Chronic Salmonella Typhi carriage at sites other than the gallbladder

• Published in: PLoS neglected tropical diseases Vol. 17; no. 3; p. e0011168
• Main Authors: Hoffman, Seth A, Sikorski, Michael J, Levine, Myron M
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.03.2023; Public Library of Science (PLoS)
• Subjects: Analysis; Antibiotics; Bile; Biology and Life Sciences; Body Fluids; Bone marrow; Carriers; Chronic infection; Diagnosis; Disease transmission; Drug resistance; Epidemics; Fatalities; Feces; Fever; Food contamination; Gall bladder; Gallbladder; Gallbladder diseases; Gallstones; Harbors; Health; Health aspects; Humans; Immunization; Infections; Ingestion; Kidney; Medical libraries; Medicine and Health Sciences; Mortality; Multidrug resistance; Pathogens; Pathology; Persistence; Public health; Review; Risk factors; Salmonella; Salmonella typhi; Sanitation; Strains; Tropical diseases; Typhoid; Typhoid fever; Typhoid Fever - epidemiology; Urinary tract; Urine; Urogenital system; Vaccines; Water pollution; Waterborne diseases; United States
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0011168

Typhoid fever caused by infection with Salmonella enterica subspecies enterica serotype Typhi (S. Typhi), an important public health problem in many low- and middle-income countries, is transmitted by ingestion of water or food contaminated by feces or urine from individuals with acute or chronic S. Typhi infection. Most chronic S. Typhi carriers (shedding for ≥12 months) harbor infection in their gallbladder wherein preexisting pathologies, particularly cholelithiasis, provide an environment that fosters persistence. Much less appreciated is the existence of non-gallbladder hepatobiliary chronic S. Typhi carriers and urinary carriers. The former includes parasitic liver flukes as a chronic carriage risk factor. Chronic urinary carriers typically have pathology of their urinary tract, with or without renal or bladder stones. Even as the prevalence of multidrug-resistant and extensively drug-resistant S. Typhi strains is rising, global implementation of highly effective typhoid vaccines is increasing. There is also renewed interest in identifying, monitoring, and (where possible) treating chronic carriers who comprise the long-term reservoir of S. Typhi.