Host restriction, pathogenesis and chronic carriage of typhoidal Salmonella

While conjugate vaccines against typhoid fever have recently been recommended by the World Health Organization for deployment, the lack of a vaccine against paratyphoid, multidrug resistance and chronic carriage all present challenges for the elimination of enteric fever. In the past decade, the development of in vitro and human challenge models has resulted in major advances in our understanding of enteric fever pathogenesis. In this review, we summarise these advances, outlining mechanisms of host restriction, intestinal invasion, interactions with innate immunity and chronic carriage, and discuss how this knowledge may progress future vaccines and antimicrobials.

Automated summary

The lack of vaccines against paratyphoid, multidrug resistance, and chronic carriage pose challenges for enteric fever elimination, despite the recent recommendation of conjugate vaccines for typhoid fever by WHO. Advances in in vitro and human challenge models in the past decade have enhanced understanding of enteric fever pathogenesis and have the potential to drive future developments in vaccines and antimicrobials.