Infectious Diseases Research Laboratory, Sheba Medical Center, Tel-Hashomer, Israel
Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Clin Microbiol Rev. 2018 Nov 28;32(1). doi: 10.1128/CMR.00088-18. Print 2019 Jan.
The ability of pathogenic bacteria to affect higher organisms and cause disease is one of the most dramatic properties of microorganisms. Some pathogens can establish transient colonization only, but others are capable of infecting their host for many years or even for a lifetime. Long-term infection is called persistence, and this phenotype is fundamental for the biology of important human pathogens, including , , and Both typhoidal and nontyphoidal serovars of the species can cause persistent infection in humans; however, as these two groups cause clinically distinct diseases, the characteristics of their persistent infections in humans differ significantly. Here, following a general summary of pathogenicity, host specificity, epidemiology, and laboratory diagnosis, I review the current knowledge about persistence and discuss the relevant epidemiology of persistence (including carrier rate, duration of shedding, and host and pathogen risk factors), the host response to persistence, genes involved in this lifestyle, as well as genetic and phenotypic changes acquired during prolonged infection within the host. Additionally, I highlight differences between the persistence of typhoidal and nontyphoidal strains in humans and summarize the current gaps and limitations in our understanding, diagnosis, and curing of persistent infections.
病原菌影响高等生物并导致疾病的能力是微生物最显著的特性之一。有些病原体只能建立短暂的定植，而有些则能够感染宿主多年甚至终生。长期感染被称为持续感染，这种表型对于包括伤寒沙门氏菌、副伤寒沙门氏菌和鼠伤寒沙门氏菌在内的重要人类病原体的生物学特性至关重要。该物种的伤寒和非伤寒血清型都能在人类中引起持续感染；然而，由于这两个菌组引起的临床疾病明显不同，因此它们在人类中的持续感染特征有很大的差异。在这里，在对病原性、宿主特异性、流行病学和实验室诊断进行了一般性总结之后，我回顾了关于持续感染的现有知识，并讨论了持续感染的相关流行病学（包括带菌率、排出时间以及宿主和病原体的风险因素）、宿主对持续感染的反应、涉及这种生活方式的 基因，以及在宿主内长期感染期间获得的遗传和表型变化。此外，我还强调了人类中伤寒型和非伤寒型 菌株持续感染的差异，并总结了我们在理解、诊断和治疗持续感染方面的现有差距和局限性。
