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ToolsVan Be Bay, Pham, Wain, John, Phuong, Le Thi, Ho, Vo Anh, Hien, Tran Tinh and Parry, Christopher M. (2022) Quantitative bacterial counts in the bone marrow of Vietnamese patients with typhoid fever. Transactions of the Royal Society of Tropical Medicine and Hygiene, 116 (8). pp. 736-744. ISSN 0035-9203
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Abstract
Background: Bone marrow culture (BMC) is the reference standard for typhoid fever diagnosis. We studied the additional yield of BMC over blood culture (BC) and the relationship between quantitative BMC counts and severe disease. Methods: Hospitalised Vietnamese patients with suspected typhoid fever were prospectively investigated with a BC, BMC, faecal culture and quantitative BMC counts. Results: Salmonella typhi was isolated in 195 of 231 patients: from BC and BMC in 144 (73.8%), from BMC alone in 33 (16.9%), from BC alone in 12 (6.2%) and from faeces alone in 6 (3.1%). In 167 patients the median extracellular count of S. typhi was 2.5 cfu/mL (interquartile range [IQR] 0-10) and the intracellular count was 10.5 cfu/mL (IQR 2-42) with a ratio of 1.3 bacteria/cell (IQR 0.6-2.5). The median count of intracellular bacteria in 24 patients with severe disease was 46 bacteria/cell (IQR 9-105) compared with 6.5 bacteria/cell (IQR 2-34) in 143 with non-severe disease (p=0.005). The intracellular BMC count was negatively correlated with the peripheral white cell count and positively correlated with hepatomegaly, splenomegaly, aspartate transaminase, a positive BC and the fever clearance time following treatment with azithromycin, ofloxacin or a combination of the two. Conclusions: BMC gave a moderate additional yield over BC. Intracellular BMC counts may reflect the bacterial load in typhoid fever.
| Item Type: | Article |
|---|---|
| Additional Information: | Data availability statement: The data from this study are available upon request to the corresponding author. Funding information: This work was supported by the Wellcome Trust of Great Britain. The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript. |
| Uncontrolled Keywords: | azithromycin,multiple drug resistance,ofloxacin,quantitative bone marrow counts,salmonella enterica serovar typhi,typhoid fever,parasitology,public health, environmental and occupational health,infectious diseases,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2400/2405 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 29 Oct 2024 11:30 |
| Last Modified: | 04 Nov 2024 12:30 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/97304 |
| DOI: | 10.1093/trstmh/trac003 |
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