scholarly journals USE OF WIDAL TEST IN DIAGNOSIS OF TYPHOID FEVER IN NORTH INDIAN POPULATION BY ESTIMATING BASELINE TITER IN CONTROL GROUP

2017 ◽  
Vol 10 (7) ◽  
pp. 251
Author(s):  
Shetty Jeevan
Keyword(s):  
Typhoid Fever ◽  
Healthy Volunteers ◽  
Enteric Fever ◽  
Early Recognition ◽  
Test Group ◽  
Salmonella Typhi ◽  
Control Group ◽  
Age Group ◽  
Widal Test ◽  
Medical College

Objective: This study was undertaken to establish a cutoff significant titer for Widal test using healthy volunteers as control group. Utilizing the baseline titer obtained from the control group, a diagnosis of typhoid fever was made in the test group comprising outpatients and inpatients. Methods: Blood samples were collected from healthy volunteers and patients attending G.S Medical College and Hospital, Pilkhuwa, over a period of 6 months from September 2016 to March 2017. Antibodies to Salmonella typhi (TO, TH) and Paratyphi A (AH) and Paratyphi B (BH) are determined by this tube agglutination test. A total of 124 healthy controls and 303 patients having clinical suspicion of typhoid fever were subjected to Widal test. Results: In healthy control group, titer TO ≥20 was observed in 43 (34.7%), TO ≥40 in 48 (38.7%), TO≥80 in 25 (20.2%), and titer TO ≥160, TO ≥320 was observed in none of the control group. Titer TH ≥40 in 58 (46.8%), AH ≥40 in 7 (5.6%), and BH ≥40 in 13 (10.5%) were observed in the control group. Among the test group, 96 (31.7%) sera were positive out of 303 clinically suspected enteric fever by the Widal test. Among different age group studied, 34 (46.6%) patients belonged to the age group of 11-20 years which formed the highest followed by the age group of 21-30 years (33.3%). Conclusion: Based on the study, a cutoff titer of ≥160 for anti-O and anti-H antibodies and titer of ≥80 for anti-AH and anti-BH antibodies be considered as significant titer in diagnosis of enteric fever in this region. The baseline titer helps in early recognition and treatment of this serious health problem.

scholarly journals Antimicrobial sensitivity pattern of Salmonella typhi isolated from blood culture in a referral hospital

2011 ◽  
Vol 5 (1) ◽  
pp. 16-20 ◽  
Author(s):  
Bulbul Hasan ◽  
Sabera Gul Nahar ◽  
Laila Akter ◽  
Ahmed Abu Saleh
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Antimicrobial Susceptibility ◽  
Salmonella Typhi ◽  
Susceptibility Pattern ◽  
Widal Test ◽  
College Hospital ◽  
Medical College ◽  
Antimicrobial Susceptibility Pattern ◽  
Sensitivity Pattern

The present study has been carried out in an attempt to evaluate antimicrobial susceptibility patterns with special reference to susceptibility of Salmonella Typhi to ciprofloxacin isolated from blood culture. The study is also designed to find out the MIC of Ciprofloxacin by E- test. Blood samples were taken for culture sensitivity, Widal test and ICT from 100 clinically suspected cases of typhoid fever in 1st week of illness who attended at out patient department of Rajshahi Medical College Hospital (RMCH).The study was done in Microbiology Department of Rajshahi Medical College and Shishu Hospital, Dhaka. Diagnosis of patients was based on history of fever, blood culture, Widal test and ICT. The antimicrobial susceptibility pattern of isolates from blood culture was recorded. Further more, the minimum inhibitory concentration of Ciprofloxacin was determined by E-test for the isolates resistance to Ciprofloxacin. Out of 100 suspected cases of typhoid fever, blood culture positive for S. Typhi were 16 (16%). Antimicrobial susceptibility pattern of 16 isolates of S. Typhi showed that no isolate was resistant to Ceftriaxone and Ceftazidime, only 03(18.75%) were resistant to Ciprofloxacin and Azithromycin whereas 10(62.5%) were MDR showing resistance to Ampicillin, Co-trimoxazole and Chloramphenicol which are first-line antityphoidal drugs. On the other hand, all (100%) the isolates were resistant to Nalidixic acid. The study revealed that Ceftriaxone and Ceftazidime are the most effective drugs in the treatment of typhoid fever. Moreover, E-test has been found to be helpful to determine appropriate therapeutic dose of Ciprofloxacin especially in case of drug resistance and pediatric population.DOI: http://dx.doi.org/10.3329/bjmm.v5i1.15816 Bangladesh J Med Microbiol 2011; 05 (01): 16-20

scholarly journals Study on the efficacy of ceftriaxone versus azithromycin for the treatment of uncomplicated enteric fever among the patients admitted in a tertiary level hospital

2021 ◽  
Vol 11 (1) ◽  
pp. 1
Author(s):  
Sougata Mitra ◽  
Masuma Khanam ◽  
M. Iqbal Hossain ◽  
Rukhsana Quadir
Keyword(s):  
Blood Culture ◽  
Physical Examination ◽  
Typhoid Fever ◽  
Clinical Cure ◽  
Enteric Fever ◽  
Salmonella Typhi ◽  
Clearance Time ◽  
Medical College ◽  
Fever Clearance Time ◽  
Culture Positive

Background: Typhoid fever is a severe debilitating and potentially life threating illness. In Bangladesh, typhoid fever is a round the year problem which sometimes take epidemic proportions. The reasons behind such occurrences are unsafe water supply, defective sewage system and unhygienic food handling practice. This study aimed to compare the efficacy of ceftriaxone and azithromycin in the treatment of uncomplicated enteric fever.Methods: An observational study was conducted at the department of pharmacology in Dhaka medical college, Dhaka, Bangladesh. Data were collected from blood culture positive patients for Salmonella typhi and Salmonella paratyphi, who admitted in the Dhaka medical college and hospital, Dhaka during the period of July 2015 to June 2016. Data was collected by using a structured questioner, face to face interview, physical examination and investigation reports. Patients were hospitalized during the entire treatment period and at admission evaluation was made by history and physical examination in a structured format. Subjects ware asked regarding changes in symptoms and possible adverse effects of the study drugs. All patients were asked to return two weeks after completion of treatment for follow up. Blood culture of Salmonella typhi or Salmonella paratyphi were done in all cases. Total 91 patients were culture positive for either S. typhi or S. paratyphi which were finally studied.Results: During the study period out of 91 patients, 51 were receiving ceftriaxone and 40 were receiving azithromycin. Clinical cure was achieved in 46 patients (90%) of ceftriaxone group and in 31 patients (78%) in the azithromycin group. There were no significant differences of clinical cure between both treatment groups (p>0.05). Mean fever clearance time in ceftriaxone group was 3±1.4 days and was 4±1.6 days for azithromycin group. Difference in fever clearance time was statistically significant (p<0.05). No clinical relapses were detected in any study subject. No major side effects of both drugs occurred in any subject.Conclusions: These results indicated that both ceftriaxone and azithromycin were effective against enteric fever caused by sensitive organisms and multi drug resistant S. typhi and S. paratyphi. It is concluded that ceftriaxone is more effective and can be a convenient alternative for the treatment of enteric fever, especially in developing countries like us where medical resources are scarce.

scholarly journals Comparative evaluation of rapid Salmonella Typhi IgM/IgG and Widal test for the diagnosis of enteric fever

2020 ◽  
Vol 14 (1) ◽  
pp. 18-25
Author(s):  
Farjana Akter ◽  
Mahmuda Yeasmin ◽  
Md Zahangir Alam ◽  
Md Rokibul Hasan ◽  
Fahmida Rahman ◽  
...  
Keyword(s):  
Blood Culture ◽  
Sensitivity And Specificity ◽  
Enteric Fever ◽  
Salmonella Typhi ◽  
Widal Test ◽  
Diagnostic Challenge ◽  
Medical College ◽  
Resource Limited ◽  
Test Kit ◽  
User Friendly

Background: Accurate and early diagnosis of enteric fever is a diagnostic challenge where facility for blood culture is not available. As a result, Widal test is still used widely in resource limited settings. Recently, user-friendly rapid immunochromatographic tests (ICT) have been introduced for quick diagnosis of enteric fever. So, we evaluated sensitivity and specificity of an immunochromatography based Salmonella Typhi IgM/IgG test kit and Widal test compared to blood culture for the diagnosis of enteric fever. Method: The study was conducted in the Department of Microbiology, Ibrahim Medical College (IMC) and Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) from June 2017 to September 2017. Clinically suspected enteric fever cases were included. Blood culture, Widal and Salmonella Typhi IgM/IgG detecting ICT were employed for the diagnosis of enteric fever. Results: Out of 71 suspected cases of enteric fever, blood culture was positive in 36 cases (50.7%) while 42 (59.15%) and 35 (49.29%) cases were positive by Widal test and ICT respectively. Widal and ICT had sensitivity and specificity of 100% and 89.9% and 82.9% & 91.4% respectively. Conclusion: Findings of the study suggest that both Widal and immunochromatographic tests can be used interchangeably for rapid diagnosis of enteric fever. Ibrahim Med. Coll. J. 2020; 14(1): 18-25

scholarly journals Clinical Features and Socio – Demographic Factors Affecting the Prevalence of Enteric Fever: A Prospective Observational Study

2020 ◽  
Vol 8 (2) ◽  
pp. 86-90
Author(s):  
Sadia Saber ◽  
Md Tarek Alam ◽  
Nazi Yasmin ◽  
Mohammad Monwer Hossain ◽  
Rafi Faria Alam
Keyword(s):  
Abdominal Pain ◽  
Seasonal Variation ◽  
Blood Culture ◽  
Observational Study ◽  
Typhoid Fever ◽  
Marital Status ◽  
Enteric Fever ◽  
Salmonella Typhi ◽  
Age Group ◽  
Socio Demographic Factors

Background: Enteric fever otherwise called Typhoid fever is a systemic disease caused by Salmonella typhi and Salmonella paratyphi, having reservoir in contaminated water and food. It affects considerable number of populations of the world but regions of South Asia are most commonly affected. Aims and Objective: The objective of this study to find the prevalence of Typhoid fever with respect to age, gender, marital status, occupation, seasonal variation, treatment of drinking domestic water source, and clinical features. Methodology: This is a cross- sectional observational study conducted at Bangladesh Medical College Hospital (BMCH), Dhanmondi, Dhaka from January to December 2019. Those presenting both outpatient departments or admitted to the inpatient units with complains of fever and abdominal pain underwent blood culture for the diagnosis of Typhoid fever. Patients with informed consent and positive blood culture report (including both Salmonella typhi and Salmonella paratyphi) were included in the study. Results: Total 1375 tests were performed, out of which 407 came out to be positive blood culture report (including both Salmonella typhi and Salmonella paratyphi). Out of these tests 31.65% were males and 27.35% were females. Highest occurrence of typhoid fever was observed among males of age group 18 – 45 years and least with patients between age group above 75 years. As for the influence of occupation, male civil servants recorded the highest occurrence in the hospitals while artisans recorded the least. The influence of marital status revealed the highest occurrence in the single males with the married females had the least. In relation to months the prevalence was the highest in the month of July - September (11.42%). Water quality, vaccination and season have great impact on the burden of typhoid fever in population. Fever, diarrhea and abdominal pain are the major symptoms associated with typhoid fever. Conclusion: Socio-demographic factors such as age, gender, marital status, and seasonal variation, treatment of drinking water supply, occupation and presenting complaints influenced the distribution pattern of typhoid fever among the population in BMCH, Dhanmondi, Dhaka. Bangladesh Crit Care J September 2020; 8(2): 86-90

Antibiotic Sensitivity and Resistance Patterns of Salmonella Typhi in Rajshahi Medical College Hospital

2020 ◽  
Vol 33 (2) ◽  
pp. 10-14
Author(s):  
Md Azizul Haque ◽  
Laila Shamima Sharmin ◽  
KM Faisal Alam ◽  
Md Mohimanul Hoque ◽  
M Morsed Zaman Miah ◽  
...  
Keyword(s):  
Blood Culture ◽  
Enteric Fever ◽  
Antibiotic Sensitivity ◽  
Salmonella Typhi ◽  
Medical College Hospital ◽  
Personal Hygiene ◽  
Care Hospital ◽  
College Hospital ◽  
Medical College ◽  
Sensitivity Pattern

Typhoid and paratyphoid fevers, collectively known as enteric fever, is caused by Salmonella enterica subspecies serovars Typhi and Paratyphi A, B and C. Despite this declining global trend, enteric fever is still considered to be a major public health hazard in Bangladesh and other developing countries due to poor sanitation, inadequate food safety measures and poor personal hygiene. In Bangladesh, the incidence of typhoid fever was reported to be 200 episodes per 100,000 person-years during 2003–2004. Multidrug-resistant (resistance to the first-line antimicrobials ampicillin, cotrimoxazole, and chloramphenicol) strains of S. Typhi and S. Paratyphi are on the rise globally and even cases of extensively drug-resistant (XDR) typhoid cases resistant to chloramphenicol, ampicillin, trimethoprim-sulfamethoxazole, third generation cephalosporins and fluoroquinolones are being reported from many corners of the world. This descriptive, observational study was carried out in Rajshahi Medical College Hospital Hospital, Rajshahi, Bangladesh from July 2017 to June 2019. Antibiotic sensitivity pattern of total 76 cases of enteric fever due to Salmonella Typhi were studied. Blood culture was carried out by BACT ALERT-3D, Automated blood culture analyzer from BioMeriuex SA, France Patented FAN Plus method. Based on the minimum inhibitory concentration (MIC), the organism was categorized as sensitive, intermediate, and resistant against the respective antibiotics as per Clinical and Laboratory Standards Institute (CLSI) criteria. We are reporting antibiotic sensitivity and resistant patterns of S. Typhi documented in Rajshahi Medical College Hospital, a large tertiary care hospital in Northern Bangladesh. TAJ 2020; 33(2): 10-14

scholarly journals Antimicrobial susceptibility pattern for Salmonella Typhi isolated from blood in Shaheed Suhrawardy Medical College, Dhaka

2019 ◽  
Vol 10 (2) ◽  
pp. 96-98 ◽  
Author(s):  
Mst Naznin Tarana ◽  
Samshad Jahan Shumu ◽  
Rashida Akter Khanam ◽  
Hosne Jahan ◽  
Soma Sarker ◽  
...  
Keyword(s):  
Public Health ◽  
Typhoid Fever ◽  
Salmonella Typhi ◽  
Health Concern ◽  
Public Health Concern ◽  
Salmonella Spp ◽  
Sensitivity Testing ◽  
Female Ratio ◽  
Medical College ◽  
Sensitivity Pattern

Background: Typhoid fever remains a public health concern in developing countries. Antibiotic therapy constitutes the mainstay of management and multidrug resistant Salmonella spp has been emerged as a major public health concern. Objective: This study was done to evaluate antimicrobial sensitivity pattern of Salmonella typhi isolated from blood in Shaheed Suhrawardy Medical College Hospital. Methods: The retrospective study was done from January 2017 to December 2017 at microbiology laboratory, Shaheed Suhrawardy Medical College. A total of 367 samples, 30 isolates of Salmonella typhi obtained from blood culture. Both the indoor and outdoor patients were enrolled in this study. Results: During one year study period, total 367 cases were enrolled and the prevalence of Salmonella typhi was 30 (8.2 %). Among them (56.1%) were male with a male to female ratio 1.27:1. The bulk (50.1%) cases were in the age group of 15-30 years, 14.4% cases were in less than 15 years and 6.5% cases were in more than 60 years of age. Regarding antibiotic sensitivity pattern, 70% strains were sensitive to amikacin, 73.33% to azithromycin, 63.33% to ceftazidime, 66.66% to ceftriaxone, 86.66% to ciprofloxacin and 70% were nalidixic acid resistant Salmonella typhi. Conclusion: Ciprofloxacin may be used to treat typhoid fever cases and Ceftriaxone, azithromycin may be used as alternative drugs if they are found susceptible in culture and sensitivity testing. J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 96-98

scholarly journals Drug-Resistant Salmonella typhi in Pakistan

2019 ◽  
Vol 59 (1) ◽  
pp. 31-33 ◽  
Author(s):  
Christine E. Petrin ◽  
Russell W. Steele ◽  
Elizabeth A. Margolis ◽  
Justin M. Rabon ◽  
Holly Martin ◽  
...  
Keyword(s):  
United States ◽  
Typhoid Fever ◽  
Enteric Fever ◽  
The United States ◽  
Salmonella Typhi ◽  
Antimicrobial Treatment ◽  
Third Generation ◽  
Drug Resistant ◽  
Oral Transmission ◽  
Third Generation Cephalosporins

Enteric fever (formerly typhoid fever) is a bacterial illness caused by fecal-oral transmission of Salmonella typhi or paratyphi. In early 2018, an outbreak of Salmonella typhi resistant to third-generation cephalosporins, ampicillin, ciprofloxacin, trimethroprim-sulfamethoxazole, and chloramphenicol was reported in Pakistan. This strain, termed “extensively resistant typhi,” has infected more than 5000 patients in endemic areas of South Asia, as well as travelers to and from these areas, including 5 cases in the United States. We present the case of one such child who developed extensively resistant enteric fever during a recent visit to Pakistan and required broader antimicrobial treatment than typically required. Clinicians should be aware that incoming cases of enteric fever may be nonsusceptible to commonly recommended antibiotics and that extensively resistant typhi requires treatment with carbapenems such as meropenem or azithromycin.

scholarly journals Salmonella Hepatitis in Children : An Update

2020 ◽  
Vol 10 (2) ◽  
pp. 397-399
Author(s):  
Sadika Kadir ◽  
Tamanna Begum ◽  
Md Rafiqul Islam ◽  
Golam Nabi ◽  
Md Ashraful Haque ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
Enteric Fever ◽  
Clinical Course ◽  
Clinical Importance ◽  
Positive Culture ◽  
Reticuloendothelial System ◽  
Bleeding Diathesis ◽  
Medical College ◽  
Time Index ◽  
Atypical Presentations

Salmonella hepatitis is one of the atypical presentations of typhoid fever and can be defined as reversible involvement of liver during the course of typhoid fever. There have been more than 150 cases of salmonella hepatitis reported both in developed and developing countries. The documented incidence varies widely from 1 to 26% of patients with Typhoid fever. It presents with jaundice and tender hepatosplenomegaly. Investigation shows slightly raised transaminase levels with or without 5 adenosine neucleosidase and or decreased prothombin time index. It complicates into hepatic encephalopathy and bleeding diathesis. A positive culture for Salmonella from blood or stool is essential to differentiate Salmonella hepatitis from other causes of acute hepatitis. Hepatic pathology is characterized by the presence of typhoid nodules with marked hyperplasia of reticuloendothelial system. The ALT/LDH ratio < 9 is suggestive of Salmonella hepatitis which is > 9 in viral hepatitis. The prognosis is usually good as Salmonella hepatitis responses with specific antibiotic therapy and jaundice resolves with clinical improvement. The clinical course can be severe with high mortality (20%) sometime. In our country where enteric fever is endemic, the recognition of Salmonella hepatitis is of clinical importance . Northern International Medical College Journal Vol.10 (2) Jan 2019: 397-399

scholarly journals An investigation of the normal agglutinins for typhoid and paratyphoid bacilli in human sera in Victoria, and the interpretation of the Widal test

1938 ◽  
Vol 38 (5) ◽  
pp. 566-574 ◽  
Author(s):  
T. S. Gregory ◽  
Nancy Atkinson
Keyword(s):  
Typhoid Fever ◽  
Enteric Fever ◽  
Local Level ◽  
Widal Test ◽  
Human Sera

1. Five hundred samples of sera sent for the Wassermann test were tested for the presence of H and O agglutinins for Bact. typhosum, Bact. paratyphosum A and Bact. paratyphosum B. Histories were obtained of nearly all those persons whose sera gave H agglutination at dilutions of 1:40 or higher, or O agglutination at 1:80 or higher. It was found that at least 20 people in this series had been inoculated or had suffered from enteric fever. The remaining 480 were considered to be normal. This assumption is likely to be correct in this community where typhoid is the only enteric fever which occurs, and that rarely, and where inoculation is not commonly practised.2. The results are tabulated so as to show all the combinations of agglutinins which occurred at serum dilutions from 1:20 to 1:1280. Out of sixty-three possible combinations of agglutinins twenty-three were found to occur.3. The interpretation of the results for single agglutinins and for certain combinations of agglutinins is discussed, and also the application of these results to the diagnosis of typhoid fever in this community and enteric fever elsewhere.4. A comparison of the local “level” of normal agglutinins with that of other communities is made, and the origin of normal and co-agglutinins discussed.

scholarly journals Utility of A Single Widal Test in The Diagnosis of Typhoid Fever

2012 ◽  
Vol 35 (2) ◽  
pp. 53-58 ◽  
Author(s):  
ABM Shahidul Alam ◽  
Fahim Ahmed Rupam ◽  
Farhana Chaiti
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Predictive Value ◽  
Salmonella Typhi ◽  
Definitive Diagnosis ◽  
Blood Cultures ◽  
Widal Test ◽  
Female Ratio ◽  
The Mean ◽  
Agglutinin Titer

Background & objectives: The clinical diagnosis of typhoid fever is difficult, as the presenting symptoms are often diverse and similar to those observed with other febrile illnesses. The definitive diagnosis of typhoid fever requires the isolation of Salmonella typhi or paratyphi from the patient concerned. Since patients often receive antibiotics prior to a confirmatory diagnosis, there is uncertainty that bacteria can be isolated from the blood cultures. Besides this, the facilities for blood culture are not always available or feasible. All these limitations have made Widal test the most utilized diagnostic test for typhoid fever. Many studies have produced data which had cast serious doubts on the value of the Widal Test and thus reappraisal of the role of a single Widal test is needed.Methods & materials: This study was carried out to determine the changes in clinical pattern of enteric fever. A total of 153 children, aged 0 to 14 years, diagnosed as typhoid fever (either positive blood culture for Salmonella typhi or paratyphi) were induced in the study. Of them, 86 children were with a definitive diagnosis of typhoid or paratyphoid fever as indicated by the isolation of S. typhi or S. paratyphi from the blood and 17 had negative blood culture but were clinically suspected of having typhoid fever. The control group was comprised of 50 children with non-typhoidal fevers The Widal test was carried out using rapid slide agglutination method and its accuracy was assessed by comparing the findings with that obtained through blood culture.Result: The mean age of the patients was 5.2 ± 2.8 years and the youngest and oldest patients were 0.7 and 14 years respectively and male to female ratio was roughly 1:1. Nearly one-quarter (24.6%) of the patients had been suffering from the disease for >10 days and the mean duration of illness was 8.2 ± 3.3 days. Widal Test result showed that an ‘O’ agglutinin titer of cut-off value e”1:40 gave a sensitivity of 87.2%, a specificity of 47.1%, a positive predictive value (PPV) of 89.2% and a negative predictive value (NPV) of 42.1%. The sensitivity and NPV decreased with the increase in titer levels and were 56.9% and 31.5% at cut-off value of e” 1:320, while the specificity and PPV increased with the increase in titer levels from 47.1% and 89.2% respectively at a titer of e”1:40 to 100% at a titer of e” 1:320. The ‘titer behaved in the same way as did the ‘O’ agglutinin titer. Similarly when H’ agglutinin was used the sensitivity and NPV decreased from 65% and 31.7% at a titer of e”1:40 to only 25% and 20% respectively at a titer of > 1:320, while specificity and PPV increased from 76.4% and 81.1% at >1:40 to 94.1% and 95.6% respectively at e” 1:320. When either ‘O’ or ‘H’ antibody titer of e”1:160 was used, a good sensitivity (71%), specificity (70.6%) and PPV (92.4%) resulted, though NPV decreased to 32.4%.Conclusion: The Widal test can be of diagnostic value when blood cultures are not available nor practically feasible.DOI: http://dx.doi.org/10.3329/bjch.v35i2.10377  Bangladesh J Child Health 2011; Vol 35 (2): 53-58

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