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Typhoidal and Non-Typhoidal Salmonella in Urinary Tract Infections: An Investigation of Clinical Occurrence in
Mandeep Kaur1, Akriti Aggarwal2, Meenakshi Singh3
1Department of Microbiology, Government Medical College, Patiala, India.
Abstract:
Enteric fever is a multi-systemic illness of major public health concern. Also known as typhoid fever, it is caused due to both Salmonella typhi and Paratyphi species. Salmonella species have the ability to cause acute, latent, or chronic disease apart from biofilm formation. The outcome of infection depends on various factors, such as the growth state of Salmonella, the environmental conditions encountered at the time of infection, as well as the infected host, and the immune response elicited. If properly treated, many of the patients recover from the acute phase of enteric fever; however, only 3-5% of individuals can develop a chronic carrier state and can act as a reservoir of infection by continued shedding of bacteria in urine and faeces. In infected individuals, Salmonella colonizes the gall bladder and remains there long after symptoms subside, acting as a reservoir for the further spread of the disease. Symptomatic urinary tract infection (UTI) due to Salmonella is uncommon and is rarely encountered especially in an immunocompromised patient with some underlying abnormality involving the urinary tract. In this review, we have tried to explore new directions in the field of Salmonella causing UTI in immunocompetent patients, particularly as it relates to chronic infection.
Insights
Enteric fever, caused by Salmonella Typhi/Paratyphi, can lead to chronic infection and carrier states. This review explores Salmonella-associated urinary tract infections in immunocompetent individuals, focusing on chronic infection dynamics.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Enteric fever, caused by Salmonella Typhi and Paratyphi, is a significant global health issue.
- Salmonella infections can manifest acutely, latently, or chronically, with potential for biofilm formation.
- A small percentage of patients develop a chronic carrier state, often involving gallbladder colonization and shedding of bacteria.
Purpose of the Study:
- To review current understanding of Salmonella causing urinary tract infections (UTIs) in immunocompetent individuals.
- To explore novel insights into chronic Salmonella-related UTIs.
- To highlight the role of Salmonella in UTIs beyond typical presentations.
Main Methods:
- Literature review focusing on Salmonella species and urinary tract infections.
- Analysis of factors influencing Salmonella infection outcomes, including host immunity and bacterial characteristics.
- Exploration of chronic infection reservoirs and transmission pathways.
Main Results:
- Symptomatic Salmonella UTIs are uncommon, particularly in immunocompetent hosts without underlying urinary tract abnormalities.
- Gallbladder colonization by Salmonella serves as a persistent reservoir for infection.
- Chronic shedding of bacteria in urine and feces characterizes the carrier state.
Conclusions:
- Salmonella can cause uncommon UTIs in immunocompetent individuals, often linked to chronic infection.
- Understanding chronic Salmonella infections, including UTIs, is crucial for public health strategies.
- Further research is needed to explore new directions in managing and preventing chronic Salmonella-related UTIs.
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