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| CASE REPORT |
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| Year : 2017 | Volume
: 6
| Issue : 1 | Page : 68-70 |
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Infection caused by Salmonella gallinarum emergent bacteria
Youssef Moutaouakkil, Mohammed Frikh, Adil Maleb, Abdelhay Lemnouer, Mostafa Elouennass
Service of Bacteriology, Mohammed V Military Teaching Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| Date of Web Publication | 17-Jul-2017 |
Correspondence Address:
Youssef Moutaouakkil
Service of Bacteriology, Mohammed V Military Teaching Hospital, Hay Riad, 10100 Rabat
Morocco
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/sjhs.sjhs_81_16
Salmonella gallinarum is a Gram-negative bacillus. The ubiquitous Salmonella reservoir is very wide, and many animals (mammals, birds, reptiles, fish, and insects) may harbor these bacteria. Expose a Host Tropism more restricted in poultry. This is essentially an opportunistic pathogen in immunocompromised patients. Its detection in crops is always difficult because it simulates many bacteria which are often associated in pathological products. S. gallinarum infections are rare, as we know, tree cases have been described in the literature. We report one case of S. gallinarum infection. Keywords: Immunodepression, Salmonella gallinarum, septicemia, susceptibility
How to cite this article:
Moutaouakkil Y, Frikh M, Maleb A, Lemnouer A, Elouennass M. Infection caused by Salmonella gallinarum emergent bacteria. Saudi J Health Sci 2017;6:68-70 |
| Introduction | |  |
Salmonella More Details is a bacterial enteric pathogen capable of infecting a guest host. Depending on the serotype of the infected host, Salmonella can induce various diseases, gastroenteritis type, and systemic infection, through the asymptomatic carriage.[1],[2],[3]
Salmonella gallinarum bacteremia is rare, as we know, trees cases have been described in the literature. We report another case of infection due to Salmonella gallinarum.
| Case Report | | |
Mrs. FM aged 75, diabetic and hypertensive Type I, admitted to the orthopedic trauma service for support of an abscess of the thigh and leg evolving for over a month. The admission to clinical examination revealed a lower limb edema and inflammation that extends from the lower third of the thigh to the rear side of the leg; laboratory tests found the C-reactive protein (CRP) 252.1 mg/L, leukocytosis was 22,000/mm 3, and severe renal impairment with a creatinine clearance modification of diet in renal diseases was 17 ml/min. The patient was admitted to the operating room and after surgical treatment, The biological examination showed numerous neutrophils and some Gram-negative bacilli and Gram-positive. The subculture on agar media horse blood 5% led to the isolation after 48 h at 37°C and 8% CO2 rich atmosphere of Gram-negative bacteria, and identification of S. gallinarum gallery was made by API 20 E (bioMerieux, France) Marcy star (95.1% excellent identification). The patient was put under amoxicillin-clavulanic acid 1 g × 3/day. On the fourth postoperative day The patient developed a septic shock crisis with cardiac arrest That was recovered. The patient was transferred in the middle of resuscitation with stopping amoxicillin-clavulanic acid and relay ciprofloxacin 200 mg/24 intravenous and metronidazole 500 mg × 3/day for 3 days. The outcome was a marked clinical and laboratory improvement (CRP was 63.6 mg/l, K + is 7.80 mmol/L, the blood count showed leukocytes at 22,000/μl, a hemoglobin at 9.3 g/day, red blood cell 3.07 106).
The study of the sensitivity of the isolates, by disk diffusion method, showed the same profile; sensitivity at ertapenem, cefalotin, amoxicillin, ticarcillin, amoxicillin + clavulanate, cefotaxime, piperacillin + tazobactam, cefoxitin, fosfomycin, colistin, gentamicin, tobramycin, amikacin, netilmicin, ciprofloxacin, cotrimoxazole.
| Discussion | | |
The genus Salmonella belongs to the family Enterobacteriaceae. Discovered by Theobald Smith (1859–1934) in 1885, it was named in honor of the American Dr. Daniel Elmer Salmon (1850–1914).
The genus Salmonella comprises Gram-negative bacteria motile with peritrichous flagellae. D-glucose is fermented with the production of acid and usually gas. Other carbohydrates usually fermented are L-arabinose, maltose, D-mannitol, D-mannose, L-rhamnose, D-sorbitol (except ssp VI), trehalose, D-xylose, and dulcitol. Oxidase negative, catalase positive, indole and Voges-Proskauer negative, and methyl red and Simmons citrate positive. H2S is produced; urea is not hydrolysed.
The genus Salmonella consists of two species: The genus Salmonella consists of two species: (1) Salmonella enterica, which is divided into six subspecies – S. enterica subsp. enterica (I), S. enterica subsp. salamae (II), S. enterica subsp. arizonae (IIIa), S. enterica subsp. diarizonae (IIIb), S. enterica subsp. houtenae (IV), S. enterica subsp. indica (VI); and (2) almonella bongori (formerly subsp. V).
S. enterica subspecies are further classified into many serovars, and more than 2500 serovars have been identified so far; they include many pathogens having great medical and veterinary importance. These serovars differ greatly in their host range and their degree of host adaptation.[5],[6]
S. enterica serovar gallinarum (S. gallinarum) is distinct from the rest of the known Salmonella serovars; this is the only known serovar that is highly adapted to fowls and is the only known serovar that is nonmotile. This serovar includes two biovars, gallinarum, and pullorum.
This microorganism may be responsible for intestinal colonization with no symptoms (asymptomatic carriers), gastroenteritis or a generalized infection, sometimes fatal.
Since its description, Salmonella gallinarum expose a host tropism is more restricted in poultry. However, cases of infections in humans are rare; they occur in immunocompetent than in immunocompromised as is the case of our patient had an abscess of the thigh and leg. The defective humoral immunity in our patient could be one of the factors favoring the invasive infection, plus the potential virulence of this species.[7]
In fact, the study of the evolution of genomes of different serotypes indicates that S. gallinarum descend ubiquitous serotypes such as Salmonella enteritidis and typhimurium and their genomes have suffered significant damage, mainly deletions and formation of pseudogenes.[7],[8]Salmonella virulence genes may be located on a plasmid or on the chromosome and that, in isolation, in operon or within regions called genomic islands. These genomic islands include many genes involved in the same function as the metabolic adaptation to a specific environment, antibiotic resistance, or virulence.[9] Two genomic islands were found Salmonella pathogenicity island (SPI) -13 SPI-14 in S. gallinarum exhibiting virulence in avian model.
S. gallinarum infection is not explainable to this day; it seems that this is a result of an adverse effect of the typhoid-paratyphoid A and B (TAB) vaccination.
In the literature, three cases of infection with S. gallinarum were enacted: in 2001, two cases in two apparently immunocompetent patients have been reported. These boxes were both from the Indo-Pakistan subcontinent and developed a septicemic illness TAB following vaccination in Saudi Arabia.[10] In 2006, patient from Iran was apparently immunocompetent with empyema due to Salmonella gallinarum.[11]
The recognition of this bacterium in bacterial cultures can be tricky for several reasons: On the one hand growth can be supplanted by other rapid-growing bacteria, On the other hand, coexistence with other microorganisms.
To diminish the risk of obtaining false negative results, a nonselective preenrichment, a combination of two selective enrichments and plating on two selective media are performed:
- Preenrichment in nonselective medium (buffered peptone water)
- Selective enrichment in tetrathionate broth (Müller-Kauffmann) and Rappaport-Vassiliadis soya peptone broth
- Subcultivation on xylose lysine deoxycholate agar and on Brilliant Green agar (or another selective agar media).
On the study of the susceptibility of S. gallinarum, there are no established recommendations. Strains tested in the literature were sensitive to gentamicin, tobramycin, and cefalotin; but resistant to penicillin, sulfamethoxazole-trimethoprim, chloramphenicol, erythromycin, tetracycline.[10] The results obtained using any method (diffusion method, E-test) should be interpreted with caution.
Although our strain was sensitive to the molecule used in the treatment, the net clinical course of our patient could be due to ground debility and probably to the potential virulence of this strain.
| Conclusion | | |
S. gallinarum infections are rare. Their diagnosis is sometimes difficult. The difficulty of highlighting a real problem and sometimes retards supported. Moreover, further studies are needed to standardize its susceptibility.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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