https://doi.org/10.4081/hls.2023.11345

Assessment of blood culture and tube agglutination serology test for the diagnosis of typhoid fever amongst malaria-negative patients: a one-year hospital-based study

Vol. 11 No. 1 (2023)
Submitted: 31 March 2023
Accepted: 7 June 2023
Published: 19 June 2023
Blood culture, Widal test, malarianegative typhoid fever
Abstract Views: 1354
PDF: 364
HTML: 232
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Kirti Nirmal
https://orcid.org/0000-0001-5437-9050
Department of Microbiology, University College of Medical Sciences and Guru Tag Bahadur Hospital, Delhi, India.
Vikas Saini
vikassaini287@gmail.com
https://orcid.org/0000-0003-3051-6166
Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Nadeem Ahmad
https://orcid.org/0000-0001-5783-6368
Department of Microbiology, University College of Medical Sciences and Guru Tag Bahadur Hospital, Delhi, India.
Narendra Pal Singh
Department of Microbiology, University College of Medical Sciences and Guru Tag Bahadur Hospital, Delhi, India.

Salmonella serotypes, including Salmonella Typhi, S. Paratyphi A, S. Paratyphi B, and S. Paratyphi C, are responsible for the systemic, protracted febrile sickness known as typhoid fever. Various antibody-based tests are being used for diagnosing typhoid fever. This study was carried out to assess the performance of the widal test and blood culture for the diagnosis of typhoid fever among malaria-negative patients in a tertiary care hospital in east Delhi, India. The study was conducted from July 2021 to June 2022 in the Department of Microbiology of a tertiary care hospital in Delhi. Patients, including the adult and pediatric population, were evaluated for typhoid fever and participated in an observational, prospective study on febrile patients that was malaria-negative. Venous blood samples were obtained under strict aseptic conditions and further processed for widal serology and blood culture tests for typhoid fever. In our study, the prevalence of blood culture-positive Salmonella species was 0.3% (30/10,000 = 0.3%) Among antimicrobial susceptibility patterns, S. Typhi revealed the highest resistance rates for Ciprofloxacin (43.33%), Azithromycin (36.66%), and third-generation cephalosporins. Out of 30 blood culture-positive Salmonella Typhi of typhoid fever patients, 5 (17%) samples were negative for the Widal test. Among 30 samples, all were blood culture positive, but only 25 samples show Widal titer above the baseline i.e. >1:64. Although blood culture is the gold standard for the diagnosis of typhoid fever, the Widal test does play a role in the diagnosis and management of typhoid fever, especially in suspected cases when blood culture is negative, especially in government tertiary care hospitals.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Willke A, Ergonul O, Bayar B: Widal test in diagnosis of typhoid fever in Turkey. Clin Diagn Lab Immunol 2002;9:938–41. DOI: https://doi.org/10.1128/CDLI.9.4.938-941.2002
Crump JA, Luby SP, Mintz ED: The global burden of typhoid fever. Bull World Health Organ 2004;82:346–53.
Gopalakrishnan V, Sekhar WY, Soo EH, et al. Typhoid fever in Kuala Lumpur and a comparative evaluation of two commercial diagnostic kits for the detection of antibodies to salmonella typhi. Singapore Med J 2002;43:354–8.
Nsutebu EF, Martins P, Adiogo D. Prevalence of typhoid fever in febrile patients with symptoms clinically compatible with typhoid fever in Cameroon. Trop Med Int Health 2003;8:575–8. DOI: https://doi.org/10.1046/j.1365-3156.2003.01012.x
Onyekewere CA. Typhoid fever: misdiagnosis or over diagnosis. Niger Med Pract 2007;51:76–9. DOI: https://doi.org/10.4314/nmp.v51i4.28846
Wain J, Hosoglu S. The laboratory diagnosis of enteric fever. J Infect Dev Ctries 2008;2:421–5. DOI: https://doi.org/10.3855/jidc.155
Parry CM, Tuyet HNT, Diep TS, et al. Value of a single-tube Widal test in diagnosis of typhoid fever in Vietnam. J Clin Microbiol 1999;37:2882–6. DOI: https://doi.org/10.1128/JCM.37.9.2882-2886.1999
Wain J, Diep TS, Be Bay PV, et al. Specimens and culture media for the laboratory diagnosis of typhoid fever. J Infect Dev Ctries 2008;2:469–74. DOI: https://doi.org/10.3855/jidc.164
Krishna S, Desai S, Anjana VK, Paranthaaman RG. Typhidot (IgM) as a reliable and rapid diagnostic test for typhoid fever. Ann Tropical Med Public Health 2011;4:42. DOI: https://doi.org/10.4103/1755-6783.80535
Olsen SJ, Pruckler J, Bibb W, et al. Evaluation of rapid diagnostic tests for typhoid fever. J Clin Microbiol 2004;42:1885-9. DOI: https://doi.org/10.1128/JCM.42.5.1885-1889.2004
Begum Z, Hossain MA, Shamsuzzaman AK, et al. Evaluation of Typhidot (IgM) for early diagnosis of typhoid fever. Bangladesh J Med Microbiol 2009;3:10-3. DOI: https://doi.org/10.3329/bjmm.v3i1.2964
Ley B, Mtove G, Thriemer K, et al. Evaluation of the Widal tube agglutination test for the diagnosis of typhoid fever among children admitted to a rural hospital in Tanzania and a comparison with previous studies. BMC Infect Dis 2010;10:180. DOI: https://doi.org/10.1186/1471-2334-10-180
Beyene G, Asrat D, Mengistu Y, et al. Typhoid fever in Ethiopia. J Infect Dev Ctries 2008;2:448–53. DOI: https://doi.org/10.3855/jidc.160
Olopoenia LA, King AL. Widal agglutination test - 100 years later: still plagued by controversy. Postgrad Med J 2000;76:80–4. DOI: https://doi.org/10.1136/pmj.76.892.80
Laxminarayan R, Matsoso P, Pant S, et al. Access to effective antimicrobials: a worldwide challenge. Lancet 2016;387:168-75. DOI: https://doi.org/10.1016/S0140-6736(15)00474-2
Murray CK, Gasser RA, Jr., Magill AJ, Miller RS. Update on rapid diagnostic testing for malaria. Clinical Microbiol Rev 2008;21:97–110. DOI: https://doi.org/10.1128/CMR.00035-07
Wongsrichanalai C, Barcus MJ, Muth S, et al. A review of malaria diagnostic tools: microscopy and rapid diagnostic test (RDT). Am Soc Trop Med Hygiene 2007;77:119–27. DOI: https://doi.org/10.4269/ajtmh.2007.77.119
Bell D, Peeling RW. Evaluation of rapid diagnostic tests: malaria. Nat Rev Microbiol 2006;4:S34–8. DOI: https://doi.org/10.1038/nrmicro1524
WHO. Report of a Joint WHO/USAID Informal Consultation. New perspectives: malaria diagnosis. Geneva, Switzerland: World Health Organization; 1999.
Banoo S, Bell D, Bossuyt P, et al. Evaluation of diagnostic tests for infectious diseases: general principles. Nat Rev Microbiol 2006;4:S20–2. DOI: https://doi.org/10.1038/nrmicro1570
Kalpana P, Sharma VK, Maharjan R. Prevalence and antibiotic sensitivity test of salmonella serovars from enteric fever suspected patients visiting Alka Hospital, Lalitpur. Am J Microbiol 2015;6:40-43. DOI: https://doi.org/10.3844/ajmsp.2015.40.43
Globally TD-RI. Final report and recommendations. Review on Antimicrobial Resistance Report. 2016.
Tewari R, Jamal S, Dudeja M. Antimicrobial resistance pattern of Salmonella enterica servars in southern Delhi. Int J Community Med Public Health 2015;2:254–8. DOI: https://doi.org/10.18203/2394-6040.ijcmph20150478
Shukla S, Patel B, Chitnis DS. 100 years of Widal test & its reappraisal in an endemic area. Indian J Med Res 1997;105:53-7.

How to Cite

Nirmal, K., Saini, V., Ahmad, N., & Pal Singh, N. (2023). Assessment of blood culture and tube agglutination serology test for the diagnosis of typhoid fever amongst malaria-negative patients: a one-year hospital-based study. Healthcare in Low-Resource Settings, 11(1). https://doi.org/10.4081/hls.2023.11345
Copyright (c) 2023 the Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.