The studies on the standard plate count, most probable number(MPN) and isolation of the Enterobacteriaceae, especially Salmonella species from stream waters of Kyong-Ju city were carried out from June to July, 1988. The relationship between water temperature, weather and standard plate count were observed. The locations where all of the MPN was higher than 1,600 were Mun-chon bridge, Wol-song bridge, Go-hun bridge and the area adjoining the Hyong-san river. The higher the water temperature, the more the viable counts without rain. Bacteriological survey of the Salmonella species was performed with the total 80 specimens isolated from 16 areas which are the main streams in Kyong-Ju city. The author identified 5 strains(2.36%) of Salmonella typhi, 5 strains(2.3%) of Salmonella paratyphi, 2 strains(1.42%) of Salmonella paratyphi B, 63 strains(29.72%) of other Salmonella groups by biochemical tests and serotyping tests with slide agglutination.
Agglutination ; Enterobacteriaceae ; Gyeongsangbuk-do* ; Rain ; Rivers* ; Salmonella ; Salmonella paratyphi A ; Salmonella paratyphi B ; Salmonella typhi ; Serotyping ; Water ; Weather

A 48-year-old woman was presented to our clinic with some fever and neck pains for about one month. Based on the symptoms and results of image, an empirical diagnosis of tuberculous cervical spondylitis was made. The pain was not significantly decreased after anti-tuberculosis therapy. And, 3 weeks later, she was re-admitted to our hospital for the unbearable pain. An exploration of the C4/5 by the anterior medial approach was recommended to evaluate the germ and debridement. Bacteriological tests showed that the pathogen was Salmonella Enteritidis. The pain was relieved significantly after operation and sensitive antibiotic treatments. Infections with Salmonella Typhi or Salmonella Paratyphi have been well-documented, while there are few reports of cervical spondylitis caused by Salmonella Enteritidis. We reported a case of a healthy woman with whom pyogenic cervical spondylitis of Salmonella Enteritidis was corroborated and treated and reviewed according to previous reports about spondylitis caused by Salmonella Enteritidis in the literature.
Cervical Vertebrae ; Debridement ; Diagnosis ; Female ; Fever ; Humans ; Middle Aged ; Neck Pain ; Salmonella enteritidis* ; Salmonella paratyphi A ; Salmonella typhi ; Salmonella* ; Spondylitis*

BACKGROUND: Widal test has been one of the most important diagnostic tests for typhoid and is still widely used. Widal test has been useful diagnostic tool for typhoid in endemic areas, while it has been largely abandoned in developed countries. Since 1990, occurrance of typhoid has been markedly decreased in Korea, we studied diagnostic usefulness and criteria of Widal test from 1990 to 1997. METHODS: Using rapid slide titration method (Stained Salmonella suspensions, Murex Biotech Ltd., Dartford, England), the Widal test was done in 116 nontyphoid salmonellosis patients, 75 patients with proven typhoid fever, and 173 cases of clinically suspected typhoid fever patients. Stastical analysis was done with discriminant analysis in culture proven salmonellosis. RESULTS: Fifty-four culture proven cases of Salmonella paratyphi (S. paratyphi) A and S. paratyphi B showed no significant cutoff value in O antibodies. Salmonella typhi (S. typhi) O titer at the 1:160 and above showed lower sensitivity (37.3% vs. 69.3%) and specificity (91.4% vs. 93.1%) compared to S. typhi H titer at the 1:320 and above in diagnosis of culture proven cases of typhoid. We applied D (0.01xH titer+0.001xO titer-1.635) score which result from discriminant analysis. Positive D score (> or =0.21) showed sensitivity of 72% and specificity of 92.2% in culture proven cases of typhoid. In clinically suspected patients, positive D score showed 39.3% of sensitivity. CONCLUSIONS: We concluded that the Widal test for O antibodies of S. paratyphi A and S. paratyphi B is not useful for diagnosis of paratyphoid fever. In the present study S. typhi H antibodies are more diagnostic than S. typhi O antibodies. We appled D score and positive D score showed increased sensitivity of Widal test than application of O antibody titer.
Antibodies ; Developed Countries ; Diagnosis ; Diagnostic Tests, Routine ; Humans ; Korea ; Paratyphoid Fever ; Salmonella ; Salmonella Infections ; Salmonella paratyphi A ; Salmonella typhi ; Sensitivity and Specificity ; Suspensions ; Typhoid Fever

OBJECTIVETo analyze the molecular types of Salmonella paratyphi A strains isolated in the recent years, and to construct the standard S. paratyphi A databank in the laboratory surveillance network PulseNet China.

METHODSS. paratyphi A isolates from 4 provinces were analyzed with the standard pulsed-field gel electrophoresis (PFGE) protocol used in PulseNet and their patterns compared. The databank was constructed with BioNumerics.

RESULTSEleven PFGE patterns were obtained, in which 3 predominant patterns were identifies with a similarity coefficient of 96.3%. The strains of these patterns, accounted for 86.5% of the analyzed strains, appeared in different provinces and years.

CONCLUSIONThe databank of S. paratyphi A was constructed and could be used in laboratory surveillance of S. paratyphi A in PulseNet China. From the analyses on molecular typing of the isolates, data suggested that the predominant strains might cause the epidemics in different regions.

China ; Electrophoresis, Gel, Pulsed-Field ; Salmonella paratyphi A ; classification ; genetics ; isolation & purification

Salmonellae cause a number of characteristic clinical infections in humans, including gastroenteritis, enteric fever, bacteremia, focal metastatic infection and an asymptomatic chronic carrier state. We report a case of large hepatic cyst infected with Salmonella paratyphi A. A 47-year-old woman was admitted, because of abdominal complains (fullness and pain) and fever. On physical examination, a mass was palpated on right upper quadrant of the abdomen. The computerized tomography of the abdomen showed a large hepatic cyst, but not cystic infection. Aspiration and percutaneous drainage of the hepatic cyst were perfomed for the therapeutic decompression under fluoroscopic guidance. Cultures of the cyst fluid revealed growth of Salmonella paratyphi A. Radiologic contrast media after draining of the cyst fluid revealed no communication between the cyst and bile ducts. Infected hepatic cyst appeared to result from hematogenic seeding. One month later, the patient improved and was discharged without any complication.
Abdomen ; Bacteremia ; Bile Ducts ; Carrier State ; Contrast Media ; Cyst Fluid ; Decompression ; Drainage ; Female ; Fever ; Gastroenteritis ; Humans ; Middle Aged ; Physical Examination ; Salmonella paratyphi A* ; Salmonella* ; Typhoid Fever

Salmonellae cause a number of characteristic clinical infections in humans, including gastroenteritis, enteric fever, bacteremia, focal metastatic infection and an asymptomatic chronic carrier state. We report a case of large hepatic cyst infected with Salmonella paratyphi A. A 47-year-old woman was admitted, because of abdominal complains (fullness and pain) and fever. On physical examination, a mass was palpated on right upper quadrant of the abdomen. The computerized tomography of the abdomen showed a large hepatic cyst, but not cystic infection. Aspiration and percutaneous drainage of the hepatic cyst were perfomed for the therapeutic decompression under fluoroscopic guidance. Cultures of the cyst fluid revealed growth of Salmonella paratyphi A. Radiologic contrast media after draining of the cyst fluid revealed no communication between the cyst and bile ducts. Infected hepatic cyst appeared to result from hematogenic seeding. One month later, the patient improved and was discharged without any complication.
Abdomen ; Bacteremia ; Bile Ducts ; Carrier State ; Contrast Media ; Cyst Fluid ; Decompression ; Drainage ; Female ; Fever ; Gastroenteritis ; Humans ; Middle Aged ; Physical Examination ; Salmonella paratyphi A* ; Salmonella* ; Typhoid Fever

Infection due to Salmonella typhi and Salmonella paratyphi is called enteric fever which is manifested by fever, abdominal pain, and intermittently other gastrointestinal symptoms like vomiting and diarrhea. Although Salmonella species may invade any site of the gastrointestinal tract, it usually invades terminal ileum. The pathologic manifestation of salmonellosis may vary from nonspecific mucosal change (erythema, edema, ulceration etc.) of invaded site to intestinal perforation or hemorrhage. However, the report of upper gastrointestinal invasion by Salmonella species is rare, and confirmation by tissue culture is difficult because gastric acid and the normal propulsive peristaltic flow of the small bowel help to limit the bacterial populations of the upper gastrointestinal tract. We report here a case of Salmonella paratyphi infection proven by tissue culture in a 26-year-old man who presented with fever and watery diarrhea and was found to have multiple duodenal and terminal ileal ulcers.
Abdominal Pain ; Adult ; Diarrhea ; Edema ; Fever ; Gastric Acid ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileum ; Intestinal Perforation ; Salmonella Infections ; Salmonella paratyphi A* ; Salmonella typhi ; Salmonella* ; Typhoid Fever ; Ulcer* ; Upper Gastrointestinal Tract ; Vomiting

INTRODUCTIONEnteric fever is a common infection in endemic areas; however, there are few reports describing the computed tomography (CT) manifestations of enteric fever. We aim to describe and illustrate CT findings in enteric fever in this study.

MATERIALS AND METHODSA retrospective search of medical records in our institute for patients with positive blood cultures for Salmonella typhi, and Salmonella paratyphi organisms yielded 39 cases. Among these patients, 12 had undergone a CT study of the abdomen. The CT images, laboratory and clinical findings of these 12 patients were reviewed.

RESULTSThe most common clinical presentation was fever (100%). Typical features of gastroenteritis were present in only over half of the patients. Liver function tests were abnormal in all patients. The most common abdominal manifestations on CT were the presence of mesenteric lymphadenopathy and splenomegaly (75%). Other features were circumferential small bowel wall thickening (58.3%) and free intraperitoneal fluid (50%). Three patients were found to have complications; one with bleeding from terminal ileal ulceration, another with an ileal perforation and the third with renal abscess formation.

CONCLUSIONCT is useful in evaluating enteric fever in patients with severe forms of presentation, a longer clinical course or less specific symptoms. Although the imaging features overlap with other abdominal infections, when combined with clinical features, travel history to endemic areas and presence of transaminitis, the diagnosis of enteric fever should be considered. CT in particular, is useful for the detection of complications such as perforation, bleeding and abscess formation.

Abscess ; diagnostic imaging ; Adolescent ; Adult ; Aged ; Ascitic Fluid ; diagnostic imaging ; Child ; Child, Preschool ; Female ; Humans ; Intestine, Small ; diagnostic imaging ; Lymphatic Diseases ; diagnostic imaging ; Male ; Middle Aged ; Paratyphoid Fever ; diagnostic imaging ; Radiography, Abdominal ; Retrospective Studies ; Salmonella paratyphi A ; Salmonella paratyphi B ; Salmonella typhi ; Splenomegaly ; diagnostic imaging ; Tomography, X-Ray Computed ; Typhoid Fever ; diagnostic imaging

Reviewing the results of the blood cultures performed at Yeungnam University Hospital during 4-year-period through January, 1, 1984 to December 31, 1987, the following results were obtained. 1) Out of 8083 blood specimens cultured microorganisms grew in 582 specimens with positivity rate of 7.20%. Polymicrobial bacteremia was found in 16 patients. 2) Among 582 positive specimens, Gram-positive cocci grew in 189 specimens, and Gram-negative bacilli, in 393 specimens. Clinically significant microorganisms consisted of 82 Staphylococcus aureus, and 20 Streptococcus species in Gram-positive cocci group, 80 Salmonella typhi, 72 Escherichia coli, 72 Salmonella paratyphi A in Enterobacteriaceae, and 46 Pseudomonas cepacia, and 16 Pseudomonas aeruginosa in glucose non-fermenting microorganisms. 3) Increasing incidence of Serratia, Acinetobacter and Pseudomonas species as major nosocomial infection source is noteworthy. They showed increased tendency from 6.3% of 1984 to 17.7% of 1987 of total positive blood cultures. 4) High isolation rate of Pseudomonas species and Aeromonas hydrophila was noted in summer, while Salmonella typhi showed high prevalence from May to September and in January. 5) In susceptibility tests of isolated organisms, staphylococcus aureus was sensitive to basic antimicrobial agents except for ampicillin. The glucose non-fermenting microorganisms showed high resistance to basic antimicrobial agents in 32.2%. In conclusion, considering the relatively higher incidence of growth of Staphylococcus epidermidis than ideal level indicates that sampling technique should be improved. Secondly, all the hospital staffs in cooperation with Hospital Infection Committee are desirable to pay efforts to decrease the nosocomial infection.
Acinetobacter ; Aeromonas hydrophila ; Ampicillin ; Anti-Infective Agents ; Bacteremia ; Burkholderia cepacia ; Cross Infection ; Enterobacteriaceae ; Escherichia coli ; Glucose ; Gram-Positive Cocci ; Humans ; Incidence ; Prevalence ; Pseudomonas ; Pseudomonas aeruginosa ; Salmonella paratyphi A ; Salmonella typhi ; Serratia ; Staphylococcus aureus ; Staphylococcus epidermidis ; Streptococcus

OBJECTIVETo understand the incidence rates of both typhoid fever and paratyphoid fever in the high prevalent areas of Guizhou province so as to provide evidence for the development of programs on comprehensive intervention and effectiveness evaluation.

METHODSSix townships in Pingba county were selected as intervention areas while six townships in Kaiyang county were taken as control. All hospitals and clinics were classified into A, B and C types according to its level and the capacity of the blood culture. Surveillance on typhoid and paratyphoid fever was conducted based on all population and all hospitals, clinics and county CDCs among the patients with unknown fever.

RESULTSIn the surveillance area in those two counties, there were 12 944 blood samples from patients with unknown fever which have been tested and cultured. Among them, 200 strains of Salmonella including 16 typhoid strains, 184 paratyphoid A strains were identified, with the total positive rate as 1.55%. The positive rate before the intervention program was higher than the after. The detection rate was 1.91% in the type A hospitals. 39 strains of Salmonella have been cultured from 2039 samples which accounting for 19.50% (39/200) of the total strains. 4315 blood samples were cultured at the 'Class B' sites which isolated 82 strains of Salmonella, accounting for 41.00% (82/200), with a detection rate as 1.90%. 6590 samples were cultured at the 'Class C' sites, which identified 79 strains of Salmonella, accounting for 39.50% (79/200), with a detection rate as 1.20%. The detection rate was much higher before the use of antibiotics than after using them (P < 0.05). The annual peak time of positive detection was in spring and fall. The outbreaks or epidemics often appeared in the same places, with farmers, students as the high-risk populations. Symptoms of both typhoid and paratyphoid fever were not typical.

CONCLUSIONTyphoid and paratyphoid monitoring programs which covered primary health care institutions in the high incidence area seemed to be effective in reflecting the pictures as well as the burden of both typhoid and paratyphoid.

Adolescent ; Adult ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Fever ; epidemiology ; Humans ; Incidence ; Male ; Middle Aged ; Paratyphoid Fever ; epidemiology ; prevention & control ; Population Surveillance ; Salmonella paratyphi A ; isolation & purification ; Salmonella typhi ; isolation & purification ; Typhoid Fever ; epidemiology ; prevention & control ; Young Adult