Introduction
Certain infections arise from rotten food, which can be potentially hazardous creating global health concerns. Nontyphoidal salmonellosis is one such familiar bacterial infection that develops because of the intake of spoiled food.
What Is Nontyphoidal Salmonellosis?
Nontyphoidal salmonellosis is a peculiar and frequently reported infection contracted through unsafe, contaminated, and spoiled foodstuff. Hence, it is classified as a foodborne disease. However, it can also spread from an infected person to another healthy person via oral and fecal routes. It has the potential to cause serious health issues, especially in individuals with weakened immune responses.
What Causes Nontyphoidal Salmonellosis?
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Nontyphoidal salmonella bacterial serotypes are the prime culprit behind nontyphoidal salmonellosis.
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Salmonella enterica is a specific bacterial species that encompasses diverse serotypes (subspecies) of salmonella. However, only a few serotypes can produce infections in human beings.
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Salmonella serotypes like Salmonella Enteritidis, Salmonella Heidelberg, Salmonella Javiana, Salmonella Typhimurium, Salmonella Dublin, Salmonella Choleraesuis, and Salmonella Newport are commonly seen in association with nontyphoidal salmonellosis.
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These serotypes are widely seen in animals like poultry, dogs, cats, pigs, birds, and cattle. Salmonella infection in these animals often remains asymptomatic and unrecognized.
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These bacteria enter the human body upon intake of food containing infected animal products like meat, egg, and milk.
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Proper cooking kills the bacteria in animal products, but those bacterias persist in undercooked items. Thus, improper cooking of these products increases the likelihood of developing nontyphoidal salmonellosis.
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Salmonella serotypes may sometimes acquire a human body via salmonella-contaminated drinking water.
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In addition, these infections can be contracted directly from infected animals or infected humans. Therefore, it can rapidly spread within the population in a short span of time.
What Are the Signs and Symptoms Associated With Nontyphoidal Salmonellosis?
Nontyphoidal salmonellosis is generally symptomatic and manifests diverse symptoms ranging from loose stool to severe blood infection (septicemia). Occasionally the condition settles on its own and does not necessitate treatment. Rarely, do the nontyphoidal salmonella bacteria linger in the body without eliciting any symptoms, such individuals act as a carrier for the disease asymptomatically. Routinely encountered signs and symptoms of nontyphoidal salmonellosis include the following:
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Fever: It is the most frequently reported symptom which exhibit in the form of a sudden outbreak. Fever gives a hint about the progressing infection in the body.
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Gastroenteritis: It is most extensively manifested in nontyphoidal salmonellosis. As the name indicates, it affects the stomach. Patients who develop gastroenteritis often elicit persistent diarrhea (loosening of stool) and vomiting. Stools often contain streaks of pus, and blood and become more dark in color. Most of the time, it is accompanied by severe cramping and pain in the stomach. The patient remains nauseous (increased tendency to vomit) throughout. Constant diarrhea and vomiting precipitate weakness and dehydration. All the associated symptoms of dehydration like dry skin, dry mouth, scanty urine, and many more become evident in advanced stages. In addition, it may produce mental confusion, dizziness, and irritability.
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Bacteremia: It is not a routinely presented symptom of nontyphoidal salmonellosis, however, it can be potentially life-threatening. It develops typically in individuals with significantly weakened immunity. Once the salmonella bacteria becomes active in the body it then invades into the bloodstream giving rise to a condition called bacteremia. If the immune system could not tackle the progressing bacteremia, then the bacteria gain access to other parts of the body and can precipitate infections in any of the vital organs. It is potentially fatal and hazardous as it often ends up in septicemia (fatal blood infection) and septic shock. These are medical crises demanding immediate medical attention and intervention.
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Focal diseases: Certain focal salmonella infections were reported in a very small percentage of patients. Some of the focal infections that tend to develop in nontyphoidal salmonellosis include meningitis (infection involving the protective layer of the brain), septic arthritis (joint pain elicited by bacterial infection), and osteomyelitis (bacterial bone infection). At times, the bacteria may secondarily invade an already existing tumor in the body and make the condition much more worse.
How Is Nontyphoidal Salmonellosis Diagnosed?
Detailed medical history and thorough analysis of the clinical findings act as a leading lamp for the diagnosis process. We can confirm the diagnosis only by detecting the nontyphoidal salmonella serotypes, which require specific investigatory tests. Some of the routinely advised diagnostic tests and procedures include the following:
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Stool Culture: By culturing the stool or fecal matter, the bacterial serotype involved with the infection can be recognized. It not only aids in the diagnosis but also facilitates the treatment strategy. Once the disease progress into blood infections, then occasionally stool culture could not reveal the microbe, producing a false negative response. Hence it is better to combine stool culture with other diagnostic tests.
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Blood Culture: It is quite a reliable test for nontyphoidal salmonellosis and it works by identifying the chief bacterial serotype precipitating the infection.
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Urine Culture: Urine culture and analysis are often advised supplementary to other tests. It reveals the signs of a persisting bacterial infection in the body.
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Cerebrospinal Fluid (CSF) Culture: It is advised when a focal salmonella infection involving the meninges (brain covering) is suspected. CSF culture facilitates the identification of the bacterial type in the cerebrospinal fluid.
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Antimicrobial Susceptibility Test: It is done primarily to enhance the treatment strategy. It works to figure out the antibiotic that is specifically sensitive and active against the bacterial type.
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Serotyping: It is specifically done for the identification of the exact serotype of salmonella involved in that patient.
What Are the Treatment Interventions Available for Nontyphoidal Salmonellosis?
Treatment strategies are more or less based on the health condition of the patient and the severity of the infection. In most cases, the infection does not demand treatment, and it resolves within a couple of weeks.
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Oral Rehydration Therapy: It is the only advised treatment in patients who exhibit minor symptoms with no complications. Oral rehydration therapy is advised to prevent dehydration.
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Antimicrobial Therapy: It is advised for children and patients with a weakened immune system. Antimicrobial selection is done with the help of an antimicrobial susceptibility test. The antibiotic that is specifically active against the bacterial serotype is prescribed. Fluoroquinolones are the most widely preferred antibiotic for nontyphoidal salmonellosis. In case the bacteria exhibit resistance towards Fluoroquinolone, then Azithromycin is recommended.
Conclusion
Nontyphoidal salmonellosis is a routinely encountered and extensively reported form of food infection. It exhibits a wide range of symptoms and rarely necessitates any treatment interventions unless the patient is having severely weakened immunity. Complications are often elicited in children, as the immune system is not in a fully developed stage and needs to be treated accordingly. Antibiotic therapy suffices to tackle the infection.
