Persistent Infection and Long-Term Carriage of Typhoidal and Nontyphoidal Salmonellae.

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.