Evaluation of Typhidot (IgM) for Early Diagnosis of Typhoid Fever

Begum, Zohra; Hossain, A. K. M. Zakir; Shamsuzzaman, Akm; Ahsan, Monjurul; Musa, Akm; Mahmud, Chand; Sumona, Asma Azad; Ahmed, Salma; Jahan, Nahida Akhter; Khaleque, Abdul

doi:10.3329/bjmm.v3i1.2964

Cited by 18 publications

(18 citation statements)

References 11 publications

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“…Our findings become very significant, because reports from South Asian countries have shown the isolation rate of human-restricted Salmonella spp. ranging between 9.25 and 21% by using only conventional methods (10)(11)(12). Similarly, the specimens collected from chronic typhoid carriers also yielded the bacterium in significantly larger percentages, 42% of cases by acid shock compared to 8.3% by the conventional method (P Ͻ 0.05).…”

Section: Discussionmentioning

confidence: 94%

Acid Exposure Induces Multiplication of Salmonella enterica Serovar Typhi

Ahirwar¹,

Pratap²,

Patel³

et al. 2014

J Clin Microbiol

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Salmonella enterica serovar Typhi faces several environmental stresses while going through the stomach (acidic pH) to the small intestine (basic pH) and intracellularly in macrophages (acidic pH) in humans. The acidic pH followed by alkaline pH in the small intestine might be responsible for expression of certain stress-induced genes, resulting in not only better survival but also induction of multiplication and invasion of the bacterium in the small intestine. Based on this hypothesis, we developed a process wherein we exposed the blood, urine, and stool specimens from 90 acute typhoid fever patients and 36 chronic typhoid carriers to acidic pH to see the effect on isolation rate of S. Typhi. About 5 g of freshly passed unpreserved stool, a centrifuged deposit of 15 ml of urine, and 5 ml of blood clot were subjected to 5 ml of Luria-Bertani (LB) broth (pH 3.5) for 20 min, followed by enrichment in bile broth-selenite F broth. When the combined isolation from all 3 specimens, i.e., blood, urine, and stool, after acid exposure was considered, a total of 77.7% of the acute typhoid patients were observed to be positive for the isolation of the S. Typhi serotype, compared to 8.8% by the conventional method. Similarly, 42% (15/36) of chronic carriers yielded positive for S. Typhi growth after acid exposure, compared to 5.5% (2/36) by the conventional method. It therefore can be concluded that acid shock triggers the multiplication of the bacteria, resulting in better isolation rates from blood clot, stool, and urine specimens. The estimated global incidence of typhoid fever is about 26.9 million new cases with 1% mortality annually (1). This seems to be a gross underestimate, due to poor availability and performance of diagnostics in countries where typhoid is endemic (2). The available laboratory methods, i.e., bacterial culture, serological markers, antigen detection, and nucleic acid amplification, are highly unsatisfactory in the field conditions. There is an urgent need for optimization of culture methods because of the absolute specificity of culture isolation. High density (bone marrow) or large volume (Ͼ30 ml of peripheral blood) have been reported with satisfactory levels of sensitivity for Salmonella enterica serovar Typhi/Paratyphi isolated from acute typhoid fever cases. In patients with acute typhoid fever, the bacterial density has been reported to be 10-fold higher in bone marrow than in peripheral blood (3). However, both of the above options, i.e., higher blood volume or bone marrow aspirations, are not practical, even at the tertiary level of health care settings. Interestingly, a study from Vietnam reported a median count of 0.1 to 1.0 CFU of S. Typhi/ml of blood (range, 0.3 to 387) in cases of acute typhoid fever (4). It means 5 ml of routinely collected blood should have at least 5 bacterial cells sufficient enough to grow in artificial medium that are devoid of all antibacterial factors present in vivo. In routine practice, we hardly exceed 30% of the isolation rate of S. Typhi with the above-me...

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Section: Discussionmentioning

confidence: 94%

Acid Exposure Induces Multiplication of Salmonella enterica Serovar Typhi

Ahirwar¹,

Pratap²,

Patel³

et al. 2014

J Clin Microbiol

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“…Widal test has been used for over a century in developing countries for diagnosis but it has been reported to have low sensitivity, specificity and positive predictive value [13,14]. We present here an assessment of the utility of Widal test in diagnosing typhoid fever in pediatric patients of New Delhi's one of the largest and the busiest tertiary care hospital.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Audit of the Widal Test for Diagnosis of Typhoid Fever in Pediatric Patients in an Endemic Region

Lalremruata

Chadha

2014

JCDR

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“…Almost similar result was found by Indian studies showed a higher positivity by lytic centrifugation method as compared to conventional method [20][21] . Another study from Bangladesh by Begum et al 22 showed that out of 100 clinically diagnosed typhoid fever, 14 were blood culture positive for S. typhi by conventional method. In this study, 6 (4%) of the patients with blood culture-positive by lytic centrifugation method were negative by conventional method.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Lytic Blood Culture Method with the Conventional Blood Culture Method in Cases of Enteric Fever in a Tertiary Care Hospital

Sultana¹,

Hossain

Maruf³

et al. 2017

Bangladesh J. Infect. Dis.

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Background: Blood Culture is the gold standard and accurate method of diagnosing bacteremia in enteric fever; however, conventional blood culture is slow in isolating Salmonella typhi and Salmonella paratyphi. Objective: The main aim of this study was to compare the result of the lytic centrifugation method with conventional blood culture system for the accurate diagnosis of enteric fever in febrile patients. Methodology: The cross-sectional study was carried out in the department of Microbiology, Mymensingh Medical College, Mymensingh between July 2010 and June 2011 including 200 individuals of different ages and sexes. Of them, 150 were clinically suspected cases of typhoid fever and 50 controls comprising of 25 non-typhoidal febrile patients and 25 healthy individuals. Both types of blood culture were performed for each of the cases and controls. Result: The lytic centrifugation method recovered more organisms (17.3%) than the conventional blood culture method (13.3%). Time required for isolation of S. typhi and S. paratyphi A was short in lytic method (18-20hours) than conventional method (42-72hours). Total contamination rate was 0.5% by lytic as compared to the conventional blood culture method which was 5.0%. Conclusion: In conclusion the lytic method is better than conventional blood culture system for good result, short isolation time and less chance of contamination. [Bangladesh Journal of Infectious Diseases 2016;3(1):6-10]

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Evaluation of Typhidot (IgM) for Early Diagnosis of Typhoid Fever

Abstract: Typhoid fever still continues to be a major public health problem, particularly in many developing countries. A simple, reliable, affordable and rapid diagnostic test has been a long-felt need of the clinicians. We, therefore,

Cited by 18 publications

References 11 publications

Acid Exposure Induces Multiplication of Salmonella enterica Serovar Typhi

Acid Exposure Induces Multiplication of Salmonella enterica Serovar Typhi

Retrospective Audit of the Widal Test for Diagnosis of Typhoid Fever in Pediatric Patients in an Endemic Region

Comparison of the Lytic Blood Culture Method with the Conventional Blood Culture Method in Cases of Enteric Fever in a Tertiary Care Hospital

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