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

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 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 Study of Widal and Typhidot Test in the Diagnosis of Typhoid Fever in Children

2016 ◽  
Vol 36 (2) ◽  
pp. 131-135
Author(s):  
B. Sreenivasa ◽  
G.V. Kumar
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Sensitivity And Specificity ◽  
Age Groups ◽  
Systemic Infection ◽  
Widal Test ◽  
College Hospital ◽  
Medical College ◽  
Life Threatening ◽  
Specific Symptoms

Introduction: Typhoid fever is a life threatening systemic infection that is usually presented with non- specific symptoms and signs. Its diagnosis is usually confirmed by blood culture and Widal test. The delayed results of microbiologic examination and the unreliable results of Widal test makes the search for a rapid and reliable method for diagnosis of typhoid fever. An early and accurate diagnosis is necessary for a prompt and effective treatment. The objectives were to compare the sensitivity and specificity of Widal test and typhidot with the blood culture in the diagnosis of typhoid fever in children.Material and Methods: A total of 200 hundred clinically suspected typhoid fever cases of 2-12 year age groups from both sexes attending Basaveshwara Medical College Hospital Chitradurga were studied. The blood collected aseptically was used for blood culture and clotted blood was used for Widal test and typhidot test.Results: Of 200 blood samples studied, 28 cases were positive by blood culture. Widal test showed sensitivity and specificity of 53% and 83% on blood culture proven cases. Typhidot test showed sensitivity and specificity of 93% and 83%, respectively on blood culture proven cases.Conclusion: Using blood culture as the gold standard, typhidot showed a higher sensitivity compared to Widal test. The specificity of both Widal and typhidot remained the same. Typhidot could be a practical alternative to Widal test in the diagnosis of typhoid fever even in the resource poor laboratories.J Nepal Paediatr Soc 2016;36(2):131-135.

scholarly journals Comparative Study Of Blood Culture with Rapid Diagnostic Tests for Diagnosis Of Enteric Fever In A Tertiary Centre Of NE-India.

JMS SKIMS ◽  
2019 ◽  
Vol 22 (3) ◽  
Author(s):  
Anjan Sarma ◽  
Dipa Barkataki
Keyword(s):  
Blood Culture ◽  
Sensitivity And Specificity ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Lateral Flow ◽  
Diagnostic Tools ◽  
Lateral Flow Immunoassay ◽  
Lower Sensitivity ◽  
Widal Test ◽  
Early Therapy

Introduction: Enteric fever is a global health problem and is also endemic in India. The laboratory diagnosis of enteric fever is very important mainly because in post-antibiotic era most cases are treated empirically and investigated for various causes of PUO including enteric fever.  A fast, reliable, and easy to perform serodiagnostic test with a higher sensitivity and specificity is required for rapid diagnosis and management of typhoid cases, thereby enabling clinicians to initiate an early therapy, reducing morbidity and its complications. Aim : The study was performed to evaluate the performance of Widal test  and Typhidot, a lateral flow immunoassay test. Materials and Methods: This study was carried out in the Department of Microbiology in a tertiary care center for 1 year (August 2016– July2017).  A total of 110 blood samples were collected from patients (cases) clinically suspected of enteric fever. Culture and Serological  tests were done in all the 110 cases. Salmonella isolation was done by conventional methods of culture. Demonstration of presence of anitibodies were done by Widal tests using commercially available kits. Typhidot, a lateral flow immunoassay, was used to  test and detect IgM and IgG antibodies against the outer membrane protein (OMP) of the Salmonella Typhi. The performances of the tests were compared, and diagnostic accuracy determined. Results : Out of 110 cases, highest percentage of positive  cases were found by Typhidot test (29.09%) followed by Widal test (23.63%) . 18.18% cases were confirmed by blood culture. Taking blood culture as gold standard , it was found that Widal test had a sensitivity of 30% and specificity of 78% and Typhidot had a sensitivity of 75% and specificity of 81%. Conclusion : Though definitive diagnosis of enteric fever is  isolation of the causative organism from the patient, Widal test and Typhidot test are important diagnostic tools in the medical set up. Typhidot is fast becoming a practical alternative to Widal test. Typhidot test had a fairly good sensitivity and specificity, whereas  Widal test had good specificity but a lower sensitivity.

Streptokinase clot culture compared with whole blood culture for isolation of Salmonella typhi and S. paratyphi A from patients with enteric fever

1988 ◽  
Vol 82 (2) ◽  
pp. 340-341 ◽  
Author(s):  
Cyrus H. Simanjuntak ◽  
Stephen L. Hoffman ◽  
Ruwido Darmowigoto ◽  
Murad Lesmana ◽  
Soeprawoto ◽  
...  
Keyword(s):  
Blood Culture ◽  
Whole Blood ◽  
Enteric Fever ◽  
Salmonella Typhi

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

scholarly journals Antibiogram of Salmonella Isolates from Blood with an Emphasis on Nalidixic Acid and Chloramphenicol Susceptibility in a Tertiary Care Hospital in Coastal Karnataka: A Prospective Study

2012 ◽  
Vol 4 (02) ◽  
pp. 074-077 ◽  
Author(s):  
Anup Kumar Shetty ◽  
Ichlampady Nagaraj Shetty ◽  
Zevita Venisha Furtado ◽  
Beena Antony ◽  
Rekha Boloor
Keyword(s):  
Blood Culture ◽  
Nalidixic Acid ◽  
Antibiotic Susceptibility ◽  
Enteric Fever ◽  
Salmonella Typhi ◽  
Multidrug Resistant ◽  
Care Hospital ◽  
First Line ◽  
Periodic Analysis ◽  
Paratyphi B

ABSTRACT Background: Enteric fever is caused by the serotypes Salmonella Typhi, Salmonella Paratyphi A, Salmonella Paratyphi B and Salmonella Paratyphi C. After emergence of multidrug resistant Salmonellae Ciprofloxacin, a fluorquinolone antibiotic was the first-line therapy. Treatment failure was observed with Ciprofloxacin soon and such strains showed in-vitro resistance to Nalidixic acid. Recent reports suggest re-emergence of Chloramphenicol sensitive strains and increasing Nalidixic acid resistance. This study is aimed at detecting the current trend in the antibiogram of Salmonella isolates from blood culture in coastal Karnataka, with an emphasis on antibiotic susceptibility of Nalidixic acid and Chloramphenicol and evaluate, if there is a need to modify the strategies in the antibiotic therapy for enteric fever. Materials and Methods: Blood samples received for culture in the laboratory between June 2009 and August 2011 was cultured in Brain Heart infusion broth, bile broth or in a commercial BACTEC culture media. The growth from blood cultures were processed for identification and antibiotic susceptibility as per standard methods. Antibiotic susceptibility for Ampicillin, Trimethoprim-sulphamethoxazole, Chloramphenicol, Ciprofloxacin, Ceftriaxone and Nalidixic acid were noted. Results: Out of 9053 blood culture specimens received, Salmonella was isolated from 103 specimens. There were 85 Salmonella Typhi isolates, 16 Salmonella Paratyphi A and two Salmonella Paratyphi B. Salmonella Typhi and Salmonella Paratyphi A showed the highest resistance to Nalidixic acid. Salmonella Typhi showed highest susceptibility to Ceftriaxone and Salmonella Paratyphi A to trimethoprim-sulphamethoxazole and Chloramphenicol. Two isolates were multidrug resistant. One Salmonella Paratyphi A was resistant to Ceftriaxone. Conclusion: Routine screening of Nalidixic acid susceptibility is practical to predict fluorquinolone resistance in Salmonella and preventing therapeutic failure while treating with it. It is worthwhile to consider replacing fluorquinolones with Chloramphenicol or Ceftriaxone as the first line of therapy for enteric fever. Periodic analysis of Salmonella antibiogram should be done to formulate the best possible treatment strategies.

scholarly journals Re-Emargence of Susceptibility to Conventional First Line Drugs in Salmonella Typhi and Paratyphi a Isolated from Enteric Fever Patients in a Tertiary Care Hospital of Northern Bangladesh.

2017 ◽  
Vol 11 (1) ◽  
pp. 3-5
Author(s):  
Maiz Ul Ahad Suman ◽  
Md Abdullah Siddique ◽  
SM Shamsuzzaman ◽  
Abu Rayhan Khandakar
Keyword(s):  
Enteric Fever ◽  
Health Care Cost ◽  
Tertiary Care ◽  
Empirical Therapy ◽  
Salmonella Typhi ◽  
Care Hospital ◽  
First Line ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College

Enteric fever is endemic in Bangladesh and involves significant health care cost. The first-line drugs chloramphenicol and co-trimoxazole have not been the part of empirical therapy for decades due to development of multidrug resistant Salmonella strains. The objective of this study was to determine the antibiogram pattern of Salmonella strains isolated from the blood of clinically suspected enteric fever patients. A cross sectional study was conducted in Rajshahi Medical College Hospital & Dhaka Medical College from August 2014 to July 2015. Total 323 blood samples were collected from suspected enteric fever patients and isolation rate of Salmonella was 9.29% [S.typhi (3.41%), and S.paratyphi A (5.88%)]. Among isolated S.typhi, 9.09% were resistant to chloramphenicol, cotrimoxazole and cefixime and there were no S.typhi resistant to azithromycin and cefotaxime. Among the isolated S.paratyphi A, 5.26% were resistant to chloramphenicol, co-trimoxazole, azithromycin, cefotaxime, and cefixime. There were no ceftriaxone resistant Salmonella. Low proportion of resistance to first line antibiotics (chloramphenicol, co-trimoxazole) suggests that these drugs can be used once again. Bangladesh J Med Microbiol 2017; 11 (1): 3-5

Sign in / Sign up

Export Citation Format

Share Document