Salmonella typhi is a Gram-negative, motile rod-shaped bacterium and belongs to the pathogenic enterobacteria.
Salmonella typhi causes a systemic infection known as typhus. The disease progresses in different stages:
Stadium incrementi (first week): Headaches, nausea, fever, constipation
Stadium fastigii (second to third week): Fever, abdominal pain, diarrhea, impaired consciousness, cough, roseole (skin rash)
Stadium decrementi (fourth to fifth week): gradual regression of symptoms
Complications: Intestinal bleeding, intestinal perforation, meningitis
Salmonella typhi is most common in developing countries; in industrial nations the pathogen occurs primarily as an imported infection due to travel.
Relevance of pathogen in transmission in endoscopy
Pulmonology: Not relevant
Ear, nose, and throat: Not relevant
Urology: Not relevant
Relevance for endoscope surveillance
High concern organism
Salmonella typhi is transmitted from human to human via the fecal-oral route as well as via contaminated water and food (fertilized fruit/vegetables, mussels, oysters).
Resistance to antibiotics
Reduced antimicrobial susceptibility is described, including against fluoroquinolones and sulfonamides. Multi-resistance is increasingly occurring in Asia and Africa.
Beecham HJ 3rd et al. Salmonella typhimurium. Transmission by fiberoptic upper gastrointestinal endoscopy, JAMA. 1979 Mar;241(10):1013–1015.
Gries O, Ly T: Infektologie – Kompendium humanpathogener Infektionskrankheiten und Erreger, Springer-Verlag Berlin Heidelberg 2019.
Typhus abdominalis, RKI-Ratgeber, Robert Koch-Institut, https://www.rki.de/DE/Content/Infekt/EpidBull/Merkblaetter/Ratgeber_Typhus_Paratyphus.html (accessed on 08.05.2021)
Typhoid Fever and Paratyphoid Fever, Centers for Disease Control and Prevention, https://www.cdc.gov/typhoid-fever/health-professional.html (accessed on 08.05.2021).