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Quantitative bacterial counts in the bone marrow of Vietnamese patients with typhoid fever
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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9356000/ https://www.ncbi.nlm.nih.gov/pubmed/35092688 http://dx.doi.org/10.1093/trstmh/trac003 |
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author | Van Be Bay, Pham Wain, John Phuong, Le Thi Ho, Vo Anh Hien, Tran Tinh Parry, Christopher M |
author_facet | Van Be Bay, Pham Wain, John Phuong, Le Thi Ho, Vo Anh Hien, Tran Tinh Parry, Christopher M |
author_sort | Van Be Bay, Pham |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-9356000 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-93560002022-08-09 Quantitative bacterial counts in the bone marrow of Vietnamese patients with typhoid fever Van Be Bay, Pham Wain, John Phuong, Le Thi Ho, Vo Anh Hien, Tran Tinh Parry, Christopher M Trans R Soc Trop Med Hyg Original Article 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. Oxford University Press 2022-01-29 /pmc/articles/PMC9356000/ /pubmed/35092688 http://dx.doi.org/10.1093/trstmh/trac003 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Van Be Bay, Pham Wain, John Phuong, Le Thi Ho, Vo Anh Hien, Tran Tinh Parry, Christopher M Quantitative bacterial counts in the bone marrow of Vietnamese patients with typhoid fever |
title | Quantitative bacterial counts in the bone marrow of Vietnamese patients with typhoid fever |
title_full | Quantitative bacterial counts in the bone marrow of Vietnamese patients with typhoid fever |
title_fullStr | Quantitative bacterial counts in the bone marrow of Vietnamese patients with typhoid fever |
title_full_unstemmed | Quantitative bacterial counts in the bone marrow of Vietnamese patients with typhoid fever |
title_short | Quantitative bacterial counts in the bone marrow of Vietnamese patients with typhoid fever |
title_sort | quantitative bacterial counts in the bone marrow of vietnamese patients with typhoid fever |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9356000/ https://www.ncbi.nlm.nih.gov/pubmed/35092688 http://dx.doi.org/10.1093/trstmh/trac003 |
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