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[Salmonellosis: retrospective study of 136 cases hospitalized at the C.H.U. of Tours].

136 cases of salmonellosis were seen in the Tours Hospital Center from 1965 to 1971. Salmonella typhi produced 32 cases of typhoid fever and 2 focal infections: a bacterial pleural effusion and an osteoarthritis. Salmonella para B induced 16 cases of typhoid fever. All these 50 patients were given chloramphenicol that was effective in vitro and in vivo as well. They usually exhibited very few and mild signs or symptoms but long lasting fever. Complications were very rare. There was no death. Paradoxically, the 86 "minor" salmonellosis (i.e. caused by other Salmonella species than S. typhi, S. paratyphi A, B or C) exhibited a much more overt symptomatology. Though all the "major" salmonellosis occurred in previously healthy patients and caused no death, the "minor" salmonellosis occurred mostly in seriously ill patients and had a lethal outcome for 5 out of 86. There was no typhoid fever epidemic in Touraine during recent years. Lysotyping ruled out the hypothesis of an endemic local reservoir. On the other hand, two hospital outbreaks of "minor" salmonellosis were recognized: one in a psychiatric ward due to S. java in 1967, the other in a pediatric ward due to S. wien in 1971-1972 respectively.

Adolescent

[Current aspects of human salmonellosis in Upper Volta. Study carried out at Centre Muraz (Bobo-Dioulasso) from 1966 to 1977: isolation of 1,013 Salmonella strains].

In a long term research programme of Centre Muraz a study on salmonellosis in Upper Volta has been carried out, at Bobo-Dioulasso, from 1966 to 1977. Investigations have been executed at Centre Muraz, at Bobo-Dioulasso hospital and at Ouagadougou hospital. All the strains of Salmonella were collected at Centre Muraz by biology laboratory, which is a reference service for Upper Volta. This country is include; among the 32 countries which collaborate with W.H.O. and are involved in the world epidemiological surveillance of salmonellosis. For twelve years, 1.013 Samonella strains have been isolated : 1.002 from man and only 11 from animals. The study, which is presented, deals with human salmonellosis. These diseases have been considered from several points of view : bacteriology, clinic, treatment and epidemiology. The various origins of these strains have been specified. The different technics used for diagnosis are discussed briefly : hemoculture (for typhoïd fever and few other types of salmonellosis), coproculture (for "minor" salmonellosis) are the most common and useful methods. Among the 1.013 which have been found, S. typhi is highly predominant (67 p. 100). In the other hand, S. dublin and S. typhi murium play an important role in the various serotypes which occured. A total of 76 serotypes, already known elsewhere, but found for the first time in Upper Volta, have been observed. Three new serotypes have been described : S. bobo, S. kua and S. farakan. As far as clinical problem is concerned, two main aspects are frequent : either typhoid fever syndrome (caused by S. typhi and, scarcely, by other germs, like S. dublin) or gastrointestinal infections, which present different forms and are more or less severe. Up to now, one single strain of S. typhi murium, suspected to be resistant to chloramphenicol has been isolated in 1977. Such a problem would need more complete research in a reference centre. Otherwise, no epidemic multiresistance has been observed. Checking strictly all the strains by systematic antibiograms is now absolutly essential in the plan of a steady epidemiological surveillance.

Adult

[Salmonellosis in children in Ivory Coast, (A study on 69 cases) (author's transl)].

Salmonellosis are still endemic in Ivory Coast. In 1975 they were responsible for 1,75 p. 100 of the admittances in the pediatric department of Treichville University Hospital. In children, the conventional distinction between major and minor salmonellosis is not always obvious. Interpretation of Widal sero-diagnosis is often difficult and awkward. Chloramphenicol generally leads to satisfactory evolution. Salmonellosis are still a problem for Public Health Service. Immunization, is the only effective prophylaxis, but is not carried out yet in Ivory Coast.

Adolescent

[Salmonellosis in Dakar: bacteriological, clinical, epidemiological and therapeutic aspects. Ten years records (author's transl)].

A study on salmonellosis in Senegal has been carried out in Dakar at the University Hospital of Fann from 1966 to 1976. The authors describe the various methods of isolating the germs (mainly hemoculture and coproculture) and the techniques used for bacteriological research (antibiograms, tests on plasmidic resistance). The results of these investigations, which took the whole of 10 years, are presented below, in accordance with their different aspects: - bacteriological: 1 335 strains of Salmonella have been isolated. Significantly, S. typhi is predominant (56,6 p. 100). But 7 serotypes represent 90 p. 100 of the total strains which are now in existence in Dakar; - clinical: the aspects of these diseases vary: typhoïd fever, encephalitis, diarrheic syndrome, especially among infants, and purulent meningitis, which is generally severe; - therapeutic: 880 strains have been tested with 10 antibiotics. Two groups of Salmonella serotypes are opposed: those which are sensitive (S. typhi, S. typhi murium, S. enteritidis, S. paratyphi C), those which have become resistant (S. stanleyville, S. havana, S. ordonez). The most frequent antibiotype of this kind is ASKCTSu. This is a phenomenon of plasmidic resistance, demonstrated by in vitro experiments; - epidemiological: the lysotypes of 86 strains have been determined. Two epidemiological features must be described: either a stable endemic situation with sensitive strains - or epidemics, lasting several years, with resistant serotypes. Different therapeutic schemes can be used: chloramphenicol for typhoid fever, or sometimes cotrimoxazole, or ampicillin for meningitis. In diarrheic syndrome, symptomatic treatment is enough. Then, the authors give their comments on the special characteristics of salmonellosis in Dakar: - the influence of environment on the various clinical aspects of these diseases: very serious cases of meningitis, typhoid fever, which is more severe than in France, and complications when treatment has gone wrong at the beginning; - antibiograms, which are essential, in order to choose the adequate therapeutics; - and the different aspects of epidemillogy, which are linked to the sensitivity of the serotypes to the most active antibiotics. The existence of several resistant serotypes in Senegal is a real danger: plasmidic resistance could be transferred to S. typhi. In such a situation, epidemiological surveillance of salmonellosis is absolutely necessary, and control of enteric diseases, characterized by foecal transmission, must be carried out, with the techniques available in the country.

Anti-Bacterial Agents

Salmonellosis in children with cancer: review of 42 cases.

Forty-two episodes of culture-proved salmonellosis were found retrospectively among 2,262 patients treated for malignant diseases at St Jude Children's Research Hospital, Memphis. These cases were reviewed in an effort to determine whether Salmonella infections in childhood cancer patients are associated with an increased frequency of septicemia and death, as has been reported for adults with cancer. Septicemia occurred in only 10% of the patients studied, consistent with the frequency established in general populations. There were no deaths attributable to Salmonella infection. Most of the patients (57%) with salmonellosis had gastroenteritis, and the clinical course of this syndrome was no more severe or prolonged than that seen in otherwise normal children. We recommend that management of Salmonella infections in children with cancer follow presently accepted guidelines for normal hosts.

Adolescent

Prevalence and epizootiology of equine salmonellosis.

Feces from 1,451 horses entering a veterinary hospital over a 13-month period were cultured for salmonella. A total of 46 horses (3.2%) yielded 1 or more salmonella-positive fecal cultures. Twenty horses were found to be excreting salmonella in the feces on admission, and 5 of these later had severe diarrhea associated with enteric salmonellosis. Abdominal surgery and other severe stresses were associated with all cases of severe enteric salmonellosis. Serotypes of salmonella isolated included Salmonella agona (15), S anatum (14), S typhimurium (7), S typhimurium var copenhagen (4), S infantis (2), S montevideo (1), S meleagridis (1), S drypool (1), and an unnamed Salmonella serotype (1). Seven deaths were attributed to 4 serotypes (S typhimurium, 3; S anatum, 2; S typhimurium var copenhagen, 1; and S montevideo, 1). A marked seasonal incidence is isolations was found with isolations highest in later summer to early fall and lowest in the spring. It was also found that horses can shed salmonella intermittently, and a minimal of 5 consecutive negative fecal cultures is recommended before considering a horse not to be infected with salmonella.

Animals

[Ulterior acquisitions regarding the salmonellosis (author's transl)].

The Authors report the results of the bacteriological researches on the incidence of the Salmonella of our zone, after a brief consideration of general aspects salmonellosis. Our observations are refered to 1005 samples of feces of which 84 cases proved positive to Salmonella. It is pointed out that morbidity, represented by Salmonella typhi, paratyphi A and B is low, while it is high for the Salmonella typhimurium and Salmonella enteritidis. The Authors conclude stating that epidemiological situation of salmonellosis still represents a problem of remarkable importance which demands the intensification and the use of efficacious measures of prophylaxis.

Disease Outbreaks

Immunization of calves against salmonellosis.

Salmonella typhimurium bacterins, containing adequate antigenic mass, protected calves against clinical signs of salmonellosis and death. Protection against salmonellosis was correspondingly reduced when the bacterin was diluted 1:10 and 1:100. A mouse protection test revealed that 17 of 18 (94%) of the S typhimurium-containing bacterin serials produced in 1977 stimulated adequate immunity.

Administration, Oral

Injury of liver in experimental salmonellosis of rabbits infected by salmonella agona.

Liver injury was investigated in the course of salmonellosis evoked by Salmonella agona in experimental infection of rabbits. Histological and biochemical examination (proteinogram, the level of bilirubin, fibrinogen, cholesterol and its esters in blood, activity of asparine and alanine aminotransferases and alkaline phosphatase and guanase in blood) were carried out in 70 animals. Liver injury showing degeneration, steatosis and necrosis was found in the course of salmonellosis. Hepatitis gigantocellularis was sporadically observed. Biochemical parameters were not in correlation with the observed histological changes.

Animals

Studies on oral adjuvants against murine salmonellosis.

1) Attempts were made to develop oral adjuvants against murine salmonellosis. 2) Streptomycin, levamisole and PHA show potential immunoenhancing properties against salmonella infection. 3) The mode of action of these agents remain to be elucidated. Observed results of PHA enhancement may be related to its blastogenic effects in the splenic T-cells. 4) Decrease in certain bacterial flora resulting in less antigenic competition may be the mode of action of streptomycin as adjuvant when added to oral salmonella vaccine.

Adjuvants, Immunologic

Colonic involvement in salmonellosis.

Although small intestine is generally regarded as the principal site involved in human salmonella infection of food-poisoning type, the pathophysiology of salmonella diarrhoea remains obscure. A sigmoidoscopic and biopsy study of 23 hospital inpatients with acute salmonella infection revealed presence of active colitis in 21. It is suggested that colonic involvement is common in human salmonellosis and probably plays an important role in the causation of diarrhoea.

Adolescent

Portal hypertension and chronic salmonellosis in situs invertus.

The unique combination of a late complication of Schistosoma mansoni infection in situs invertus is reported. The improvement in both the haematological and biochemical indices of the patient after splenectomy is discussed. An association between chronic salmonellosis and schistosomiasis is demonstrated; the experience of the author and other workers with this syndrome is discussed.

Adult

Salmonellosis in young calves due to Salmonella enteritidis.

The clinical and epidemiological features of an outbreak of salmonellosis due to Salmonella enteritidis in a group of calves are described. The major clinical signs were dullness, pyrexia and diarrhoea. Five of the 15 calves died but deaths were mainly confined to the younger members of the group. The recovery of salmonella organisms from rectal swabs was maximal shortly before four of the five deaths occurred and declined rapidly thereafter. Only two of the surviving 10 calves developed significant flagellar agglutination titres.

Agglutinins

Eidemiological aspects of an outbreak of salmonellosis in sheep.

An outbreak of salmonellosis caused by Salmonella typhimurium occurred in a lambing flock where management factors and fostering movements were responsible for spread within the group and to farm personnel and their families. Possible sources of the infection are discussed.

Animals

Studies on salmonellosis in the house mouse, Mus musculus.

Salmonellae were isolated from the faeces from 17 of 170 (10%) wild house mice. Salmonella typhimurium was isolated from 10, S. typhimurium, var. Copenhagen from 2, S. thompson from 1, and S. muenchen from 4. It was concluded that house mice could be a reservoir of infection and play an important role in human and animal salmonellosis.

Animals

Renal amyloidosis with nephrotic syndrome in two patients with schistosomiasis mansoni and chronic salmonellosis.

This report describes two Egyptian patients who presented with the nephrotic syndrome and concurrent infections with Schistosoma mansoni and Salmonella paratyphi A. Unlike similar cases previously reported from this unit, these patients did not respond to antimicrobial and antischistosomal therapy, and their renal biopsies demonstrated amyloidosis. These two case reports and several experimental observations suggest that chronic schistosomiasis and salmonellosis may lead to secondary amyloidosis in susceptible individuals.

Adolescent

[Salmonellosis in children. II: management and follow-up (author's transl)].

The clinical records of 185 cases of Salmonellosis have been reviewed retrospectively, in order to study a relation between the evolution and the treatment given, so as to be able to determine the therapeutic criteria. 139 cases showed as gastroenteritis, 48 of which received antibiotic treatment and 91 did not. Statistic differences were observed in favour of the non treated cases where, the average time of hospitalization, the negative copro-cultive and the onset of complications were more favourable. All the cases with Tipho-Paratific fever were treated with antibiotics without finding any significant differences in the clinical evolution not withstanding the antibiotic used. The data here obtained is compared with that previously reported. According to the results a treatment planning is suggested.

Acute Disease