Salmonella species

Gram-negative
Rod-shaped
Motile
Non-sporeforming

Sources
Food sources: meats, poultry, eggs, milk and dairy
products, fish, shrimp, spices, yeast, coconut, sauces,
freshly prepared salad dressings made with
unpasteurized eggs
Cross contamination: A contaminated food or an
infected food handler or animal to other foods or objects
in the environment
Contaminated water / untreated sewage

Target population
Weak immune system (very young and the elderly)
Immunocompromised (HIV or chronic illnesses,
immunosuppressant drugs user)

Two types of illness

Nonthyphoidal salmonellosis
Typhoid fever

Non-typhoidal salmonellosis
Other than S. Typhi and S. Paratyphi A
Mortality: Generally less than 1%
Onset: 6 to 72 hours
Infective dose: As low as one cell
Route of entry: Oral
Symptoms: Nausea, vomiting, abdominal cramps,
diarrhea, fever, headache
Duration: Generally last 4 to 7 days (acute symptoms
1 to 2 days)

Complication
s

Dehydration and electrolyte

imbalance
Reactive arthritis may follow 3 to
4 weeks after the onset of acute
symptoms
Septicaemia

Typhoid fever
S. Typhi and S. Paratyphi A
Mortality: Untreated, as high as 10%
Onset: Generally 1 to 3 weeks, but may be as long as 2 months
Infective dose: Fewer than 1,000 cells
Route of entry: Oral
Symptoms: High fever (39.4 to 40 C), lethargy, GI symptoms
(abdominal pains and diarrhea or constipation); headache;
achiness; LoA; skin rashes ( a flat, rose-coloured spots)
Duration: Generally 2 to 4 weeks

Complicatio
ns

Septicaemia
Septic arthritis
Chronic infection of
gallbladder

Diagnosis
Serological identification of cultural isolates from stool

Antibiotics
Non-typhoidal salmonellosis
T. Ciprofloxacin 500mg BD (750mg BD in severe infection)

Tyhoid fever
IM/ IV injection/ IV infusion Cefotaxime 1g/12hours (8g daily in
4 divided doses; up to 12g daily in 3-4 divided doses)

Bacillus cereus
Gram-positive
Facultative anaerobic
Endospore-forming
Large rod

Sources
Diarrheal-type food poisoning: meats, milk, vegetables,
and fish
Vomiting-type food poisoning: rice products, starchy
foods (potato, pasta) and cheese products

Target population
All people are believed to be susceptible to B. cereus
food poisoning

Two types of illness

Diarrheal type of illness (large-molecular-weight protein)
Emetic type of illness (low-molecular-weight
dodecadepsipeptide)

 Mortality: Rare
Infective dose: The number of organism most often
associated with a potential human illness is 10^5 to
10^8 (The pathogenicity arises from preformed toxin)
Duration of symptoms: Usually subside after 24 hours
of onset
Route of entry: Consumption of food contaminated
with enterotoxigenic B. cereus or with the emetic toxin

Diarrheal type of illness

Onset: 6 to 15 hours
Symptoms: Watery diarrhea, abdominal cramps, and
pain

Emetic type of illness

Onset: 0.5 to 6 hours
Symptoms: Nausea and vomiting

Complications
Severe systemic and pyogenic infections
Gangrene
Septic meningitis
Cellulitis
Panophthalmitis
Lung abscesses
Infant death
Endocarditis

Diagnosis
Isolation of strains of the same serotype from the
suspect food and faeces or vomitus of the patient
Isolation of large numbers of a B. cereus serotype
known to cause foodborne illness from the suspect food
and faeces or vomitus of the patient
Isolation of B. cereus from the suspect foods and
determination of their enterotoxigenicity by serological
(diarrheal toxin) or biological (diarrheal and emetic) test

Unreported or misdiagnosed
outbreaks
B. cereus diarrheal type (Clostridium perfringens)
B. cereus emetic type (Staphylococcus aureus)