Antibiotic sensitivity profile of the Salmonella isolates in hospitalized children with enteric fever – A cross-sectional study

Background: Enteric fever is a major public health problem in developing countries like India. It affects all age groups but young children are at highest risk. Timely management with appropriate antimicrobial therapy can reduce both morbidity and mortality. In recent years, the emergence of antimicrobial resistance is a significant challenge. Therefore, this study was undertaken to study antibiotic sensitivity pattern of the Salmonella isolates. Aims and Objectives: The aim of this study was to estimate the prevalence of resistance to commonly used antibiotics in the Salmonella isolates. Materials and Methods: Children between 6 months and 14 years of age admitted for fever and whose blood culture was positive for Salmonella Typhi or Salmonella Paratyphi A, B, or C were included in the study over a period of 2 years (August 2018–July 2020). Results: There were 155 patients of enteric fever whose blood culture results were positive for S. Typhi/S. Paratyphi who were included in the study. Out of the 155 culture positive cases, S. Typhi was isolated in 135 (87.1%), S. Paratyphi A in 16 (10.3%) and S. Paratyphi B in 4 (2.6%) cases. All the 135 isolates of S. Typhi were sensitive to cephalosporins. High rate of sensitivity was noted for the first-line drugs – amoxicillin, ampicillin, and trimethoprim-sulfamethoxazole. All 16 isolates of S. Paratyphi A were sensitive to cephalosporins. All the isolates of S. Paratyphi B tested were sensitive to cephalosporins, azithromycin, nalidixic acid, and trimethoprim-sulfamethoxazole. Conclusion: At present, there is low prevalence of resistance to first-line drugs and third-generation cephalosporins and high resistance to fluoroquinolones, nalidixic acid, and azithromycin as noted in this region. Rational antibiotic selection should be based on sensitivity pattern to prevent emergence of resistant strains.

In vivo Antisalmonellal and Antioxidant Activity of Hydroethanolic Extract of Bauhinia rufescens Leaves in Wistar Albino Rats Infected with Salmonella Typhi

Infectious diseases such as typhoid fever lead to the formation of free radicals which can have a detrimental effect on the body. Typhoid fever is caused by poor sanitation, lack of clean water and resistance of germs to antibiotics and reactive oxygen species (ROS). Hence an urgent needs to find alternative treatments with little or no toxicity for the treatment of this disease. Objective: This work aims to evaluate the in vivo antisalmonellal and antioxidant activity of the 95% hydroethanolic extract of the leaves of Bauhinia rufescens (Fabaceae) in rats experimentally infected with Salmonella Typhi ATCC6539, as an alternative therapy. Methods: The rats were randomly divided into twelve groups (six per sex) of animals. Thus 3 control groups: (T0) uninfected and untreated; (T-) infected and untreated; (T+) infected and treated with ciprofloxacin (14 mg/kg) and 3 test groups: T1, T2 and T3 infected and treated with different doses of the extract (40, 80 and 117.71 mg/kg respectively). The evolution of the infection and the effectiveness of the treatment were monitored by blood culture, food consumption and weight growth were assessed during the trial; at the end of which the animals were sacrificed and the different parameters were evaluated. Results: Infected animals treated with different doses of the extract showed zero bacterial loads from the twelfth day post infection in both sexes. Regardless of sex, animals treated with the extract at the dose of 117.71mg/Kg were cured by the seventh day after the start of treatment while those treated with the doses of 40 mg/Kg and 80 mg/kg were cured by the ninth day after the start of treatment. Infection induced a significant (p < 0.05) decrease in food consumption and weight growth, while treatment induced, at all doses, an increase in food consumption and weight growth. Infection also caused a significant (p < 0.05) increase in NO and MDA levels, as well as a significant decrease in catalase and peroxidase activities in animal tissue homogenates. However, treatment resulted in a significant decrease in NO and MDA levels, and a significant (p < 0.05) increase in catalase and peroxidase activities. Conclusion: These results showed that the 95% hydroethanolic extract of Bauhinia rufescens leaves has mixed antisalmonellal and antioxidant activity in vivo and could be developed for the treatment of typhoid fever.

Fiebre tifoidea: una etiología poco frecuente de síndrome febril prolongado en pediatría / Typhoid fever: a rare etiology of prolonged febrile illness in pediatrics / Febre tifoide: uma etiología rara de síndrome febril prolongada em pediatría

Introducción: Las infecciones representan la etiología más frecuente del síndrome febril prolongado (SFP). Si bien las fiebres entéricas constituyen una causa posible, en Uruguay su prevalencia ha disminuido significativamente con la mejora de las condiciones socio sanitarias. Objetivo: Comunicar el caso de un adolescente con una etiología actualmente excepcional de SFP. Caso clínico 14 años, sano, zona suburbana. Comienza 2 semanas previo al ingreso con dolor en hemiabdomen superior. Agrega cefalea holocraneana leve y vómitos ocasionales. 5 días previos al ingreso fiebre 40°C axilar, un pico diario, sin otra sintomatología. Tránsito digestivo bajo y urinario normal. Examen físico: lúcido, buen aspecto general, abdomen doloroso a la palpación profunda en epigastrio. Sin irritación peritoneal. Resto normal. Analítica: Leucocitos 5200mm3, Proteína C reactiva 71.4mg/dL, hemocultivo sin desarrollo. Ecografía abdominal, radiografía de tórax y ecocardiograma normales. Serologías para Virus Epstein Barr, Citomegalovirus, y Bartonella henselae negativas. Orina normal, urocultivo sin desarrollo. Persiste con fiebre, agrega exantema macropapular evanescente en tronco, sin otros síntomas. Al 7° día de internación nuevo hemocultivo: Salmonella Typhi sensible a ampicilina que recibe por 14 días. Buena evolución. Discusión: La fiebre tifoidea es una enfermedad infectocontagiosa, aguda, potencialmente mortal. Las condiciones socioeconómicas son determinantes en su transmisión. La sensibilidad del hemocultivo es mayor durante la primera semana de enfermedad, por lo que en ocasiones es necesario reiterarlo. Sus manifestaciones clínicas inespecíficas y la baja incidencia hacen que esta etiología no sea habitualmente sospechada en nuestro medio. Por tanto, es importante aumentar el índice de sospecha y considerar entre los diagnósticos diferenciales de SFP esta etiología.

Introduction: Infections are the most frequent etiology of prolonged febrile illness (PFI). Although enteric fevers are a possible cause, their prevalence has significantly diminished in Uruguay, due to improved socio-sanitary conditions. Objective: To communicate the case of an adolescent with a currently exceptional etiology of PFI. Clinical case: 14 years old, healthy, suburban area. Two days prior to admission the patient has pain in upper hemi abdomen. Adds mild holocranial headache and occasional vomiting. 5 days prior to admission axilary temperature of 40°C, one daily peak, without other symptoms. Normal lower digestive and urinary transit. Physical examination: lucid, good general aspect, pain at deep palpation in epigastrium. No peritoneal irritation. Rest is normal. Laboratory: leukocytes 5200 mm3, C-reactive protein 71.4mg/dL, blood culture shows no growth. Abdominal sonogram, thoracic X-ray and echocardiogram are normal. Negative serology for Epstein Barr Virus, Cytomegalovirus and Bartonella henselae. Normal urine, urine culture with no growth. Fever persists, adds evanescent macropapular exanthema in on the trunk, without other symptoms. On the 7th day in hospital a new blood culture shows Salmonella Typhi sensitive to ampicillin, which he receives for 14 days. Good evolution. Discussion: Typhoid fever is an acute, life-threatening, infectious disease. Socioeconomic conditions are determinant in its transmission. Blood culture sensitivity is greater during the first week of the disease, that is why it must occasionally be repeated. Its unspecific clinical manifestations and low incidence make this etiology not be usually suspected in our surroundings. It is therefore important to increase our suspicion and to consider it amongst differential diagnosis in PFI.

Introdução: As infecções representam a etiologia mais frequente da síndrome febril prolongada (SFP). Embora as febres entéricas sejam uma causa possível, no Uruguai sua prevalência diminuiu significativamente com a melhoria das condições sociossanitárias. Objetivo: Relatar o caso de um adolescente com etiologia atualmente excepcional de SFP. Caso clínico 14 anos, saudável, zona suburbana. Começa 2 semanas antes da admissão com dor no abdome superior. Adiciona dor de cabeça holocraniana leve e vômitos ocasionais. 5 dias antes da admissão febre 40°C axilar, pico diário, sem outros sintomas. Trânsito digestivo inferior e trânsito urinário normais. Exame físico: lúcido, bom aspecto geral, abdome doloroso à palpação profunda no epigástrio. Sem irritação peritoneal. Resto normal. Análise: Leucócitos 5200mm3, proteína C reativa 71,4mg/dL, hemocultura sem desenvolvimento. Ultrassonografia abdominal, radiografia de tórax e ecocardiograma foram normais. As sorologias para vírus Epstein Barr, Citomegalovírus e Bartonella henselae foram negativas. Urina normal, urocultura sem desenvolvimento. Persiste com febre, acrescenta erupção macropapular evanescente no tronco, sem outros sintomas. No 7º dia de internação, nova hemocultura: Salmonella Typhi sensível à ampicilina, que recebeu por 14 dias. Boa evolução. Discussão: A febre tifóide é uma doença infecciosa aguda, potencialmente fatal. As condições socioeconômicas são decisivas na sua transmissão. A sensibilidade da hemocultura é maior durante a primeira semana da doença, por isso às vezes é necessário repeti-la. Suas manifestações clínicas inespecíficas e baixa incidência fazem com que essa etiologia não seja usualmente suspeitada em nosso meio. Portanto, é importante aumentar o índice de suspeição e considerar essa etiologia entre os diagnósticos diferenciais da SFP.

Antibacterial Properties of Young and Mature Mango Leaves (Mangifera indica) Extract on Some Clinical Isolates

Aim: This study was carried out to investigate the antibacterial properties and efficacy of mango (Mangifera indica) leaf extracts on some clinical isolates as test rganisms. Study Design: The study employed statistical analysis of the data and interpretationPlace and Duration of Study: Young and mature mango leaves were collected from the Botanical Garden, Kenule Beeson Saro-Wiwa Polytechnic, Bori, Nigeria, and taken to the laboratory for analyses. Methodology: The samples were dried in an oven at 80oC for 3 days. Thereafter, 50 g of each ground mango leaf (young and mature leaves) were soaked separately in 500 ml of water, ethanol (95% v/v), and acetic acid (99.9% v/v) respectively for another 3 days. The soaked materials were filtered through Whatman No. 1 filter paper into sterile beakers and evaporated to dryness in a water bath at 80oC. The dried extracts obtained were reconstituted with water at concentrations of 100, 75, 50, and 25 mg/ml. Test organisms, Escherichia coli, Staphylococcus aureus, Salmonella typhi, Proteus mirabilis, Bacillus cereus, and Pseudomonas aeruginosa were obtained after proper laboratory screening of isolates from the diagnostic laboratory of the Rivers State University Teaching Hospital, Port Harcourt, Nigeria, for confirmation of identity and storage in universal bottles in a refrigerator. Sensitivity tests were carried out with the agar well diffusion method against the test organisms, using tetracycline as the standard control drug, with cultures incubated accordingly. The measured zones of inhibition were compared with the controls and interpreted as resistant, intermediate, or susceptible to mango extracts in accordance with the interpretive guidelines published by the National Committee for Clinical Laboratory Standards (NCCLS). Assay for minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) was also carried out. Results: Results obtained showed that acetic acid young leaf extract at 100mg/ml produced 50 % susceptibility and 50 % intermediate response of test bacterial species. Generally, at 100 mg/ml, acetic acid young leaf extracts yielded 50% susceptibility and 50% intermediate response among both Gram-positive and Gram-negative bacteria. Ethanolic extracts gave 100% intermediate sensitivity of Gram-negative species and 50% each of resistant and intermediate response in Gram-positive forms. Aqueous extracts also produced no susceptibility among the test organisms as there was 100% resistance. Extracts of mature mango leaves of all solvents and at all concentrations used yielded no susceptibility response among the test bacterial species on the NCCLS scale. Minimum inhibitory and bactericidal concentrations were found to range from 25 mg/ml to 50 mg/ml. Additionally, it was observed that the sensitivity of organisms to mango extracts increased with concentration.Conclusion: In conclusion, acetic acid has a better extracting potential than ethanol and water as a solvent for the extraction of mango parts. More so, young mango leaves extracted with acetic acid possess higher broad-spectrum antibacterial properties than the mature mango leaves extracted from the same plant. It is therefore recommended that young mango leaves, extracted with acetic acid, be used for the treatment of microbial infections at concentrations not below 50 mg/ml.

Susceptibility of Escherichia coli, Salmonella typhi and Shigella spp to Ethanoic Extract of Lawsonia inermis

Background: The acceptance of traditional medicine as an alternative form of healthcare and the development of microbial resistance to the available antibiotics has led researchers to investigate the antimicrobial activity of plant extracts. Aim: This was to evaluate antibacterial activity and potential effect of Lawsonia inermis leaves against three tests organisms namely: Escherichia coli, Salmonella typhi, and Shigella. Methodology: Ethanoic extracts of Lawsonia inermis was obtained. The extracts were boiled, macerated, soaked and the implementation of the extracts to determine the antimicrobial activities on culture was performed by diffusion method. Three antibiotics (Gentamicin, Ciprofloxacin and Cefataxime) were used as control for the test organisms respectively. Results: The inhibition of each test organism was achieved in one or two extracts. Escherichia coli had the highest (7.25mm) zone of inhibition from soaked extract with lowest (5.00mm) zone of inhibition from boiled extract, Salmonella typhi had the highest (11.63mm) zone of inhibition from boiled extract with lowest (8.25mm) zone of inhibition from macerated extract, and Shigella had the highest zone of inhibition 19.50mm from soaked extract, and had the lowest zone of inhibition 12.63mm from boiled extract. Furthermore, the soaked ethanoic extract had a zone of inhibition ranging from 7.25mm- 19.50mm. Also, the ethanoic extract boiled had zones of inhibition ranging from 5.00mm – 12.63mm, and the ethanoic extract macerated had a zone of inhibition range of 6.63mm- 17.75mm. The zones of inhibition produced by the controls are; gentamicin produced zones of inhibition ranging from 25.00mm – 26.00mm, ciprofloxacin produced zones of inhibition ranging from 20.00mm – 22.00mm, and cefataxime produced zones of inhibition ranging from 18.00mm – 21.00mm. The Statistical analysis was applied to the result using the one-way ANOVA test to compare the differences in the means. Conclusion: The results indicated that there was no significant difference in the effects of the ethanoic extracts of Lawsonia inermis on the tests organisms S. typhi, E. coli and Shigella and the controls. (p<0.05, F Cal = 0.103, F Tab = 4.257).

Typhoid Outbreak during the Pandemic of COVID-19 : A Report

Background : In the 19th Week of 2020, Integrated Disease Surveillance Programme (IDSP) noted an unusual increase in the number of fever cases in Routine Syndromic Surveillance. Objectives : The unusual increase of fever cases were investigated to identify the agent, the source of infection and to propose recommendations for control measures. Methods : Active surveillance of fever cases done, blood samples, stool samples and water samples were collected from the affected area. The secondary data of indoor and outdoor patient were collected from the nearest health facilities. Result : It was a single peak outbreak of typhoid, started from 1st May, 2020, had peaked during the 19th Week of May, 2020 and ended on 31st May, 2020. The epicentre of the outbreak was the residential colony of Industrial labour. The outbreak of Typhoid occurred due to conditions generated due to the pandemic of COVID -19. Two sources of active infection were found. First, contaminated supply of drinking water and second a food-handler, who was the carrier of Typhoid. Interpretation and Conclusion : It is a lesson to learn that the local communicable diseases should be monitor during the pandemic. Otherwise, that can cause the situation of co-epidemic

Antibacterial Activity of Composite Mixture of Senna siamea Leaves and Tamarind Pulp Extracts on Multidrug Resistant Salmonella typhi

Background: For many years, antimicrobial chemotherapeutic approach have been challenged by drugs resistant bacteria such as Salmonella associated with gastrointestinal infections. To overcome these effects, several attempts by herbalists and traditional healers were in progress, using some plants parts to treat Typhoid fever in Nigeria. Aim: The aim of this work was to determine the antibacterial activity of Senna siamea leaves and Tamarindus indica fruit pulp against multidrug resistant Salmonella typhi. Methods: A total of 168 samples of stool and blood from patients with suspected cases of typhoid fever were collected and only three (3) Salmonella typhi isolates were recovered (from the 168 samples) by conventional microbiological techniques. The isolates were screened for multidrug resistant properties according to Kirby -Bauer disc diffusion method. Water and ethanol were used to extract phytochemical components from powdered leaves of Senna siamea and Tamarindus indica fruit pulp via percolation method. The extracts were tested for the antibacterial activity against the clinical isolates of Salmonella typhi. Results: All the isolates (100%) were resistant to Ampicillin, Amoxicillin, while two (66.7%) to Erythromycin and Tetracycline and sensitive (100%) to Streptomycin, Gentamycin, Nalidixic acid Ciprofloxacin, Cotrimoxazole, Augmentin and Chloramphenicol, The phytochemical screening o of both plants extracts showed the presence of alkaloids, terpenoids, flavonoids, saponins, tannins, carbohydrates and cardiac glycosides. The result shows that aqueous and ethanolic extracts of combined Tamarind and Senna siamea were more active (2.50µg/ml) against Salmonella typhi when compared to individual extracts. Conclusion: This study shows that aqueous and ethanol extracts of both plants exhibited activity on S. Typhi, hence, possess antimicrobial potentials that it can be used in treatment of typhoid.

Optimizing factors for the efficient expression and purification of spao and lamb from Salmonella typhi

We optimized the expression and purification of outer membrane proteins SpaO and LamB from Salmonella typhi. We investigated various factors in the expression and purification processes, including the use of isopropyl ß-d-1 thiogalactopyranoside (IPTG), imidazole, and urea. First, PCR amplification was carried out on SpaO and LamB genes. The genes were then cloned in pTZ57R/T, and then expressed in pET28a vector and transformed into Escherichia coli BL21 (DE3). Gene insertion was confirmed by enzymatic digestion with NdeI and XhoI. Inclusion bodies expressing recombinant SpaO and LamB were induced with 200 and 400 µL 0.5 mM IPTG, respectively. The formed protein inclusion bodies were then isolated from the pellet and solubilized in IB buffer containing 8 M urea for SpaO and 6 M urea for LamB. Proteins were refolded by dialysis in 3M urea. Purified proteins with nickel-nitrilotriacetic acid affinity chromatography and eluted with buffer containing 250 mM imidazole for SpaO and 150 mM imidazole for LamB. The protein expression profiles were analyzed by SDS-PAGE, which identified the 33 and 49 kDa bands corresponding to rSpaO and rLamB. Western blotting Purification was carried out by nickel affinity resin with 250 mM and 150 mM imidazole for rSpaO and rLamB and refolded through stepwise dialysis with anti-His tag antibodies confirmed their expression. These optimized methods can be used to generate recombinant proteins for the development of future vaccines.

Evaluation of the efficiency of ciprofloxacin against S. Typhi by altering the production of cytokines in acute typhoid fever in patients at Al-Diwaniyah Hospitals, Iraq

Aims@#Typhoid fever is a life-threatening disease in the developing world that claims >600,000 deaths per year. Its causative agent Salmonella Typhimurium (S. Typhi) can be treated with ciprofloxacin, an effective broad-spectrum antibiotic that enhances the natural host defenses. However, the emergence of resistant bacterial strains may be a warning alarm against the clinical use of this antibiotic. This study was aimed to investigate the efficiency of ciprofloxacin treatment (250 mg/mL) against S. Typhi by altering the production of serum cytokines IL-10, 1L-6 and TNF-α in acute typhoid fever patients in Diwanyah Hospitals.@*Methodology and results@#ELISA and Western Blot methods were used to investigate cytokine levels in patients and healthy controls sera. Our results showed that all cytokines’ levels before treatment with ciprofloxacin were significantly higher than the control (healthy group). However, treated patients with ciprofloxacin revealed a significantly reduced concentration of IL-10 and TNF-α compared to untreated control samples. However, the level of IL-6 was higher even with ciprofloxacin treatment.@*Conclusion, significance and impact of study@#The study concluded that ciprofloxacin (250 mg/mL) might significantly alter serum cytokines IL-6, IL-10 and TNF-α levels in acute typhoid fever patients. Therefore, further molecular studies are essential to understand the effect of ciprofloxacin on the production of cytokines.

Extensively drug-resistant Salmonella typhi causing rib osteomyelitis: A case report

Rationale: Salmonella (S.) typhi is a rare cause of osteomyelitis in immunocompetent adults. Extensive drug resistance (XDR) may lead to more complicated cases of S. typhi osteomyelitis. Patient concern: A 55-year-old female presented with a persistent low-grade fever and a swelling on her lower left chest with a sinus discharging purulent fluid for the past 8 months. Her symptoms had been unresponsive to previous anti-microbial therapy. Diagnosis: Rib osteomyelitis caused by XDR S. typhi. Interventions: Surgical wound debridement, left 7th-9th rib resection and intravenous IV meropenem were done. Outcome: Fever resolved and left-sided swelling resected without recurrence. Lessons: The prevalence of XDR S. typhi is growing in South Asia and should be considered as the differential diagnosis of chronic osteomyelitis.

Typhoid fever presenting as acute psychosis in a young adult: case report and literature review of typhoid psychosis

@#The rarity of acute psychosis in typhoid fever can result in delayed and misdiagnosis of the condition. We report a case of a 20-year-old man who presented with fever and acute psychotic symptoms. This was associated with headache, dizziness, and body weakness. There were no other significant symptoms. Neurological examination revealed reduced muscle tone of bilateral lower limbs but otherwise unremarkable. The computed tomography (CT) scan of his brain showed no abnormality. Blood specimens for microbiological culture grew Salmonella Typhi. This isolate was susceptible to chloramphenicol, ampicillin, ceftriaxone, ciprofloxacin, and trimethoprim-sulfamethoxazole. He was treated with intravenous ceftriaxone for one week and responded well. He was discharged with oral ciprofloxacin for another week. The repeated blood and stool for bacterial culture yielded no growth of Salmonella Typhi.

Moringa oleifera Derived Phytochemicals against 2-hydroxy-3-oxopropionate Reductase of Salmonella typhi Causing Typhoid

Phytochemicals from Moringa oleifera plant extract can cure Typhoid. It is caused by Salmonella typhi. Molecular docking method applied using “Biovia Discovery Studio”. “High positive values of -CDOCKER energy and -CDOCKER interaction energy” suggested that 4,8,12,16-tetramethylheptadecan-4-olide can effectively deactivate the 2-hydroxy-3-oxopropionate reductaseenzyme thereby interrupting the life cycle of the organism

Estudio de problemas de enfermedades causados ​​por Salmonella y relación con la fiebre tifoidea / Study of Illness Problems Caused By Salmonella and Relation with Typhoid

There is urgent need to address illness problems caused by Salmonella enteric serotype Typhibacteria. The bacteria are deposited in water or food by human carrier and are then spread to other people in the area. In this research, a blood specimens were collected from typhoid fever patients, and serum levels of IFN-γ and IL-6 during the chronic and acute phase in typhoid patients group was determined according protocol kit and calculation, results were higher levels in chronic phase (137.187 ± 0.703.427 ± 206.545pg/ml respectively) and in acute phase were 128.787 ± 2.522, 137.733 ± 23.424 pg/ml, respectively with highly significant (P ≤ 0.01) than those in healthy control group. Salmonella infects hosts as diversified as human, animal, and plant

Perfil de resistencia de la Salmonella sp durante un periodo de tres años en un hospital de Colombia / Resistance Profile of Salmonella SP During a Period of Three Years in a Hospital of Colombia / Perfil de resistência de Salmonella SP durante um período de três años em um hospital da Colômbia

Resumen Introducción: en Colombia, del 2000 al 2012, se describió un aumento progresivo en la resistência a betalactámicos y quinolonas en los aislamientos de Salmonella sp. A partir de esta fecha se desconoce la evolución de las tasas de resistencia en el país. El objetivo de este estúdio fue describir el perfil de suscep tibilidad durante el periodo 2014-2017 así como evaluar la asociación entre las características clínicas y sociodemográficas de la población con los patrones de resistencia de Salmonella sp. Materiales y méto dos: estudio de corte transversal del 2014 al 2017, realizado en la Fundación Cardioinfantil en mayores de 18 años, con aislamiento de Salmonella sp en cualquier tipo de muestra biológica. Resultados: se encontraron sesenta casos, ningún aislamiento fue resistente a quinolonas, uno mostró resistencia a ampicilina y uno se caracterizó como ; el 95 % tenia perfil de susceptibilidad usual. No se encontró asociación entre las variables estudiadas y la presencia de resistencia. Conclusión: los resultados pueden reflejar un cambio en el perfil de susceptibilidad de Salmonella sp en Colombia, con una disminución en la resistencia a betalactámicos y quinolonas a partir del 2014. Sin embargo, se requiere una mayor muestra poblacional para corroborar esta hipótesis.

Abstract Objective: In Colombia, from 2000 to 2012, a progressive increase in resistance to beta-lactams and quinolones was described in isolates of Salmonella As of this date, the evolution of resistance rates in the country is unknown. The objective of this study is to describe the susceptibility profile from 2014 to 2017, as well as to evaluate the association between the clinical and sociodemographic characteristics of the population with the resistance patterns of Salmonella Materials and methods: The study is a cross-sectional study between 2014 and 2017 at the Fundación Cardioinfantil, in patients over 18 years of age with Salmonella in any type of biologic sample. Results: The authors found 60 cases, no isolate was resistant to quinolones. One showed resistant to ampicillin, and añother one was characterized as amp-C; 95% had a usual susceptibility profile. No association was found between the variables studied and the presence of resistance. Conclusion: The results may reflect a change in the susceptibility profile of Salmonella in Colombia, with a decrease in resistance to beta-lactams and quinolones as of 2014; however, a larger population sample is required to corroborate this hypothesis.

Resumo Objetivo: Na Colômbia do ao 2000 ao 2012 se descreveu um aumento progressivo na resistência a beta-lactâmicos e quinolonas nos isolamentos de Salmonella sp. A partir desta data se desconhece a evolução das taxas de resistência no país. O objetivo deste estudo é descrever o perfil de susceptibilidade do ao 2014 ao 2017, assim como avaliar a associação entre as características clínicas e sociodemográficas da população com os patrões de resistência Salmonella sp. Materiais e métodos: Estudo de corte transversal do ano 2014 ao ao 2017 realizado na Fundación Cardioinfantil em maiores de 18 ao anos com isolamento de Salmonella sp, em qualquer tipo de amostra biológica. Resultados: se encontraram 60 casos, nenhum isolamento foi resistente a quinolonas, um mostrou resistência a ampicilina e um se caracterizou como AMP-C, o 95 % tinha perfil de susceptibilidade usual. Não se encontrou associação entre as variáveis estudadas e a presença de resistência. Conclusão: Os resultados podem refletir uma mudança no perfil de susceptibilidade de Salmonella sp. Na Colômbia, com uma diminuição na resistência a beta-lactâmicos e quinolonas a partir do año 2014, no entanto se requere uma maior amostra populacional para corroborar esta hipótese.

Malaria or typhoid co-infection in a tertiary care hospital of Bareilly, Uttar Pradesh, India

Background: Malaria is a protozoal disease caused by infection with parasite of genus Plasmodium. Typhoid is common with malarial infection.Methods: A cross sectional study was done to find out co-infection of typhoid and malaria. Study was done in central pathological lab of department of pathology, RMCH, Bareilly. Blood samples were collected in EDTA vial and plain vial. Blood smear was examined for malaria parasite within RBCs. Malaria rapid test was done for detection of Plasmodium species and Widal test was done for typhoid.Results: In this study found co-infection of malaria with typhoid was 15.64%. In malarial cases 54.50% were males, while maximum cases (26.92%) were in 21-30 yrs age group. Cases of P. vivax was maximum (86.28%) and maximum cases of P. vivax (29.42 %) was in 11-20 yrs age group while that of P. falciparum (22.22%) was in 11-20, 21-30, 41-50 yrs age group and maximum number (23.60%) of mixed malarial infection was in 31-40 yrs age group, While co-infection of malaria with typhoid was maximum (24.59%) was in 11-20 yrs age group and maximum (53.28%) in females. Maximum (79.51%) cases of typhoid were of P. vivax.Conclusions: Malaria and typhoid co-infection still remain a major public health problem in many developing countries. Concurrent infection with two agents can result in an illness having overlapping symptoms creating a diagnostic dilemma for the treating physician.

The Prevalence of Salmonellosis in Patients with Malaria Attending an Urban Hospital in Douala, Littoral Region, Cameroon

Aims:This study was carried out to determine the rate of co-infection of Malaria/typhoid fever among patients attending the hospital.Study Design:The study was a hospital based cross-sectional.Place and Duration of Study:The study was carried out at the Centre Medical Camrail,de Bassa (CMCD), Douala, Littoral Region, Cameroon, from April to May 2015.Methods:One hundred and sixty (160) blood and stool Samples were collected. Blood samples were subjected to microscopic examination used for the malaria parasite. Widal agglutination slide and tube test were performed for the identification of antibodies to Salmonella typhiand stool culture used for isolation of Salmonella species.Results:Overall malariaprevalence was 19.4% (31/160) with a geometric mean parasite density (GMPD) of 788.62±1945.763 parasites/μL of blood. The overall prevalence of typhoid fever by stool culture was 32.5% (52/160) while malaria/typhoid fever and malaria/non-typhoidal salmonella co-infection rates were 29% (9) and7% (3) respectively. Of the positive malaria samples, 03 (4%) were identified as Salmonella typhi,4 (5.3%)as S.typhimirium,02 (2.6%)asS. paratyphi Aand 03 (4%) as S. paratyphi B. They were no significant relationship between malaria and typhoid fever (χ2=.609; p= .738). Typhoid fever was grossly underdiagnosed by Widal test 1.25% (2/160) compared to stool culture 34.4% (55/160).Conclusion:The study showedthe rate of co-infections of malaria and typhoid fever is relatively high. Malaria was the most prevalent disease among febrile patients in the study area. There was a substantial result discrepancy between Widal test and stool culture for the diagnosis of typhoid fever

Evaluation of Antimicrobial Prescription in Empiric and Definitive Therapy Of Bloodstream Infections due to Salmonella spp. and Salmonella typhi

@#Introduction: As the main cause of typhoid, Salmonella spp., especially Salmonella typhi contribute to the incidence of community-acquired bloodstream infections in developing countries. Annually, there are around 20 million cases of typhoid fever and more than 150,000 deaths reported. However, several studies suggest Salmonella spp. have become resistant to some antimicrobials. This resistance to antibiotics may be caused by inappropriate antimicrobial prescriptions. Methods: This research was a descriptive observational study. Data of clinical isolates of Salmonella spp. from blood cultures and results of antimicrobial sensitivity tests were obtained from the Clinical Laboratory Installation of Dr. Sardjito General Hospital. The data were then processed and analyzed using descriptive statistics and proportion tests. Results: We obtained 14 isolates of Salmonella spp. and 11 isolates of Salmonella typhi. All of the Salmonella spp. isolates were resistant to cefazolin, but 100% of isolates were sensitive to aztreonam, ceftazidime, ciprofloxacin, etc. All of the Salmonella typhi isolates were resistant to tetracycline and cefazolin, but 100% of isolates were sensitive to aztreonam, ceftazidime, ciprofloxacin, etc. The number of inappropriate definitive antimicrobial prescriptions due to Salmonella spp. and Salmonella typhi infections at Dr. Sardjito General Hospital was 47.36% (p=0.0015;95%CI:0.2846-0.6614). The proportion of cephalosporin used as empiric therapy for bloodstream infection was 68% (95%CI:0.52-0.83). Conclusions: Significant number of inappropriate antimicrobial prescriptions in definitive treatment of bloodstream infections caused by Salmonella typhi and Salmonella spp. were found at Dr. Sardjito General Hospital in 2018. More efforts are needed to properly prescribe antimicrobials and prevent increases in antibiotic resistance microbes.

Salmonella liver abscess: an unusual complication of typhoid fever with hepatitis: a coinfection

Typhoid fever continues to be a major cause of mortality and morbidity particularly in children and adolescent in developing countries due to poor sanitation and lack of safe drinking water facilities.Even in antibiotic era, complications of typhoid fever continue to be a common problem due to many factors like inadequate treatment, delayed presentation, drug resistance and associated morbidity. Hepatic involvement in typhoid fever is common in children, but liver abscess due to Salmonella species is rare. We hereby present a case of a 5-year-old Indian female child who was initially managed as acute viral hepatitis (hepatitis-A IgM positive). However, persistence of fever and pain abdomen led to the diagnosis of liver abscess on ultrasound. Blood culture and aspirate of the abscess grew salmonella typhi. She was adequately managed with intravenous antibiotics leading to complete resolution of the abscess.

Two cases of Salmonella breast abscess in pregnancy: a diagnostic challenge

Breast abscess in pregnancy due to Salmonella has been very rarely reported in the literature and most of the cases till now are due to unknown risk factors or in otherwise immunocompromised adults. Localized disease can occur due to bacteremia followed by seeding of bacteria at distant sites. We report two cases of breast abscess in pregnancy cause by Salmonella typhi where drainage of abscess and appropriate antibiotics helped in complete resolution.

Preliminary Phytochemical Analysis and In vitro Antimicrobial Study of the Root and Stem Bark Extracts of Ficus sycomorus Linn

This study was conducted to carryout preliminary phytochemical analysis and in vitro antimicrobial activities of aqueous and ethanolic root and stem bark extracts of Ficus sycomorus. Qualitative phytochemical analysis for tannins, saponin, terpenoids, flavonoids, alkaloids, glycosides, steroids, phenols, and reducing sugar was done using standard methods. The antimicrobial activities of the extracts were tested against four micro- organisms; Escherichia coli, Staphylococcus aureus, Shigella dysentrae, and Salmonella typhi. Agar well diffusion method was used for the antimicrobial studies. Phytochemical screening of both root and stem bark aqueous extracts showed the presence of tannin, saponin, terpenoid, flavonoid, alkaloids, glycoside, steroid, reducing sugar, and phenol. Glycoside was not detected in both the aqueous and ethanolic extracts of the root bark. The result of the antimicrobial studies showed that the aqueous root extract have higher antimicrobial activity ranging from (2-12 mm) on the tested microorganisms than aqueous stem bark extract (3-9 mm), while for ethanol extract both stem and root bark extract has almost the same effect or antimicrobial activity on the tested pathogens ranging from (2-15 mm) which is having higher activity compared to the aqueous extracts. The Minimum inhibitory concentration (MIC) and Minimum bactericidal concentration (MBC) of both the extracts were found to be 50 mg/mL and 100 mg/mL respectively. From this study, it can, therefore, be concluded that the root and stem bark extract is a potential antimicrobial agent which support the claim of the traditional users of this plant in herbal medicine for the treatment of diseases that are of microbial origin.