scholarly journals Blood Culture and Widal Test as Diagnostic Tools for Enteric Fever with Antibiogram in a Tertiary Care Centre at Dhaka in Bangladesh

2021 ◽  
pp. 97-106
Author(s):  
Sushmita Roy ◽  
Iftikhar Ahmed ◽  
Provash Chandra Saha ◽  
Bhuiyan Mohammad Mahtab Uddin ◽  
Mejbah Uddin Ahmed ◽  
...  
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Antibody Titer ◽  
Antibiotic Susceptibility ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Diagnostic Methods ◽  
Diagnostic Tools ◽  
Widal Test ◽  
Sensitivity Pattern

Background: Enteric fever still exists as one of the major public health issue occurring in our country. Antimicrobials are the mainstays of treatment of typhoid fever. Due to rapidly growing antibiotic resistance, Salmonella spp. is required to be periodically tested for susceptibility patterns. This will also enable planning of rational use of antibiotics. Objective: To observe the diagnostic accuracy of enteric fever by blood culture and Widal test in a tertiary care center, at Savar, Dhaka; Bangladesh. Antimicrobial sensitivity pattern of this study will guide to modify recent changes in the trends of antimicrobial use at the local level. Methodology: Blood samples were collected from 2194 febrile patients with clinically suspected enteric fever cases at a Tertiary Care Outdoor Centre from January 2017 to March 2020. Blood culture was performed to isolate S. typhi and S. paratyphi. Widal tests were done for the determination of antibody titer. An antibody titer of ≥1:80 for anti TO and anti TH were taken as a cut off value to indicate recent infection of typhoid fever. Antibiotic susceptibility testing was carried out using modified disk diffusion (Kirby–Bauer) technique. Results: Out of 111 Salmonella isolates, 74 (5%) were S. typhi and 37 (25%) were S. paratyphi A.  Total 697 samples were positive for Widal test. A large number of isolates showed resistance to commonly used antibiotics such as nalidixic acid (94.6%), chloramphenicol (87.3%), amoxicillin (76.6%), cephradine (53.1%), azithromycin (46.8) etc. Resistance to cefixime and cefipime, ceftriaxone tended to increase than past. Imipenem, moxifloxacin and cefuroxime are escalating resistance which is alarming. Conclusion: Blood culture is the most reliable among the diagnostic methods but it needs 5 to 7 days for delivery of final report. This delay leads to late diagnosis as well as provision of irrational usage of antibiotics. It is concluded that widal test would remain relevant as a diagnostic tool for enteric fever, which is more convenient, cheaper and faster than the other molecular tests. Our study revealed the antibiotic susceptibility of Salmonella isolates will be recommended for addressing the drug resistance.

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.

scholarly journals A COMPARATIVE STUDY OF WIDAL TEST WITH BLOOD CULTURE IN THE DIAGNOSIS OF TYPHOID FEVER IN FEBRILE PATIENTS ATTENDING GGH, ANANTHAPURAMU.

2020 ◽  
pp. 40-41
Author(s):  
B.R.Chandra Sekhar ◽  
G. Swarna Latha ◽  
M. Sailaja ◽  
M S Prabhakar
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Antibody Titer ◽  
Predictive Value ◽  
Reservoir Host ◽  
World Health ◽  
Human Beings ◽  
Widal Test ◽  
Recent Infection ◽  
Total Prevalence

Introduction Typhoid fever is a systemic prolonged febrile illness caused by certain Salmonella serotypes including Salmonella typhi, S. paratyphi A, S. paratyphi B and S. paratyphi C. 1 Human beings are the only reservoir host for typhoid fever. It is transmitted is by feco-oral contamination of water and food in endemic areas especially by carriers handling food. The World Health Organization (WHO) estimates about 21 million cases of typhoid fever with >600,000 deaths annually. 2 The cases are more likely to be seen because of rapid population growth, increased urbanization, and limited safe water, limited infrastructure and health systems. Aims & Objectives The main aim of this study is to compare the result of Widal test and blood culture in the diagnosis of typhoid fever in febrile patients. Material & Methods: This is a prospective study conducted in the GGH Anantapuramu, for a period of 18 months .i.e. from May 2018 to Oct 2019. Blood samples were collected from 542 febrile patients with symptoms clinically similar to typhoid fever. Blood culture was used to isolate S.typhi and S.paratyphi. Slide agglutination test and tube agglutination tests were used for the determination of antibody titer. An antibody titer of ≥1:80 for anti TO and ≥1:160 for anti TH were taken as a cut of value to indicate recent infection of typhoid fever. Results: A total of the 542 patients were the study population, among which 384 (70.8%) were females, and 158 (29.1%) were males. Widal and blood culture was performed, 11 (2.02%) cases of S. typhi and 5 (0.9%) cases of S. paratyphi were identified using blood culture. The total prevalence of typhoid fever is 2.95%. The specificity, sensitivity, Positive Predictive Value, and Negative Predictive Value of the Widal test with O Ag is 70%, 81.25%, 10.93%, and 96%, respectively, and with H Ag is 40%, 96%, 18.1%, 98.8% respectively.

scholarly journals CLINICAL PROFILE AND ANTIBIOTIC SENSITIVITY PATTERN OF ENTERIC FEVER AMONG CHILDREN ADMITTED IN PEDIATRICS DEPARTMENT OF JLNMCH, BHAGALPUR, BIHAR

2021 ◽  
pp. 1-3
Author(s):  
Mithilesh Kumar ◽  
R. K. Sinha ◽  
Debarshi Jana
Keyword(s):  
Enteric Fever ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Urban Slum ◽  
Case Definition ◽  
Clinical Profile ◽  
Suspected Case ◽  
Care Hospital ◽  
Widal Test ◽  
Sensitivity Pattern

Objective: In this study our main aims to know the clinical profile of pediatric enteric fever and the sensitivity pattern of the disease to drugs in this region. Methodology: This prospective observational study conducted in a tertiary care hospital at Dhaka from March to December 2019 among suspected case of Enteric fever as per case definition. Among 212 suspected enteric fever 117 children were diagnosed as enteric fever by blood culture and/or Widal test. Results: During the study, Male: female were 1.3: 1. Maximum (70%) children were in age group 5 years or more. Most of the children were from urban slum area (53.6%) of Dhaka city. Cases were admitted throughout the year. Common presentation were fever (100%), anorexia (100%), pain abdomen (74.4%) and loose motions (46.1%). The common signs were hepatomegaly (41.9%), hepatosplenomegaly (5.1%) coated tongue (64.9%), pallor (74.4%). The complications rate was 35.9% and commonest being UTI and pneumonia. The overall positivity of Widal test was 89.7% and the culture positivity was 32.5%. Among isolates, 94.7%were Salmonella typhi and 5.3% Salmonella paratyphi A. Among them18.1% isolates were multi drug resistant. Conclusion: Enteric fever is most prevalent during summer & rainy session. WASA supplied water may play a role. Hepatomegaly is common. UTI and pneumonia are the commonest complication. Multidrug resistant cases are not so as high as other countries. Cefixime, Ceftriaxone. Meropenam and Ofloxacine are the drugs of choice. Ciprofloxacin is still could be chosen for the treatment of enteric fever. Higher rate of resistant to Azithromycin is alarming.

scholarly journals Pattern of Antibiotic Sensitivity in Enteric Fever: A Tertiary Care Hospital Experience

2014 ◽  
Vol 15 (2) ◽  
pp. 122-124 ◽  
Author(s):  
Samira Rahat Afroze ◽  
Muhammad Abdur Rahim ◽  
Md. Mehedi Hasan ◽  
Farhana Afroz ◽  
Hasna Fahmima Haque ◽  
...  
Keyword(s):  
Blood Culture ◽  
Nalidixic Acid ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Sensitivity Pattern ◽  
Drug Resistant Strains

Objectives: To describe the antibiotic sensitivity pattern ofSalmonella typhi and Salmonella paratyphi from blood culture specimens. Methods: This cross-sectional study was done in the Department of Medicine, BIRDEM from July 2009 to June 2012. Standard laboratory and microbiological procedures were followed for blood culture and antibiotic sensitivity tests. Results: Among the 97 blood culture positive samples, S. typhi was 71 (73.2%) and S. paratyphi was 26 (26.8%). Multi-drug resistant strains of S. typhi and S. paratyphi were 23 (32.4%) and 3 (11.5%) cases respectively. Azithromycin, nalidixic acid, ciprofloxacin, levofloxacin and amoxicillin resistance was also found in a good number of cases (S. typhi and S. paratyphi: 71.8% and 57.7%, 42.3% and 30.8%, 38% and 34.6%, 38% and 26.9% and 38% and 26.9% cases respectively). Nineteen (31.1%) of the 61ciprofloxacin sensitive organisms were resistant to nalidixic acid. Ceftriaxone was sensitive in 100% of S. typhi and S. paratyphi. Cefixim, ciprofloxacin, levofloxacin, imipenem were among the most common sensitive antibiotics (S. typhi and S. paratyphi: 83.1% and 73.1%, 62% and 65.4%, 53.5% and 65.4%, 76.1% and 65.4% cases respectively). Conclusion: Ceftriaxone was the most sensitive antibiotic for treating enteric fever followed by cefixim, imipenem and ciprofloxacin. However, in suspected cases of enteric fever, blood culture should be requested before prescribing antibiotic.DOI: http://dx.doi.org/10.3329/jom.v15i2.20684 J MEDICINE 2014; 15 : 122-124

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

A STUDY ON CLINICAL PROFILE AND LABORATORY PROFILE CHANGES OF ENTERIC FEVER

2021 ◽  
pp. 45-47
Author(s):  
Krushna Chandra Das ◽  
Debarshi Jana
Keyword(s):  
Blood Culture ◽  
Enteric Fever ◽  
Prospective Observational Study ◽  
Widal Test ◽  
Elevated Liver Enzymes ◽  
Sensitivity Pattern ◽  
Profile Changes ◽  
Laboratory Profile ◽  
Culture Positive ◽  
Common Laboratory

AIM:The aim of the study is to asses study the clinical and laboratory prole. Culture positive & sensitivity pattern of Salmonella enteric and its response to antimicrobial therapy admitted in SSKM Hospital in Kolkata. MATERIAL AND METHOD: This is a prospective, observational study of paediatric aged between 5-12 years who are admitted in SSKM Hospital in Kolkata, West Bengal, India during the period of Sep 2016- Sep2018 the study includes 104 pediatric who were suffering from Enteric fever.RESULT:We found that 22(21.2%) patients had lymphadenopathy, 83(79.8%) patients had positive widal test (O antigen), 18(17.3%) patients had positive widal test (H antigen) and 42(40.4%) patients had positive blood culture. According to blood culture, 5(4.8%) patients had S.para typhi and 36(34.6%) patients had S.typhi. CONCLUSION: Leucopenia, eosinopenia and mildly elevated liver enzymes are common laboratory ndings. Widal is though a good screening test but has poor specicity for diagnosing culture positive enteric fever cases.

Comparison of the performance of Tubex® TF, widalimmunodiagnostic assay and blood culture in diagnosis of enteric fever in a private tertiary care hospital Peshawar, Pakistan

2020 ◽  
pp. 1-8
Author(s):  
Kamran Amir Khan ◽  
Sameed Ullah Qureshi ◽  
Shumaila Ehtisham ◽  
Admin
Keyword(s):  
Blood Culture ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Research Centre ◽  
Care Hospital ◽  
Widal Test ◽  
Culture Positive

Abstract Objective: To determine and compare the performance of TUBEX® TF, widal test & blood culture in the diagnosis of enteric fever. Methods: After approving with the ethical committee, we retrospectively identified patients presented with fever at Northwest General Hospital and Research Centre. Typhidot, Widal test and blood culture was performed as part of their evaluation from January 2018 to December 2018. SPSS 16 was used for data analysis. Results: Of the 241 patients, blood culture was positive for salmonella in 68(28.21%) and negative in 173(71.79%). In the culture positive group, TUBEX® TF was positive in 29(42.64%) and negative in 39(57.36%). Of these culture positive patients, Widal was positive in 25(36.76%) and negative in 43(63.24%). In patients with negative culture, TUBEX® TF was positive in 58(37.66%) and negative in 96(62.34%), Widal was positive in 77(44.5%) and negative in 96(55.5%). The positive predictive value of TUBEX® TF was 33.33% and the negative predictive value was 71.77%. The sensitivity of TUBEX® TF was 42.65% while specificity was 62.34%. The positive predictive value of Widal was 24.51% and the negative predictive value was 69.06%. The sensitivity of Widal was 36.76% while specificity was 55.49%. Conclusion: Sensitivity, specificity, positive predictive value and negative predictive value of TUBEX® TF and Widal test is very low as compared to blood culture. Keywords: Enteric Fever, TUBEX® TF, Widal, Continuous...

scholarly journals Clinical profile of enteric fever in tertiary care hospital of Kashmir

2017 ◽  
Vol 4 (5) ◽  
pp. 1754
Author(s):  
Sheikh Mushtaq ◽  
Altaf Ahmad Bhat ◽  
Ghulam Nabi Rather ◽  
Rukaya Akhter ◽  
Iqra Bhat ◽  
...  
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Hospital Stay ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Hospital Setting ◽  
Clinical Profile ◽  
Febrile Child ◽  
Oral Antibiotic ◽  
The Mean

 Background: Enteric fever is common cause of pyrexia in children and its diagnosis poses several problems, the diagnosis most often remains either as an unsubstantiated clinical impression or a serological diagnosis and occasionally confirmed by blood culture. Typhoid fever is a commonly encountered systemic disease caused by the gram-negative bacteria Salmonella enterica serovar typhi. It is a major public health problem in India. The incidence of enteric fever can be regarded as an index of sanitary measure practiced in our country. Aim of our study was to know the clinical profile, hematological features of clinically and serologically suspected typhoid cases, antibiotic pattern in use, the time to defervescence with the treatment received and over all hospital stay days.Methods: This was a retrospective record file review of all admitted children for pyrexia under evaluation who were clinically suspected as cases of enteric fever and serologically proven by significant titres of O and H antigen and few were culture proven cases of enteric fever carried out at a tertiary care children hospital in Kashmir valley over the period January 2012 to January 2016.Results: During this period, a total of 129 children with typhoid fever were admitted to Pediatric ward. Of the 129 children, 69 (53.5%) were boys and 60 (46.5%) were girls. The age range of the study population was 1 year to 15 years. The predominant symptoms of typhoid fever were fever 123 (95.3%), anorexia/weakness 58 (45.0%), abdominal pain 53 (41.1%), pallor 47 (36.4%), coated tongue 42 (32.6%), headache 30 (23.3%) and gastrointestinal symptoms/ dysentry 9 (7.0%). Diarrhea 25 (19.4%) was more common than constipation 5 (3.9%) in this study. Hepatomegaly 26 (20.2%) and splenomegaly 67 (51.9%), lymphadenopathy 24 (19.4%) and seizure in 5 cases (3.9%) were other major physical findings. Typhoid complications were seen in the form of jaundice (deranged LFTs) 25 (19.4%), abdominal distention 20 (15.5%) and tenderness 14 (10.9%), encephalopathy 5 (3.9%), shock 3 (2.3%) and UTI 4 (3.1%). Blood culture was positive in 36 (27.9%), 20 (15.5%) percent of the isolates were Salmonella typhi, while 16 (12.4%) were Salmonella paratyphi A. low yield was attributed to oral antibiotics received outside hospital setting. Ceftriaxone was used to treat all the patients diagnosed with enteric fever. Oral Azithromycin was added to treatment regime in those patients who were persistently febrile after 6 days. Those patients who were discharged before 14 days, therapy was completed with oral cefixime. The mean duration of hospital stay was 9.6 days for uncomplicated cases. Leukopenia was seen in majority of the patients with mean cell count of 6492.7cubic/mm. The mean time to defervescence in patients who received prior antibiotics was 4 days while that in those who did not receive prior antibiotics was 5 days.Conclusions: Atypical presentations are seen in typhoid fever patients so we need to be cautious about it, clinical symptoms and signs can vary with different regional studies, may be attributed to use of empirical oral antibiotic that alter the clinical presentation of enteric fever. Low culture positivity is due to prior or ongoing antibiotic treatment outside hospital setting. Leucopenia could be an important marker of typhoid. Ceftriaxone is important available cephalosporin for sensitive cases. Combination treatment was used to treat persistently febrile child. 

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