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2. Introduction

Jeff’s head was still reeling from the series of events that occurred over the past week. He had just finished a mixed animal externship last Friday when he developed fever, chills, diarrhea, and malaise. Jeff spent the weekend in bed and in the bathroom. However, he still felt terrible on Monday and decided to go to his physician. The doctor agreed that he had acute gastroenteritis and asked Jeff to provide a stool specimen. He suggested that Jeff stay in bed, drink plenty of fluids, and take the prescribed antibiotics. After two days of continuous misery and no easing of his symptoms, Jeff called his doctor again. He was told that his stool specimen had grown Salmonella, and if he didn’t feel better in a couple days to come back to the doctor’s office. Jeff’s situation did not improve. On Friday morning, after little sleep for the seventh consecutive night due to his frequent trips to the bathroom and persistent fever, chills, and abdominal cramps, Jeff went to the hospital emergency room. At the hospital, he was diagnosed with dehydration. He was placed on IV fluids, IV antibiotics and hospitalized. Later that morning, his physician visited Jeff and informed him that he had a multi-drug resistant Salmonella Typhimurium infection. Learn more about other multi-drug resistant "superbugs" now.

jeffzz.jpg "How in the world did I get this infection?" Jeff wondered to himself as he began to fall asleep. "I know antimicrobial resistant infections are becoming more common, but how did I get one?"

Jeff drifts off to dream…

(Click on the above link to view Jeff's dream.)

Antimicrobial Agent vs. Antibiotic

Antimicrobial Agent
Any substance – of natural, semi-synthetic or synthetic origin – that kills or inhibits the growth of a microorganism. Examples: enrofloxicin, penicillin, monensin.

Antibiotic
A substance produced by a microorganism that kills or inhibits the growth of another microorganism. All antibiotics are antimicrobial agents. Examples: penicillin, lincomycin.

 

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Salmonella

Gram-negative, rod-shaped bacteria that cause illness in humans and animals. Over 2700 serotypes of Salmonella exist. The four most common serotypes causing infections in humans are Typhimurium, Enteritidis, Heidelberg, and Newport.

Salmonellosis in Humans

Clinical signs and symptoms usually occur within 8 to 72 hours after becoming infected (usually by ingestion): diarrhea (often bloody), fever, and abdominal cramps. Serious invasive illness may occur.

Illness usually lasts 4 to 7 days.

Most recover with supportive treatment; however, some develop severe infections, and a few have chronic sequelae.

Antimicrobial agents may be life-saving. Hospitalization is common.

Drugs commonly used for empiric treatment:

Children: third generation cephalosporins (e.g., ceftriaxone)

Adults: fluoroquinolones (e.g., ciprofloxacin)

People at high risk for serious infections: elderly, infants, immune-compromised and patients taking antibiotics for treatment of other illnesses.