Salmonella enterica serotype Choleraesuis: epidemiology, pathogenesis, clinical disease, and treatment

Abstract

Nontyphoid Salmonella strains are important causes of reportable food-borne infection. Among more than 2,000 serotypes, Salmonella enterica serotype Choleraesuis shows the highest predilection to cause systemic infections in humans. The most feared complication of serotype Cholearesuis bacteremia in adults is the development of mycotic aneurysm, which previously was almost uniformally fatal. The advances in diagnostic techniques, surgical care, and antimicrobial therapy have greatly improved the survival of these patients. However, the recent emergence of serotype Choleraesuis that is resistant to ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, and, notably, fluoroquinolone antibiotics has aroused concern about the use of these agents for the empirical treatment of systemic infection caused by this organism. In view of the serious implications of the situation, the chain of transmission and mechanism of resistance should be carefully studied to reduce the spread of infection and threat to human health. To date, there are no vaccines available to prevent serotype Choleraesuis infections in humans. The availability, in the near future, of the genome sequence of serotype Cholearesuis will facilitate the development of effective vaccines as well as the discovery of new targets for novel antimicrobial agents.

FIG. 1.

Axial CT scan of the abdomen of a patient with S. enterica serotype Choleraesuis infection, depicting a periaortic mass with intimal rim enhancement (arrow). Abbreviation: Sp, spine.

FIG. 2.

Coronal MR angiogram of a patient with S. enterica serotype Choleraesuis infection, revealing aneurysm formation (arrow) at the infrarenal portion of the abdominal aorta. Abbreviations: A, aorta; K, kidney; L, liver; S, spleen.