Background: Typhoid disease remains a major public health problem globally, especially in developing countries in sub-Saharan Africa. Symptoms associated with typhoid disease mimic those of other febrile illnesses and...Background: Typhoid disease remains a major public health problem globally, especially in developing countries in sub-Saharan Africa. Symptoms associated with typhoid disease mimic those of other febrile illnesses and are thus difficult to make an accurate diagnosis. A confirmed diagnosis requires the determination or isolation of the bacteria in well-equipped laboratories. Developing countries are faced with a huge limitation of the laboratory infrastructure to diagnose typhoid disease, which would otherwise guide in treating, managing, controlling, and halting the spread of drug resistant mutants. Objective: This study, therefore, was aimed at determining the clinical presentation, performance of diagnostic tests and antibiotic susceptibility testing of Salmonella among adults attending Kangema Sub-County Hospital. Study Population: The study population was residents of Kangema Sub-County in Murang’a County, Kenya while the target population was adults. Methods: The study adopted a cross-sectional study design that employed a systematic random sampling procedure. The study took place between April and June 2021. The sample size was 97 respondents who all consented and were enrolled in the study. Interviewing the respondents was carried out by administering structured questionnaires to collect quantitative data. Stool samples were obtained and cultured in Cary Blair transport media and then cultured in appropriate media at the Murang’a County Referral Hospital Laboratory. A rapid Salmonella Antigen (SAT) test was also performed on all the stool samples. Data Analyses: Word Statistics and Data (STATA) v 13 was used for statistical analysis. Results: The prevalence of Typhoid Fever was at 6.2% (95% CI) which included S. Typhi (n = 1;16.7%) and S. Paratyphi B (n = 5;83.3%). No isolate showed resistance to Ciprofloxacin. The sensitivity of SAT is 100% and a specificity of 98.9% with a kappa statistic of almost perfect agreement (0.9641) with culture. Patients who had fever p = 0.001, abdominal distention p = 0.028, diarrhoea p = 0.038, loose or watery stool p = 0.021 and mild general condition p = 0.02 remained independently associated with Salmonella infection. Conclusion: Typhoid Fever being endemic, laboratory diagnosis was a key for confirmation after clinical diagnosis. SAT can accurately be used to detect the disease where culture is unavailable. However, antibiotic sensitivity tests were crucial when determining the drug of choice as Salmonella isolates were multi-drug resistant. Establishment of prescribing antimicrobial policies and guidelines can periodically monitor the antibiogram patterns.展开更多
In order to isolate and identify the pathogenic bacteria causing dead chickens in a chicken farm in Qinhuangdao area, the liver, heart and other organs of dead chickens suspected of salmonella disease were collected a...In order to isolate and identify the pathogenic bacteria causing dead chickens in a chicken farm in Qinhuangdao area, the liver, heart and other organs of dead chickens suspected of salmonella disease were collected aseptically, and streaked on SS agar medium and chromagar medium. Transparent colonies were observed on SS agar medium, and purple and transparent colonies on CAS medium. The isolate was conducted purification, staining microscopy, biochemical tests, and 16 S rRNA sequence analysis, and the results showed that four strains of the isolated bacte-ria were salmonella. The 16 S rRNA sequence analysis of four strains of salmonella showed that the isolates shared more than 99% homology. Drug susceptibility test was performed using paper method, and the results showed that most of the strains were resistant to tilmicosin, cefradine and sul-famethoxazole, but were sensitive to ceftriaxone.展开更多
Introduction: Infectious diseases constitute a major concern of public health in developing countries. Facilities and well trained staff have been shown to be one of the major obstacles in the rapid and quality diagno...Introduction: Infectious diseases constitute a major concern of public health in developing countries. Facilities and well trained staff have been shown to be one of the major obstacles in the rapid and quality diagnosis of these diseases. As such, we carried out an analysis to compare the Widal test and stool culture to identify febrile patients with Salmonella infection. Method: A cross sectional study was conducted to diagnose salmonella infection with out-patients who demonstrated signs of salmonella infection. Serum was harvested from blood collected from 368 (Vina = 234, Mayo Banyo 65, and Djerem = 69) patients accompanied by stool, Widal test was conducted on the spot and stool was taken to a reference laboratory for culture using standard microbiological methods, sociological set up was calculated in percentages, prevalence was calculated using excel while statistical difference was calculated using SPSS. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to compare the Widal test against stool culture. Results: A total of 368 (50.8% females and 49.2% males) participants took part in the survey. Salmonella prevalence (66.24%) in stool culture in the Vina division was significantly different (p 0.05). The sensitivity,specificity, PPV, and NPV of slide agglutination test against stool culture varied from different areas (Vina: 51.6%, 73.62%, 79.21% and 43.61%;Mayo Banyo: 60.53%, 77.78%, 79.31% and 58.33%;Djerem: 53.18%, 83.73% 73.91% and 67.39%) respectively. Slide agglutination test has a fair agreement with the stool culture (kappa, Vina = 0.202;Mayo Banyo = 0.37 and Djerem = 0.38). Conclusion: Generally, in the three areas of study, the Widal test had a fair correlation with the stool culture;This means the Widal test should not be used alone but in combination with stool culture in the detection of salmonella infections.展开更多
为调查河北地区鸡源沙门菌及其血清型的流行及分布情况,并分析其的致病性,本研究于2018年~2021年在河北省7个地区34个养鸡场共收集631份发病鸡肛拭子和62份病料样品共计693份,分别接种普通琼脂培养基分离细菌并纯化后经革兰氏染色镜检;...为调查河北地区鸡源沙门菌及其血清型的流行及分布情况,并分析其的致病性,本研究于2018年~2021年在河北省7个地区34个养鸡场共收集631份发病鸡肛拭子和62份病料样品共计693份,分别接种普通琼脂培养基分离细菌并纯化后经革兰氏染色镜检;将分离菌分别接种不同的培养基培养,并对分离菌经生化及16S r RNA基因的PCR及测序鉴定,随机选择32条测序序列经NCBI的BLAST比对,并采用DNAStar软件分析该基因的同源性。采用玻片凝集法鉴定分离菌的血清群及血清型并统计各血清群与血清型在河北不同地区的分布。结果显示,从693份病料样品中共分离到238株沙门菌,除3株未定群外,其余分离菌分属于A、B、C、D、E、F 6个血清群,其中D群最多达69.7%(166/238);238株沙门菌分属于7个不同的血清型和未定型,依次为鸡白痢沙门菌(91/38.2%)、甲型副伤寒沙门菌(43/18.0%)、鸡伤寒沙门菌(40/16.8%)、肠炎沙门菌(39/16.4%)等。血清群与血清型分布的统计结果显示,除张家口地区流行A群血清群外,其余地区流行的血清群均为D群;张家口地区流行鸡白痢沙门菌;秦皇岛地区有14种血清型,其中甲型副伤寒沙门菌为其流行血清型;石家庄、承德、唐山流行的均为鸡白痢沙门菌,邢台及保定地区分别流行肠炎沙门菌与鸡伤寒沙门菌。通过K-B药敏纸片法检测238株分离菌对7类共22种药物的敏感性;采用PCR检测分离菌的相关耐药基因并采用SPSS26.0软件中的Fisher确切概率法分析分离菌耐药表型与耐药基因之间的相关性。选取12株不同血清型的分离菌以0.2 m L/只(3×108cfu/mL)感染雏鸡,分析各分离菌对雏鸡的致病性。药敏试验结果显示,对苯唑西林、红霉素、青霉素、甲氧苄啶、氨苄西林、四环素耐药的菌株分别占97.5(232/238)、89.1%(212/238)、78.6%(187/238)、74.8%(178/238)、74.4%(177/238)、64.3%(153/238),对其它药物耐药的菌株均在32%以下,但均对头孢类药物敏感;且分离菌多呈多重耐药性(58.4%,139/238),耐6重药物的菌株(32.8%,78/238)与耐5重药物的菌株(11.8%,28/238)最多。耐药基因检测结果显示,对β-内酰胺类、磺胺类、大环内酯类、四环素类、氨基糖苷类药物的耐药基因tem、erm(B)a、tetA、strA-B的检出率分别为100%(238/238)、75.2%(178/238)、71%(169/238)、65.6%(156/238)及31.9%(76/238)。未检测到喹诺酮类和醛胺醇类耐药基因。经分析,氨基糖苷类、四环素类、磺胺类、β-内酰胺类、大环内酯类药物的耐药表型与其耐药基因的符合率分别为94.7%、98.1%、99.4%、97.5%、79.9%,相关性均较强。致病性试验结果显示,12株分离菌均能致感染鸡出现不同的临床症状及肝脏和肠道的剖检病变,且能对鸡造成不同程度的死亡,其中以致鸡死亡10只(100%)、7只(87%)为主,并从死亡鸡的肝脏再次分离到相应细菌。上述结果表明,本研究从河北不同地区分离的238株沙门菌血清群与血清型众多,大多数沙门菌的耐药性较强且多呈多重耐药性,其携带的5类药物的耐药基因与其相对应的耐药表型均呈较强的相关性,且分离菌对雏鸡呈不同的致病性。本研究为河北地区鸡源沙门菌的流行病学调查及其感染的防治提供参考依据。展开更多
从一例疑似沙门氏菌感染的发病鸡只中分离到一株细菌,对其进行培养特征、革兰氏染色、生化试验以及16S r DNA序列分析,并进一步对分离菌进行药敏试验。结果显示,该分离细菌在鲜血琼脂培养基中生长出灰白色、圆形、光滑、凸起的菌落,在S...从一例疑似沙门氏菌感染的发病鸡只中分离到一株细菌,对其进行培养特征、革兰氏染色、生化试验以及16S r DNA序列分析,并进一步对分离菌进行药敏试验。结果显示,该分离细菌在鲜血琼脂培养基中生长出灰白色、圆形、光滑、凸起的菌落,在SS琼脂培养基表现为中心黑色边缘半透明、圆形光滑菌落。革兰氏染色后可见革兰氏阴性短杆菌。生理生化试验结果符合沙门氏菌特征。PCR扩增出717 bp条带,经测序对比,与沙门氏菌基因同源性最高。药敏结果显示分离菌仅对头孢他啶表现敏感,对氨曲南表现中度敏感,对庆大霉素、新霉素等14种药物均表现为耐药。本研究为该地区沙门氏菌病的防治提供一定的参考。展开更多
目的对一起因食用肠炎沙门氏菌污染的熏肉大饼引起的食源性疾病暴发事件进行溯源分析。方法对8例患者进行流行病学调查,采集相关环境、食品及粪便等样本,根据国家标准进行实验室检测,经增菌后挑取可疑菌落进行生化鉴定,对检出的6株沙门...目的对一起因食用肠炎沙门氏菌污染的熏肉大饼引起的食源性疾病暴发事件进行溯源分析。方法对8例患者进行流行病学调查,采集相关环境、食品及粪便等样本,根据国家标准进行实验室检测,经增菌后挑取可疑菌落进行生化鉴定,对检出的6株沙门氏菌株采用标准诊断血清进行血清凝集试验,药敏试验及脉冲场凝胶电泳。结果该起事件发病8例,6份样本中,分离出肠炎沙门氏菌,沙门氏菌检出率食品、环境和病人粪便样本均为100%,药敏试验结果显示,耐药谱为多粘菌素E(Colistin,CT)―头孢噻肟(Cefotaxime,CTX)―四环素(Tetracycline,TET)―环丙沙星(Ciprofloxacin,CIP)―氨苄西林(Ampicillin,AMP)―氨苄西林/舒巴坦(Ampicillin/Sulbactam,AMS),均呈现6重耐药现象,对氯霉素(Chloramphenicol,CHL)、复方新诺明(Sulfamethoxazole,SXT)、厄他培南(Ertapenem,ETP)、美罗培南(Meropenem,MEM)、头孢他啶(Ceftazidime,CAZ)、头孢他啶/阿维巴坦(Ceftazidime/avibactam,CZA)、替加环素(Tigecycline,TIG)、阿奇霉素(Azithromycin,AZM)、阿米卡星(Amikacin,AMI)敏感,6株菌的脉冲场凝胶电泳(Pulse Field Gel Electrophoresis,PFGE)条带一致,同源性100%,显示为同一克隆。结论该起事件为市民食用被肠炎沙门氏菌污染的熏肉大饼引起的食源性疾病暴发事件。展开更多
文摘Background: Typhoid disease remains a major public health problem globally, especially in developing countries in sub-Saharan Africa. Symptoms associated with typhoid disease mimic those of other febrile illnesses and are thus difficult to make an accurate diagnosis. A confirmed diagnosis requires the determination or isolation of the bacteria in well-equipped laboratories. Developing countries are faced with a huge limitation of the laboratory infrastructure to diagnose typhoid disease, which would otherwise guide in treating, managing, controlling, and halting the spread of drug resistant mutants. Objective: This study, therefore, was aimed at determining the clinical presentation, performance of diagnostic tests and antibiotic susceptibility testing of Salmonella among adults attending Kangema Sub-County Hospital. Study Population: The study population was residents of Kangema Sub-County in Murang’a County, Kenya while the target population was adults. Methods: The study adopted a cross-sectional study design that employed a systematic random sampling procedure. The study took place between April and June 2021. The sample size was 97 respondents who all consented and were enrolled in the study. Interviewing the respondents was carried out by administering structured questionnaires to collect quantitative data. Stool samples were obtained and cultured in Cary Blair transport media and then cultured in appropriate media at the Murang’a County Referral Hospital Laboratory. A rapid Salmonella Antigen (SAT) test was also performed on all the stool samples. Data Analyses: Word Statistics and Data (STATA) v 13 was used for statistical analysis. Results: The prevalence of Typhoid Fever was at 6.2% (95% CI) which included S. Typhi (n = 1;16.7%) and S. Paratyphi B (n = 5;83.3%). No isolate showed resistance to Ciprofloxacin. The sensitivity of SAT is 100% and a specificity of 98.9% with a kappa statistic of almost perfect agreement (0.9641) with culture. Patients who had fever p = 0.001, abdominal distention p = 0.028, diarrhoea p = 0.038, loose or watery stool p = 0.021 and mild general condition p = 0.02 remained independently associated with Salmonella infection. Conclusion: Typhoid Fever being endemic, laboratory diagnosis was a key for confirmation after clinical diagnosis. SAT can accurately be used to detect the disease where culture is unavailable. However, antibiotic sensitivity tests were crucial when determining the drug of choice as Salmonella isolates were multi-drug resistant. Establishment of prescribing antimicrobial policies and guidelines can periodically monitor the antibiogram patterns.
基金Supported by The Third Batch Giant Plan of Hebei Province(180416H)
文摘In order to isolate and identify the pathogenic bacteria causing dead chickens in a chicken farm in Qinhuangdao area, the liver, heart and other organs of dead chickens suspected of salmonella disease were collected aseptically, and streaked on SS agar medium and chromagar medium. Transparent colonies were observed on SS agar medium, and purple and transparent colonies on CAS medium. The isolate was conducted purification, staining microscopy, biochemical tests, and 16 S rRNA sequence analysis, and the results showed that four strains of the isolated bacte-ria were salmonella. The 16 S rRNA sequence analysis of four strains of salmonella showed that the isolates shared more than 99% homology. Drug susceptibility test was performed using paper method, and the results showed that most of the strains were resistant to tilmicosin, cefradine and sul-famethoxazole, but were sensitive to ceftriaxone.
文摘Introduction: Infectious diseases constitute a major concern of public health in developing countries. Facilities and well trained staff have been shown to be one of the major obstacles in the rapid and quality diagnosis of these diseases. As such, we carried out an analysis to compare the Widal test and stool culture to identify febrile patients with Salmonella infection. Method: A cross sectional study was conducted to diagnose salmonella infection with out-patients who demonstrated signs of salmonella infection. Serum was harvested from blood collected from 368 (Vina = 234, Mayo Banyo 65, and Djerem = 69) patients accompanied by stool, Widal test was conducted on the spot and stool was taken to a reference laboratory for culture using standard microbiological methods, sociological set up was calculated in percentages, prevalence was calculated using excel while statistical difference was calculated using SPSS. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to compare the Widal test against stool culture. Results: A total of 368 (50.8% females and 49.2% males) participants took part in the survey. Salmonella prevalence (66.24%) in stool culture in the Vina division was significantly different (p 0.05). The sensitivity,specificity, PPV, and NPV of slide agglutination test against stool culture varied from different areas (Vina: 51.6%, 73.62%, 79.21% and 43.61%;Mayo Banyo: 60.53%, 77.78%, 79.31% and 58.33%;Djerem: 53.18%, 83.73% 73.91% and 67.39%) respectively. Slide agglutination test has a fair agreement with the stool culture (kappa, Vina = 0.202;Mayo Banyo = 0.37 and Djerem = 0.38). Conclusion: Generally, in the three areas of study, the Widal test had a fair correlation with the stool culture;This means the Widal test should not be used alone but in combination with stool culture in the detection of salmonella infections.
文摘为调查河北地区鸡源沙门菌及其血清型的流行及分布情况,并分析其的致病性,本研究于2018年~2021年在河北省7个地区34个养鸡场共收集631份发病鸡肛拭子和62份病料样品共计693份,分别接种普通琼脂培养基分离细菌并纯化后经革兰氏染色镜检;将分离菌分别接种不同的培养基培养,并对分离菌经生化及16S r RNA基因的PCR及测序鉴定,随机选择32条测序序列经NCBI的BLAST比对,并采用DNAStar软件分析该基因的同源性。采用玻片凝集法鉴定分离菌的血清群及血清型并统计各血清群与血清型在河北不同地区的分布。结果显示,从693份病料样品中共分离到238株沙门菌,除3株未定群外,其余分离菌分属于A、B、C、D、E、F 6个血清群,其中D群最多达69.7%(166/238);238株沙门菌分属于7个不同的血清型和未定型,依次为鸡白痢沙门菌(91/38.2%)、甲型副伤寒沙门菌(43/18.0%)、鸡伤寒沙门菌(40/16.8%)、肠炎沙门菌(39/16.4%)等。血清群与血清型分布的统计结果显示,除张家口地区流行A群血清群外,其余地区流行的血清群均为D群;张家口地区流行鸡白痢沙门菌;秦皇岛地区有14种血清型,其中甲型副伤寒沙门菌为其流行血清型;石家庄、承德、唐山流行的均为鸡白痢沙门菌,邢台及保定地区分别流行肠炎沙门菌与鸡伤寒沙门菌。通过K-B药敏纸片法检测238株分离菌对7类共22种药物的敏感性;采用PCR检测分离菌的相关耐药基因并采用SPSS26.0软件中的Fisher确切概率法分析分离菌耐药表型与耐药基因之间的相关性。选取12株不同血清型的分离菌以0.2 m L/只(3×108cfu/mL)感染雏鸡,分析各分离菌对雏鸡的致病性。药敏试验结果显示,对苯唑西林、红霉素、青霉素、甲氧苄啶、氨苄西林、四环素耐药的菌株分别占97.5(232/238)、89.1%(212/238)、78.6%(187/238)、74.8%(178/238)、74.4%(177/238)、64.3%(153/238),对其它药物耐药的菌株均在32%以下,但均对头孢类药物敏感;且分离菌多呈多重耐药性(58.4%,139/238),耐6重药物的菌株(32.8%,78/238)与耐5重药物的菌株(11.8%,28/238)最多。耐药基因检测结果显示,对β-内酰胺类、磺胺类、大环内酯类、四环素类、氨基糖苷类药物的耐药基因tem、erm(B)a、tetA、strA-B的检出率分别为100%(238/238)、75.2%(178/238)、71%(169/238)、65.6%(156/238)及31.9%(76/238)。未检测到喹诺酮类和醛胺醇类耐药基因。经分析,氨基糖苷类、四环素类、磺胺类、β-内酰胺类、大环内酯类药物的耐药表型与其耐药基因的符合率分别为94.7%、98.1%、99.4%、97.5%、79.9%,相关性均较强。致病性试验结果显示,12株分离菌均能致感染鸡出现不同的临床症状及肝脏和肠道的剖检病变,且能对鸡造成不同程度的死亡,其中以致鸡死亡10只(100%)、7只(87%)为主,并从死亡鸡的肝脏再次分离到相应细菌。上述结果表明,本研究从河北不同地区分离的238株沙门菌血清群与血清型众多,大多数沙门菌的耐药性较强且多呈多重耐药性,其携带的5类药物的耐药基因与其相对应的耐药表型均呈较强的相关性,且分离菌对雏鸡呈不同的致病性。本研究为河北地区鸡源沙门菌的流行病学调查及其感染的防治提供参考依据。
文摘从一例疑似沙门氏菌感染的发病鸡只中分离到一株细菌,对其进行培养特征、革兰氏染色、生化试验以及16S r DNA序列分析,并进一步对分离菌进行药敏试验。结果显示,该分离细菌在鲜血琼脂培养基中生长出灰白色、圆形、光滑、凸起的菌落,在SS琼脂培养基表现为中心黑色边缘半透明、圆形光滑菌落。革兰氏染色后可见革兰氏阴性短杆菌。生理生化试验结果符合沙门氏菌特征。PCR扩增出717 bp条带,经测序对比,与沙门氏菌基因同源性最高。药敏结果显示分离菌仅对头孢他啶表现敏感,对氨曲南表现中度敏感,对庆大霉素、新霉素等14种药物均表现为耐药。本研究为该地区沙门氏菌病的防治提供一定的参考。
文摘目的对一起因食用肠炎沙门氏菌污染的熏肉大饼引起的食源性疾病暴发事件进行溯源分析。方法对8例患者进行流行病学调查,采集相关环境、食品及粪便等样本,根据国家标准进行实验室检测,经增菌后挑取可疑菌落进行生化鉴定,对检出的6株沙门氏菌株采用标准诊断血清进行血清凝集试验,药敏试验及脉冲场凝胶电泳。结果该起事件发病8例,6份样本中,分离出肠炎沙门氏菌,沙门氏菌检出率食品、环境和病人粪便样本均为100%,药敏试验结果显示,耐药谱为多粘菌素E(Colistin,CT)―头孢噻肟(Cefotaxime,CTX)―四环素(Tetracycline,TET)―环丙沙星(Ciprofloxacin,CIP)―氨苄西林(Ampicillin,AMP)―氨苄西林/舒巴坦(Ampicillin/Sulbactam,AMS),均呈现6重耐药现象,对氯霉素(Chloramphenicol,CHL)、复方新诺明(Sulfamethoxazole,SXT)、厄他培南(Ertapenem,ETP)、美罗培南(Meropenem,MEM)、头孢他啶(Ceftazidime,CAZ)、头孢他啶/阿维巴坦(Ceftazidime/avibactam,CZA)、替加环素(Tigecycline,TIG)、阿奇霉素(Azithromycin,AZM)、阿米卡星(Amikacin,AMI)敏感,6株菌的脉冲场凝胶电泳(Pulse Field Gel Electrophoresis,PFGE)条带一致,同源性100%,显示为同一克隆。结论该起事件为市民食用被肠炎沙门氏菌污染的熏肉大饼引起的食源性疾病暴发事件。
