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Quantitation of bacteria in blood of typhoid fever patients and relationship between counts and clinical features, transmissibility, and antibiotic resistance.
J Clin Microbiol. 1998 Jun; 36(6):1683-7.JC

Abstract

Salmonella typhi was isolated from 369 and Salmonella paratyphi A was isolated from 6 of 515 Vietnamese patients with suspected enteric fever. Compared with conventional broth culture of blood, direct plating of the buffy coat had a diagnostic sensitivity of 99.5% (95% confidence interval [CI], 97.1 to 100%). Blood bacterial counts were estimated by the pour plate method. The median S. typhi count in blood was 1 CFU/ml (range, <0.3 to 387 CFU/ml), of which a mean of 63% (95% CI, 58 to 67%) were intracellular. The mean number of bacteria per infected leukocyte was 1.3 (interquartile range [IQR], 0.7 to 2.4) CFU/cell (n = 81). Children (< 15 years old; n = 115) had higher median blood bacterial counts than adults (n = 262): 1.5 (range, <0.3 to 387) versus 0.6 (range, <0.3 to 17.7) CFU/ml (P = 0.008), and patients who excreted S. typhi in feces had higher bacteremias than those who did not: a median of 3 (range, <0.3 to 32) versus 1 (range, <0.3 to 68) CFU/ml (P = 0.02). Blood bacterial counts declined with increasing duration of illness (P = 0.002) and were higher in infections caused by multidrug-resistant S. typhi (1.3 [range, <0.3 to 387] CFU/ml; n = 313) than in infections caused by antibiotic-sensitive S. typhi (0.5 [range, <0.3 to 32] CFU/ml; n = 62) (P = 0.006). In a multivariate analysis this proved to be an independent association, suggesting a relationship between antibiotic resistance and virulence in S. typhi.

Authors+Show Affiliations

Department of Microbiology, Centre for Tropical Diseases, Cho Quan Hospital, Ho Chi Minh City, Vietnam.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9620400

Citation

Wain, J, et al. "Quantitation of Bacteria in Blood of Typhoid Fever Patients and Relationship Between Counts and Clinical Features, Transmissibility, and Antibiotic Resistance." Journal of Clinical Microbiology, vol. 36, no. 6, 1998, pp. 1683-7.
Wain J, Diep TS, Ho VA, et al. Quantitation of bacteria in blood of typhoid fever patients and relationship between counts and clinical features, transmissibility, and antibiotic resistance. J Clin Microbiol. 1998;36(6):1683-7.
Wain, J., Diep, T. S., Ho, V. A., Walsh, A. M., Nguyen, T. T., Parry, C. M., & White, N. J. (1998). Quantitation of bacteria in blood of typhoid fever patients and relationship between counts and clinical features, transmissibility, and antibiotic resistance. Journal of Clinical Microbiology, 36(6), 1683-7.
Wain J, et al. Quantitation of Bacteria in Blood of Typhoid Fever Patients and Relationship Between Counts and Clinical Features, Transmissibility, and Antibiotic Resistance. J Clin Microbiol. 1998;36(6):1683-7. PubMed PMID: 9620400.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quantitation of bacteria in blood of typhoid fever patients and relationship between counts and clinical features, transmissibility, and antibiotic resistance. AU - Wain,J, AU - Diep,T S, AU - Ho,V A, AU - Walsh,A M, AU - Nguyen,T T, AU - Parry,C M, AU - White,N J, PY - 1998/6/10/pubmed PY - 1998/6/10/medline PY - 1998/6/10/entrez SP - 1683 EP - 7 JF - Journal of clinical microbiology JO - J. Clin. Microbiol. VL - 36 IS - 6 N2 - Salmonella typhi was isolated from 369 and Salmonella paratyphi A was isolated from 6 of 515 Vietnamese patients with suspected enteric fever. Compared with conventional broth culture of blood, direct plating of the buffy coat had a diagnostic sensitivity of 99.5% (95% confidence interval [CI], 97.1 to 100%). Blood bacterial counts were estimated by the pour plate method. The median S. typhi count in blood was 1 CFU/ml (range, <0.3 to 387 CFU/ml), of which a mean of 63% (95% CI, 58 to 67%) were intracellular. The mean number of bacteria per infected leukocyte was 1.3 (interquartile range [IQR], 0.7 to 2.4) CFU/cell (n = 81). Children (< 15 years old; n = 115) had higher median blood bacterial counts than adults (n = 262): 1.5 (range, <0.3 to 387) versus 0.6 (range, <0.3 to 17.7) CFU/ml (P = 0.008), and patients who excreted S. typhi in feces had higher bacteremias than those who did not: a median of 3 (range, <0.3 to 32) versus 1 (range, <0.3 to 68) CFU/ml (P = 0.02). Blood bacterial counts declined with increasing duration of illness (P = 0.002) and were higher in infections caused by multidrug-resistant S. typhi (1.3 [range, <0.3 to 387] CFU/ml; n = 313) than in infections caused by antibiotic-sensitive S. typhi (0.5 [range, <0.3 to 32] CFU/ml; n = 62) (P = 0.006). In a multivariate analysis this proved to be an independent association, suggesting a relationship between antibiotic resistance and virulence in S. typhi. SN - 0095-1137 UR - https://www.unboundmedicine.com/medline/citation/9620400/Quantitation_of_bacteria_in_blood_of_typhoid_fever_patients_and_relationship_between_counts_and_clinical_features_transmissibility_and_antibiotic_resistance_ L2 - http://jcm.asm.org/cgi/pmidlookup?view=long&amp;pmid=9620400 DB - PRIME DP - Unbound Medicine ER -