause diarrhea, which usually does not require antibiotic treatment. However, in people at risk such as infants, small children, the elderly, Salmonella infections can become very serious, leading to complications. If these are not treated, HIV patients and those with suppressed immunity can become seriously ill. Children with sickle cell anaemia who are infected with Salmonella may develop osteomyelitis.

In Germany, Salmonella infections must be reported. Between 1990 and 2005, the number of officially recorded cases decreased from approximately 200,000 cases to approximately 50,000. It is estimated that every fifth person in Germany is a carrier of Salmonella. In the USA, there are approximately 40,000 cases of Salmonella infection reported each year. According to the World Health Organization, over 16 million people worldwide are infected with typhoid fever each year, with 500,000 to 600,000 fatal cases.

Salmonella can survive for weeks outside a living body. Salmonella are not destroyed by freezing. Ultraviolet radiation and heat accelerate their demise; they perish after being heated to 55 °C for one hour, or to 60 °C for half an hour. To protect against Salmonella infection, it is recommended that food be heated for at least ten minutes at 75 °C so that the centre of the food reaches this temperature.

The AvrA toxin injected by the type three secretion system of Salmonella typhimurium works to inhibit the innate immune system by virtue of its serine/threonine acetyltransferase activity and requires binding to eukaryotic target cell phytic acid (IP6). This leaves the host more susceptible to infection. In a 2011 paper, Yale University School of Medicine researchers described in detail how Salmonella is able to make these proteins line up in just the right sequence to invade host cells. "These mechanisms present us with novel targets that might form the basis for the development of an entirely new class of anti-microbials," said Professor Dr. Jorge Galan, senior author of the paper and the Lucille P. Markey Professor of Microbial Pathogenesis and chair of the Section of Microbial Pathogenesis at Yale. In the new National Institutes of Health (NIH)-funded study, Galan and colleagues (Maria Lara-Tejero, Junya Kato, Samuel Wagner, and Xiaoyun Liu) identify what they call a bacterial sorting platform, which attracts needed proteins and lines them up in a specific order. If the proteins do not line up properly, Salmonella, as well as many other bacterial pathogens, cannot "inject" them into host cells to commandeer host cell functions, the lab has found. Understanding how this machine works raises the possibility that new therapies can be developed which disable this protein delivery machine and therefore thwart the ability of the bacterium to become pathogenic. The process would not kill the bacteria as most antibiotics do, but would cripple its ability to do harm. In theory, this means that bacteria such as Salmonella might not develop resistance to new therapies as quickly as they usually do to conventional antibiotics.

History
The genus Salmonella  was named after Daniel Elmer Salmon, an American veterinary pathologist. While Theobald Smith was the actual discoverer of the type bacterium (Salmonella enterica var. choleraesuis) in 1885, Dr. Salmon was the administrator of the USDA research program, and thus the organism was named after him. Smith and Salmon had been searching for the cause of common hog cholera and proposed this organism as the causal agent. Later research, however, would show that this organism (now known as Salmonella enterica) rarely causes enteric symptoms in pigs, and was thus not the agent they were seeking (which was eventually shown to be a virus). However, related bacteria in the genus Salmonella  were eventually shown to cause other important infectious diseases.

Salmonella nomenclature
Initially, each Salmonella species was named according to clinical considerations, e.g., Salmonella typhi-murium (mouse typhoid fever), S. cholerae-suis (hog cholera). After it was recognized that host specificity did not exist for many species, new strains (or serovar, short for serological variants) received species names according to the location at which the new strain was isolated. Later, molecular findings led to the hypothesis that Salmonella consisted of only one species, S. enterica, and the serovar were classified into six groups, two of which are medically relevant. But as this now formalized nomenclature is not in harmony with the traditional usage familiar to specialists in microbiology and infectologists, the traditional nomenclature is common. Currently, there are two recognized species: S. enterica and S. bongori, with six main subspecies: enterica (I), salamae (II), arizonae (IIIa), diarizonae (IIIb), houtenae (IV), and indica (VI). Historically, serotype (V) was bongori, which is now considered its own species. The serovar classification of Salmonella is based on the Kauffman-White classification scheme that permits serological varieties to be differentiated from each other. Newer methods for Salmonella typing and subtyping include genome-based methods such as pulsed field gel electrophoresis (PFGE), Multiple Loci VNTR Analysis (MLVA), Multilocus sequence typing (MLST) and (multiplex-) PCR-based methods.

Genetics
Serovar Typhimurium has considerable diversity and may be very old. The majority of the isolates belong to a single clonal complex. Isolates are divided into phage types, but some phage types do not have a single origin as determined using mutational changes. Phage type DT104 is heterogeneous and represented in multiple sequence types, with its multidrug-resistant variant being the most successful and causing epidemics in many parts of the world.

Serovar Typhi is relatively young compared to Typhimurium, and probably originated approximately 30,000-50,000 years ago.

Sources of infection

 * Infected food, often gaining an unusual color, odor, or chewiness, that is then introduced into the stream of commerce;
 * Poor kitchen hygiene, especially problematic in institutional kitchens and restaurants because this can lead to a significant outbreak;
 * Excretions from either sick or infected but apparently clinically healthy people and animals (especially endangered are caregivers and animals);
 * Polluted surface water and standing water (such as in shower hoses or unused water dispensers);
 * Unhygienically thawed fowl (the meltwater contains many bacteria);
 * An association with reptiles (pet tortoises, snakes, and frogs, but primarily aquatic turtles) is well described.

Salmonella bacteria can survive several weeks in a dry environment and several months in water; thus, they are frequently found in polluted water, contamination from the excrement of carrier animals being particularly important. Aquatic vertebrates, notably birds and reptiles, are important vectors of Salmonella. Poultry, cattle, and sheep frequently being agents of contamination, salmonella can be found in food, especially in milk, meats and sometimes in eggs which have cracks.

Deaths
About 142,000 (reported) Americans are infected each year with Salmonella enteritidis from chicken eggs, and about 30 die. The shell of the egg may be contaminated with Salmonella by feces or environment, or its interior (yolk) may be contaminated by penetration of the bacteria through the porous shell or from a hen whose infected ovaries contaminate the egg during egg formation. Nevertheless, such interior egg yolk contamination is theoretically unlikely. Even under natural conditions, the rate of infection was found to be very small (0.6% in a study of naturally-contaminated eggs and 3.0% among artificially- and heavily-infected hens ). A recent analysis of death certificates in the United States identified a total of 1,316 Salmonella-related deaths between the years 1990 to 2006. These were predominantly among older adults and those who were immunocompromised.