SALMONELLA-

SHIGELLA
Salmonella
Motile Gram-negative, rod shaped bacilli
Non-lactose fermenter
Produce H2S (except S. parathypi)
Causes Salmenollosis
Indole,VP, Phe deaminase, Urease Negative
Do not grow in the presence of potassium
cyanide.
 Salmonella Nomenclature
Salmonella subgroup Former Subspecies Serotypes within
genus subspecies

I Salmonella enterica subsp. enterica 1,454

II Salmonella enterica subsp. salamae 489

IIIa Arizona enterica subsp. arizonae 94

IIIb Arizona enterica subsp. diarizonae 324

IV Salmonella enterica subsp. houtenae 70

VI Salmonella enterica subsp. indica 12

Salmonella bongori (formerly subsp.V) 20

Total Serotypes: 2,463

Most significant serotypes:
Salmonella typhi : causes Typhoid fever and
carrier state
Salmonella cholerasuis: Septicemia
Salmonella enteritidis: Gastroenteritis

Human pathogens:
Salmonella serotype Typhi (Salmonella typhi)
Salmonella serotypes Paratyphi A, B, C (Salmonella
parathypi)
MODE OF TRANSMISSION:
Salmonella typhi and Salmonella parathypi
Person-to-person by fecal oral route by ingestion of
food or water contaminated with human Excreta
Other Salmonella spp:
Ingestion of contaminated food products processed
from animals (mostly poultry or dairy)
Direct person-to-person by fecal-oral route
PATHOGENIC
DETERMINANTS:
Antiphagocytic capsule (Vi antigen)
A polysaccharide capsule that
surrounds the O antigen.
Intracellular growth and replication
Endotoxin and exotoxin
 DISEASE CAUSED BY SALMONELLA
SPP.
Enteric Fever (Typhoid Fever)
Caused by S. typhi
Starts 1- 3 weeks after exposure and includes a continuous dull frontal headache
and abdominal pain that is either diffuse or localized to the right lower quadrant,
often mimicking appendicitis.
The organisms gain entrance into the lymphatic system, reach the blood stream
and spread further to the liver, spleen and bone marrow and engulfed by
macrophages (Monocytes).
Released for the second time in the blood stream and febrile episode becomes
more evident.
Organisms invade the gall bladder and Peyers patches of the bowel
Rose spots (petechiae) on the abdomen a transient rash consisting of small
pink marks seen only on light-skinned people.
Carrier State
Some people recovering from typhoid fever
become chronic carriers, harboring Salmonella
typhi in their gallbladders and excreting the
bacteria constantly. These people are not
actively infected and do not have any
symptoms.
Some carriers usually require surgical removal
of their gallbladders to cure them.
Sepsis (Bacteremia)
Caused by Salmonella cholerasuis
Characterized by prolonged fever and intermittent
bacteremia
Salmonella in the bloodstream infect lungs, brain, or
bone.
Does not involve the GI tract
Patients with underlying diseases are susceptible
Gastroenteritis (Diarrhea)
Caused by Salmonella enteritidis
One of the most common forms of food
poisoning usually attributed primarily to poultry,
milk, eggs, egg product as well as handling pets.
Symptoms include nausea, vomiting, fever, chills
accompanied by watery diarrhea and abdominal
pain.
Most susceptible are patients with sickle cell
disease, hemolytic disorders and ulcerative colitis
Shigella
Non-motile Gram-negative, facultative
anaerobic bacillus
non-lactose fermenter (except for Shigella
sonnei which is a late lactose fermenter)
Humans are the only hosts.
H2S Negative
Resistant to bile salts
Causes Shigellosis (Bacillary dysentery)
SUBGROUPS AND SPECIES:
Group A : Shigella dysenteriae most serious type of
bacillary dysentery; rare
Group B: Shigella flexneri affects mostly male
homosexuals
Group C: Shigella boydii
Group D: Shigella sonnei mild and most commonly
encountered disease; prevalent in day care centers
and close communitites.
 DIFFERENTIATION OF SHIGELLA
SUBGROUPS
Reaction dysenteria flexneri boydii sonnei
e
Fermentati
on of:
Lactose - - - -(Late)
Mannitol - + + +
ODC - - - +
ONPG - - - +
Pathogenesis:
Shigellosis

Two-stage disease:
Early stage:
Watery diarrhea attributed to the enterotoxic activity of Shiga toxin
following ingestion and noninvasive colonization, multiplication, and
production of enterotoxin in the small intestine
Fever attributed to neurotoxic activity of toxin

Second stage:
Adherence to and tissue invasion of large intestine with typical symptoms
of dysentery
Cytotoxic activity of Shiga toxin increases severity
CHARACTERISTICS OF SHIGA TOXIN

Enterotoxic, neurotoxic and cytotoxic

Encoded by chromosomal genes

Two domain (A-5B) structure

Similar to the Shiga-like toxin of enterohemorrhagic E. coli
(EHEC)
NOTE: except that Shiga-like toxin is encoded by lysogenic bacteriophage
SHIGA TOXIN EFFECTS IN SHIGELLOSIS

Enterotoxic Effect:
Adheres to small intestine receptors
Blocks absorption (uptake) of electrolytes, glucose,
and amino acids from the intestinal lumen
Note: This contrasts with the effects of cholera toxin (Vibrio cholerae) and labile
toxin (LT) of enterotoxigenic E. coli (ETEC) which act by blocking absorption of
Na+, but also cause hypersecretion of water and ions of Cl-, K+ (low potassium =
hypokalemia), and HCO3- (loss of bicarbonate buffering capacity leads to
metabolic acidosis) out of the intestine and into the lumen
Cytotoxic Effect:
B subunit of Shiga toxin binds host cell glycolipid
A domain is internalized via receptor-mediated endocytosis (coated
pits)
Causes irreversible inactivation of the 60S ribosomal subunit, thereby
causing:
Inhibition of protein synthesis
Cell death
Microvasculature damage to the intestine
Hemorrhage (blood & fecal leukocytes in stool)

Neurotoxic Effect: Fever, abdominal cramping are

considered signs of neurotoxicity
CLINICAL FEATURES
FEVER
BLOODY DIARRHOEA
ABDOMINAL CRAMPS
TENESMUS
MUCUS , PUS
CONVULSIONS
MILD INFECTION :WATERY STOOL
BACTEREMIA - RARE
REITER,S SYNDROME
HEMOLYTIC UREMIC SYNDROME
 BIOCHEMICAL REACTIONS

Test Salmonella Shigella

TSI K/A K/A

H2S + 0

IMViC 0+0+ V+00

Motility + 0

Urease 0 0

Deaminase
0 0
(Phe)

MacConkey Clear Colorless colonies

Hektoen
Green with black centers Green Colonies
Enteric
CULTURE MEDIUM
Laboratory Identification
CULTURE

In XLD they appear pinkish to reddish colonies while in

Heaktoen Enteric Agar (HEA), they give green to blue green
colonies.

Commonly used primary isolation media include MacConkey, Hektoen Enteric Agar,
and Salmonella-Shigella (SS) Agar. These media contain bile salts to inhibit the
growth of other Gram-negative bacteria and pH indicators to differentiate lactose
fermenters (Coliforms) from non-lactose fermenters such as Shigella