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Query: UMLS:C0017160 (gastroenteritis)
 11,398 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We describe 1 neonate and 3 infants with bacteremia secondary to rotavirus gastroenteritis. All had a typical course of an increase in temperature several days after admission. The causative organisms were Enterobacter cloacae and Klebsiella pneumoniae, both normal commensals of the small intestine. Pediatricians should be aware of this complication.
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PMID:Secondary bacteremia after rotavirus gastroenteritis in infancy. 1707 4

In focal infections (FI) caused by nontyphoidal Salmonella serotypes and recorded at a Spanish hospital 1991-2001, clinical and microbiological features were analyzed. Thirty-five revised episodes were related to infections of the digestive (10), urinary (10), pulmonar (4), vascular (4), osteoarticular (3) and central nervous (3) systems, and with a submaxillary lymph node. At least 16 episodes were associated with previous or concomitant gastroenteritis, 19 with primary or secondary bacteremia, and 18 with underlying diseases of different severity. Eighteen patients were male and 14 female (data were not available for three patients), while 1, 4, 12 and 15 patients were, respectively, categorized as children, young adults, senior adults and elderly. Sources of Salmonella strains were urine (13), blood (11), purulent abscess (8), cerebrospinal fluid (3), peritoneal fluid, pleural fluid, wound exudates, aneurism (2 of each), ascitic fluid, sputum, tracheal aspirate, needle aspirate, bone and lymph node (1 of each) samples. Only 28 Salmonella strains involved in FIs were available for further analysis. They were discriminated into 6 serotypes, and into 13 XbaI macrorestriction, 6 virulence, 11 antimicrobial resistance, 5 integron and 10 plasmid profiles. Broadly, the pattern of serotype distribution of salmonellas involved in FIs matched that of those causing gastroenteritis, with the pandemic Enteritidis and Typhimurium (18 and 6 strains, respectively) being clearly predominant. Within serotype, the same lineages (as revealed by XbaI-macrorestriction analysis as well as R- and V-profiles) were represented in both disease groups, with host-related factors apparently playing a more critical role than the individual strain in the outcome of the disease.
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PMID:Nontyphoidal Salmonella causing focal infections in patients admitted at a Spanish general hospital during an 11-year period (1991-2001). 1662 98

Nontyphoidal salmonellae are among the most common causes of bacterial gastroenteritis worldwide. They are also notable causes of extraintestinal infections, including bacteremia and vascular infections. Salmonella enterica serotype Choleraesuis is typically associated with invasive infections. We report a patient who had an infected intra-abdominal aortic aneurysm due to an unusually mucoid strain of Salmonella enterica serotype Choleraesuis. The isolate was erroneously identified as Hafnia alvei by the Vitek GNI+ card system. A blood culture isolate taken from the same patient 9 months earlier was also identified as H. alvei by the Vitek GNI+ card system. Despite an apparent cure with intravenous amoxicillin-clavulanic acid at that time, the Salmonella infection had not been cleared and manifested as a ruptured infected abdominal aortic aneurysm. Repeated passage of the strain yielded nonmucoid colonies, which were correctly identified by the API and PHOENIX systems. The isolates from the aneurysm and the former bacteremic episode were found to be identical using pulsed field gel electrophoresis. The fallibility of automated bacterial identification systems is highlighted. Such errors are especially important for isolates in which in vitro antibiotic susceptibility testing does not correlate with the clinical success of treatment, as illustrated by Salmonella infections.
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PMID:Misidentification of a mucoid strain of Salmonella enterica serotype choleraesuis as Hafnia alvei by the Vitek GNI+ card system. 1705 Aug 21

Salmonellosis is a worldwide health problem; Salmonella infections are the second leading cause of bacterial foodborne illness in the United States. Approximately 95% of cases of human salmonellosis are associated with the consumption of contaminated products such as meat, poultry, eggs, milk, seafood, and fresh produce. Salmonella can cause a number of different disease syndromes including gastroenteritis, bacteremia, and typhoid fever, with the most common being gastroenteritis, which is often characterized by abdominal pain, nausea, vomiting, diarrhea, and headache. Typically the disease is self-limiting; however, with more severe manifestations such as bacteremia, antimicrobial therapy is often administered to treat the infection. Currently, there are over 2,500 identified serotypes of Salmonella. A smaller number of these serotypes are significantly associated with animal and human disease including Typhimurium, Enteritidis, Newport, Heidelberg, and Montevideo. Increasingly, isolates from these serotypes are being detected that demonstrate resistance to multiple antimicrobial agents, including third-generation cephalosporins, which are recommended for the treatment of severe infections. Many of the genes that encode resistance are located on transmissible elements such as plasmids that allow for potential transfer of resistance among strains. Plasmids are also known to harbor virulence factors that contribute to Salmonella pathogenicity. Several serotypes of medical importance, including Typhimurium, Enteritidis, Newport, Dublin, and Choleraesuis, are known to harbor virulence plasmids containing genes that code for fimbriae, serum resistance, and other factors. Additionally, many Salmonella contain pathogenicity islands scattered throughout their genomes that encode factors essential for bacterial adhesion, invasion, and infection. Salmonella have evolved several virulence and antimicrobial resistance mechanisms that allow for continued challenges to our public health infrastructure.
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PMID:Food animal-associated Salmonella challenges: pathogenicity and antimicrobial resistance. 1787 85

Edwardsiella tarda, a member of the family Enterobacteriaceae, is a Gram-negative bacillus that is most often pathogenic in aquatic environments. Human infections with Edwardsiella are rare, with most occurring in immunocompromised or immunosuppressed hosts. Reported infections include meningitis, cholecystitis, endocarditis, osteomyelitis, soft tissue infections, bacteremia and septicemia, dysentery, and gastroenteritis. This report describes a case of E. tarda gastroenteritis in a renal transplant patient receiving immunosuppressive therapy. The epidemiology, diagnosis, clinical presentation, and treatment options pertaining to E. tarda infections are examined.
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PMID:Gastroenteritis caused by Edwardsiella tarda in a pediatric renal transplant recipient. 1808 38

Salmonella tiphymurium infection frequently causes gastroenteritis but some cases have a predilection for damaged blood vessels, especially those affected by atherosclerosis. The abdominal aorta is the most frequent location. Salmonella aortitis with mycotic aneurysm formation is a rare but serious condition, due to the high risk of rupture. We report the clinical case of a 61 year old man with a history of diabetes and hypertension, who was previously admitted with Salmonella gastroenteritis for which he had been treated with proper antibiotics. He was readmitted with fever, nausea and low back pain. Salmonella thyphimurium was isolated in blood cultures. The investigation revealed a pseudoaneurysm formation on the abdominal aorta. He was submitted to surgical vascular grafting with aneurysm resection and antibiotic therapy before and after surgery, with excellent clinical outcome. Bacteremia due to Salmonella Typhymurium must always raise the suspicion of focalization, especially a vascular infection. Particular attention should be given to predisposing factors, such as pre-existent atherosclerosis and age. The advised treatment of mycotic aneurysm due to a Salmonella agent must be a combined medical and surgical therapy.
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PMID:[Salmonella typhimurium aortitis]. 1816 78

The global trend toward intensive livestock production has led to significant public health risks and industry-associated losses due to an increased incidence of disease and contamination of livestock-derived food products. A potential factor contributing to these health concerns is the prospect that selective pressure within a particular host may give rise to bacterial strain variants that exhibit enhanced fitness in the present host relative to that in the parental host from which the strain was derived. Here, we assessed 184 Salmonella enterica human and animal clinical isolates for their virulence capacities in mice and for the presence of the Salmonella virulence plasmid encoding the SpvB actin cytotoxin required for systemic survival and Pef fimbriae, implicated in adherence to the murine intestinal epithelium. All (21 of 21) serovar Typhimurium clinical isolates derived from animals were virulent in mice, whereas many (16 of 41) serovar Typhimurium isolates derived from human salmonellosis patients lacked this capacity. Additionally, many (10 of 29) serovar Typhimurium isolates derived from gastroenteritis patients did not possess the Salmonella virulence plasmid, in contrast to all animal and human bacteremia isolates tested. Lastly, among serovar Typhimurium isolates that harbored the Salmonella virulence plasmid, 6 of 31 derived from human salmonellosis patients were avirulent in mice, which is in contrast to the virulent phenotype exhibited by all the animal isolates examined. These studies suggest that Salmonella isolates derived from human salmonellosis patients are distinct from those of animal origin. The characterization of these bacterial strain variants may provide insight into their relative pathogenicities as well as into the development of treatment and prophylactic strategies for salmonellosis.
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PMID:Human Salmonella clinical isolates distinct from those of animal origin. 1824 51

Listeria monocytogenes is a facultative intracellular bacterium that has predilection for causing central nervous systemic infections in humans and domesticated animals. This pathogen can be found worldwide in the food supply and most L. monocytogenes infections are acquired through ingestion of contaminated food. The main clinical syndromes caused by L. monocytogenes include febrile gastroenteritis, perinatal infection, and systemic infections marked by central nervous system infections with or without bacteremia. Experimental infection of mice has been used for over 50 years as a model system to study the pathogenesis of this organism including the mechanisms by which it invades the brain. Data from this model indicate that a specific subset of monocytes, distinguished in part by high expression of the Ly-6C antigen, become parasitized in the bone marrow and have a key role in transporting intracellular bacteria across the blood-brain barriers and into the central nervous system. This Minireview will summarize recent epidemiologic and clinical information regarding L. monocytogenes as a human pathogen and will discuss current in vitro and in vivo data relevant to the role of parasitized monocytes and the pathogenetic mechanisms that underlie its formidable ability to invade the central nervous system.
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PMID:Listeria monocytogenes: epidemiology, human disease, and mechanisms of brain invasion. 1846 88

Nontyphoidal salmonellosis is the leading cause of foodborne illness in the United States, causing about 1.4 million infections annually. Most cases of salmonellosis are due to ingestion of contaminated food items such as eggs, dairy products, and meats, but almost any foodstuff can be implicated, including peanut butter, as seen during a recent outbreak of more than 600 Salmonella infections. Although outbreaks often gain national media attention, the majority of nontyphoidal Salmonella infections in the United States occur sporadically. Risk factors for salmonellosis include gastric hypoacidity, recent use of antibiotics, extremes of age, and immunosuppressive conditions. Clinical manifestations of the infection most commonly involve self-limited gastroenteritis, but bacteremia and endovascular and localized infections may occur. Most cases of gastrointestinal involvement are self-limited, and antibiotic therapy is reserved for persons at risk for complicated disease. Preventive strategies by both industry and consumers are advocated to further reduce the occurrence of nontyphoidal salmonellosis.
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PMID:Salmonellosis and the gastrointestinal tract: more than just peanut butter. 1862 57

To evaluate whether there is any impact of rotavirus infection on nontyphoid Salmonella (NTS) gastroenteritis, a total of 207 diarrheal children who had positive stool culture for NTS and also a stool examination for the rotavirus antigen were retrospectively analyzed. According to the positivity of the stool rotavirus antigen, patients were divided into two groups and compared with regard to demographic data, clinical features, laboratory findings, and complications. The results showed that there were no significant differences between the two groups of patients with regard to demographic data, clinical features, and laboratory findings, except that vomiting was more common in patients with a coinfection of rotavirus (70.4% vs 40.0%, P = 0.003). Complication by bacteremia occurred more frequently in patients with coinfection of rotavirus (32% vs 9.3%, P = 0.004), but none of them developed extraintestinal focal infections, which were observed only in patients with isolated NTS infection. Our study indicated that concomitant rotavirus infection increased the risk of bacteremia in children with NTS gastroenteritis, although the prognosis remained favorable.
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PMID:Rotavirus infection increases the risk of bacteremia in children with nontyphoid Salmonella gastroenteritis. 1894 96


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