Salmonella - Information for Clinicians
Type of infection
Salmonella is a very hardy gram-negative bacteria with over 2000 serovars (often referred to by the serovar name: S. newport, S. typhimurium, etc.).
Sources of infection
- Reservoir is the GI tract of reptiles, birds, amphibians, and mammals.
- Salmonella infects persons of all ages but the highest incidence is in children younger than 4 years.
- Most infections come from eating undercooked food of animal origin. Salmonella can contaminate other foods including fruits and processed foods during production or harvest. Recent outbreaks have included peanut butter, sprouts, and Chia powder.
- Pet reptiles, especially iguanas, snakes, and turtles are a common source.
Usual symptoms
- Incubation period is 12-72 hours.
- Diarrhea, abdominal pain or cramps, headache, body aches, and fever.
Duration of illness
- Typically 3-7 days.
Treatment
- Antibiotics should be avoided in most people with Salmonella gastroenteritis. There is no evidence that treatment shortens symptoms and antibiotics lead to prolonged Salmonella carriage.
- Antibiotic therapy is recommended for gastroenteritis in infants younger than 6 months, and those with hemoglobinopathies, malignancy, HIV or other severe immunosuppression because of the high risk of concomitant bacteremia. Extraintestinal infections should be treated in everyone.
- Antibiotic susceptibility is highly variable; some strains are quite resistant. Ampicillin and trimethoprim sulfamethoxazole are the usual oral choices for children; flouroquinolones are an alternative. For invasive disease, ceftriaxone is the recommended empiric therapy.
Comments
- The median length of shedding after infection is 30 days and some patients shed for up to 1 year. Detection of Salmonella may reflect an earlier episode of gastroenteritis.
- Salmonella infections are reportable to the health department.
- Reinforce safe food handling.
- Limit exposure of children younger than 5 years of age and immunocompromised children to reptiles and rodents.