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Updated: Aug 19, 2026

High-throughput Assay to Phenotype Salmonella enterica Typhimurium Association, Invasion, and Replication in Macrophages
Published on: August 11, 2014
Reactive joint symptoms following an outbreak of Salmonella typhimurium phage type 135a
Anita T Y Lee1, Robert G Hall, Kevin D Pile
1Department of Rheumatology, The Queen Elizabeth Hospital, Adelaide, Australia. alee@mail.rah.sa.gov.au
Objective:
To quantify the incidence and clinical features of reactive arthritis (ReA) developing in a cohort exposed to an outbreak of Salmonella typhimurium phage type 135a, and factors affecting host susceptibility to ReA.
Methods:
A screening questionnaire was mailed to 493 patients with confirmed Salmonella infection. Musculoskeletal symptoms and extraarticular manifestations of ReA were quantified. Positive responders with joint pain were invited to participate further, with a detailed history, examination, and investigations including HLA-B27 status.
Results:
A total of 261/461 (57%) subjects responded to the questionnaire, with 23/54 adults (43%) and 41/207 children (20%) reporting joint symptoms. Although joint pains were less common in children compared with adults, those children affected usually had eye (34%) or mucocutaneous (37%) symptoms. The incidence of ReA was 14.6%, with adults more frequently affected (24%) than children (12%). This may be an underestimate given the large proportion of children involved. Associated clinical features were similar to previous studies, with the distribution of arthritis affecting the lower limbs predominantly in an oligoarticular pattern, as were the extraarticular manifestations and enthesopathy. We found 17% of subjects were HLA-B27 positive, and 55% were still symptomatic after 6 months.
Conclusion:
In an Australian cohort study of a S. typhimurium phage type 135a outbreak, joint symptoms were common, affecting 25% of subjects. The incidence of ReA of 14.6% and the clinical features were comparable to previous studies. There was a small effect of HLA-B27 status on the development of ReA.
Insights
Reactive arthritis (ReA) affected 14.6% of individuals after a Salmonella outbreak. Clinical features were typical, with a minor influence of HLA-B27 on ReA development.
Area of Science:
- Rheumatology
- Infectious Diseases
- Epidemiology
Background:
- Reactive arthritis (ReA) is a form of inflammatory arthritis.
- It can develop after certain bacterial infections, including Salmonella.
Purpose of the Study:
- To determine the incidence and clinical presentation of ReA following a Salmonella typhimurium phage type 135a outbreak.
- To identify factors influencing host susceptibility to ReA.
Main Methods:
- A cohort exposed to Salmonella typhimurium phage type 135a was studied.
- Screening questionnaires identified patients with musculoskeletal symptoms.
- Further investigations included detailed history, examination, and HLA-B27 testing.
Main Results:
- The incidence of ReA was 14.6%, with adults more affected than children.
- Joint pain was reported by 25% of subjects.
- Common clinical features included oligoarticular arthritis in the lower limbs, eye, and mucocutaneous symptoms.
Conclusions:
- The incidence and clinical features of ReA in this Salmonella outbreak were consistent with previous studies.
- HLA-B27 status had a minor impact on ReA development.
- Joint symptoms were common post-infection.
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