Typhoidal and Non-Typhoidal Salmonella in Urinary Tract Infections: An Investigation of Clinical Occurrence in Immunocompetent Patients.

Enteric fever is a multi-systemic illness of major public health concern. Also known as typhoid fever, it is caused due to both Salmonella typhi and Paratyphi species. Salmonella species have the ability to cause acute, latent, or chronic disease apart from biofilm formation. The outcome of infection depends on various factors, such as the growth state of Salmonella, the environmental conditions encountered at the time of infection, as well as the infected host, and the immune response elicited. If properly treated, many of the patients recover from the acute phase of enteric fever; however, only 3-5% of individuals can develop a chronic carrier state and can act as a reservoir of infection by continued shedding of bacteria in urine and faeces. In infected individuals, Salmonella colonizes the gall bladder and remains there long after symptoms subside, acting as a reservoir for the further spread of the disease. Symptomatic urinary tract infection (UTI) due to Salmonella is uncommon and is rarely encountered especially in an immunocompromised patient with some underlying abnormality involving the urinary tract. In this review, we have tried to explore new directions in the field of Salmonella causing UTI in immunocompetent patients, particularly as it relates to chronic infection.