D'Aoust J Y
Health Protection Branch, Sir Frederick Banting Research Centre, Ottawa, Ontario, Canada.
Int J Food Microbiol. 1991 Jan;12(1):17-40. doi: 10.1016/0168-1605(91)90045-q.
Salmonella remains a leading etiological agent in bacterial foodborne diseases. Although human salmonellosis generally presents as a self-limiting episode of enterocolitis, the disease can degenerate into chronic and debilitating conditions. Antibiotic treatment of uncomplicated salmonellosis is contra-indicated because it tends to prolong the carrier state. Clinical management of systemic infections with newer drugs such as third-generation cephalosporins and quinolones is most promising, particularly in light of the increasing resistance of Salmonella to the traditional ampicillin, chloramphenicol and trimethoprim sulfamethoxazole therapeutic agents. Research into the development of effective vaccines from avirulent auxotrophic or from virulence plasmid-cured strains may ultimately facilitate the control of salmonellosis in human populations and in various agricultural sectors. Human salmonellosis reflects the outcome of a confrontation between humoral and cellular immune responses of the host, and virulence determinants of the invasive pathogen. Following an adhesion-dependent attachment of salmonellae to lumenal epithelial cells, the invasive pathogen is internalized within an epithelial cell by a receptor-mediated endocytotic process. Cytotoxin localized in the bacterial cell wall suggestively may facilitate Salmonella entry into the epithelial layer. Cytoplasmic translocation of the infected endosome to the basal epithelial membrane culminates in the release of salmonellae in the lamina propria. During this invasive process, Salmonella secretes a heat-labile enterotoxin that precipitates a net efflux of water and electrolytes into the intestinal lumen. Although non-typhoid salmonellae generally precipitate a localized inflammatory response in deeper tissues via lymphatics and capillaries, and elicit a major immune response. Current research efforts have focused on the molecular characterization and role of virulence plasmids and chromosomal genes in Salmonella pathogenicity.
沙门氏菌仍然是细菌性食源性疾病的主要病原体。尽管人类沙门氏菌病通常表现为自限性的小肠结肠炎发作,但该疾病可能会恶化为慢性衰弱性疾病。不复杂的沙门氏菌病禁忌使用抗生素治疗,因为这往往会延长带菌状态。用第三代头孢菌素和喹诺酮等新药对全身感染进行临床管理最有前景,特别是鉴于沙门氏菌对传统的氨苄青霉素、氯霉素和甲氧苄啶磺胺甲恶唑治疗剂的耐药性不断增加。研究从无毒营养缺陷型或毒力质粒治愈菌株开发有效疫苗,最终可能有助于控制人类群体和各个农业部门的沙门氏菌病。人类沙门氏菌病反映了宿主的体液免疫和细胞免疫反应与侵袭性病原体的毒力决定因素之间对抗的结果。在沙门氏菌通过依赖黏附作用附着于肠腔上皮细胞后,侵袭性病原体通过受体介导的内吞过程被内化到上皮细胞内。细菌细胞壁中定位的细胞毒素可能有助于沙门氏菌进入上皮层。被感染的内体向基底上皮膜的细胞质转运最终导致沙门氏菌在固有层中释放。在这个侵袭过程中,沙门氏菌分泌一种热不稳定肠毒素,导致水和电解质净外流进入肠腔。虽然非伤寒沙门氏菌通常通过淋巴管和毛细血管在更深层组织中引发局部炎症反应,并引发主要的免疫反应。目前的研究工作集中在毒力质粒和染色体基因在沙门氏菌致病性中的分子特征和作用。