D'Aoust J Y
Health Protection Branch, Health Canada, Ottawa, Ont., Canada.
Int J Food Microbiol. 1994 Dec;24(1-2):11-31. doi: 10.1016/0168-1605(94)90103-1.
Non-typhoid Salmonella spp. continue to figure prominently in many national epidemiological registries as the leading cause of bacterial foodborne disease. Although Salmonella enterocolitis is generally a self-limiting illness that may require fluid and electrolyte replacement, the disease can spread systemically and degenerate into a chronic condition such as reactive arthritis, osteomyelitis, cardiac inflammation or neural disorders. Ampicillin, chloramphenicol and trimethoprim-sulfamethoxazole have provided the mainstay of therapy for the clinical management of bacteremic salmonellosis. However, the increasing occurrence of strains that are resistant to one or more of these traditional antibacterial drugs has resulted in the wider use of quinolones for the treatment of Salmonella septicaemia. Successful clinical results with these newer drugs are already being overshadowed by the emergence of salmonellae that are resistant to these therapeutic agents. A rapidly growing international trade in agricultural, aquacultural and manufactured food products has greatly facilitated the introduction of new Salmonella serovars within the geographical boundaries of importing countries. This paper reviews the prevalence of Salmonella in selected food types that are subject to the import-export market and attendant epidemiological overtones. More specifically, the importance of fresh fruits and vegetables, spices, cheese, and aquacultural products as vehicles of human infection will be underlined. The potential impact of the widespread use of antibiotics of importance in human medicine in the aquaculture industry will also be discussed. The ubiquitous distribution of Salmonella in the natural environment and its prevalence in the global food chain, the physiological adaptability and virulence of this important human bacterial pathogen, and its potentially serious economic impact on the food industry predicate the need for continued vigilance and stringent controls at all levels of food production.
非伤寒沙门氏菌在许多国家的流行病学登记中仍然是细菌性食源性疾病的主要病因。虽然沙门氏菌小肠结肠炎通常是一种自限性疾病，可能需要补充液体和电解质，但该疾病可全身扩散并恶化为慢性疾病，如反应性关节炎、骨髓炎、心脏炎症或神经紊乱。氨苄青霉素、氯霉素和甲氧苄啶-磺胺甲恶唑一直是治疗菌血症型沙门氏菌病临床管理的主要药物。然而，对一种或多种这些传统抗菌药物耐药的菌株越来越多，导致喹诺酮类药物在治疗沙门氏菌败血症方面的使用更加广泛。这些新药取得的成功临床结果已因对这些治疗药物耐药的沙门氏菌的出现而黯然失色。农产品、水产品和制成食品的国际贸易迅速增长，极大地促进了新的沙门氏菌血清型在进口国境内的引入。本文综述了进出口市场上特定食品类型中沙门氏菌的流行情况以及随之而来的流行病学影响。更具体地说，将强调新鲜水果和蔬菜、香料、奶酪及水产品作为人类感染载体的重要性。还将讨论在水产养殖业中广泛使用对人类医学重要的抗生素的潜在影响。沙门氏菌在自然环境中的广泛分布及其在全球食物链中的流行情况、这种重要的人类细菌病原体的生理适应性和毒力，以及它对食品工业可能产生的严重经济影响，都表明需要在食品生产的各个层面持续保持警惕并实施严格控制。
