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A breast abscess is a common clinical entity most commonly caused by gram-positive cocci in the lactating breast. Here we present a bilateral breast abscess due to Salmonella Typhi in a young non-lactating female. The patient presented with on and off fever and a painful lump with discharge in the left breast, followed by similar complaints in the right breast after a few days. Incision and drainage were done, and the sample was sent for microbiological analysis. Salmonella Typhi was isolated. The patient had high titers of the Widal test though her blood culture was negative. The infection was successfully treated with a combination of surgical drainage and antibiotics. This case highlights that a systemic Salmonella infection need not always present with the typical symptoms and can solely present in a focal manner (breast abscess) and highlights the importance of microbiological analysis for accurate diagnosis and proper management. J Microbiol Infect Dis 2022; 12(4):163-166.

Herbal treatments have been practiced by humans over centuries and therefore possess time-proven safety. However, it is crucial to evaluate the toxic effects of herbal medicine to confirm their safety, particularly when developing therapeutic drugs. Use of laboratory animals such as mice, rat, and rabbits was considered as gold standard in herbal toxicity assessments. However, in the last few decades, the ethical consideration of using higher vertebrates for toxicity testing has become more controversial. As a possible alternative model involving lower vertebrates such as zebra fish were introduced. Hence in the present study, swertiamain compound isolated from E. axillare was assessed for it antimicrobial activity in zebra fish larvae againt S. typhi. The cumulative mortality rate and bacterial localization in zebra fish larvae were studied. Biochemical markers assays were performed to find the preventive role of the compound during the typhoid infection. The results showed that zebra fish can be successfully used as a model to study typhoid infection and the anti-bacterial compound swertiamarin used in this study clears the bacterial load and pathogenic symptoms to a great extent.

BACKGROUND: Salmonella enterica serovar Typhi (Salmonella Typhi) is the cause of typhoid fever. Salmonella Typhi may be transmitted through shedding in the stool, which can continue after recovery from acute illness. Shedding is detected by culturing stool, which is challenging to co-ordinate at scale. We hypothesised that sero-surveillance would direct us to those shedding Salmonella Typhi in stool following a typhoid outbreak. METHODS: In 2016 a typhoid outbreak affected one in four residents of a Nursing School in Malosa, Malawi. The Department of Health asked for assistance to identify nursing students that might spread the outbreak to other health facilities. We measured IgG antibody titres against Vi capsular polysaccharide (anti-Vi IgG) and IgM / IgG antibodies against H:d flagellin (anti-H:d) three and six months after the outbreak. We selected participants in the highest and lowest deciles for anti-Vi IgG titre (measured at visit one) and obtained stool for Salmonella culture and PCR. All participants reported whether they had experienced fever persisting for three days or more during the outbreak (in keeping with the WHO definitions of 'suspected typhoid'). We tested for salmonellae in the Nursing School environment. RESULTS: We obtained 320 paired serum samples from 407 residents. We cultured stool from 25 residents with high anti-Vi IgG titres and 24 residents with low titres. We did not recover Salmonella Typhi from stool; four stool samples yielded non-typhoidal salmonellae; one sample produced a positive PCR amplification for a Salmonella Typhi target. Median anti-Vi and anti-H:d IgG titres fell among participants who reported persistent fever. There was a smaller fall in anti-H:d IgG titres among participants who did not report persistent fever. Non-typhoidal salmonellae were identified in water sampled at source and from a kitchen tap. CONCLUSION: High titres of anti-Vi IgG did not identify culture-confirmed shedding of Salmonella Typhi. There was a clear serologic signal of recent typhoid exposure in the cohort, represented by waning IgG antibody titres over time. The presence of non-typhoidal salmonellae in drinking water indicates sub-optimal sanitation. Developing methods to detect and treat shedding remains an important priority to complement typhoid conjugate vaccination in efforts to achieve typhoid elimination.

Salmonella Typhi has been an important human-restricted pathogen from time immemorial, and unfortunately, the indiscriminate use of antibiotics has induced the emergence of multidrug resistance in S. Typhi. Bacteriophage therapy may be a possible alternative in countering antimicrobial resistance. Therefore, this study was planned to assess the efficacy of bacteriophages in treating acute and chronic S. Typhimurium infection in the mouse as a surrogate model. We isolated bacteriophages against S. Typhimurium and selected three different bacteriophages for the in vivo experiments. The lethal dose of S. Typhimurium was decided for Swiss albino mice, and acute infection was developed. Further, bacteriophage therapy by daily intraperitoneal injection of phage cocktail was given for 14 days. While the chronic carrier state of S. Typhimurium in Swiss albino mice was developed by inoculating intraperitoneally sequential 10-fold increasing doses of the bacterium. On the successful establishment of carrier state, oral feeding of phage cocktail at a high count was given, which completely cured the carrier state within 7 days of feeding. These experiments confirmed that the phage cocktail could eradicate the S. Typhimurium from the mice in both types of infections, that is acute and chronic.

Typhoid conjugate vaccine (TCV) has recently been introduced in the expanded program for immunization (EPI) in Pakistan. Before its introduction in routine immunization, a onetime catchup campaign among children 9 months to 15 years old was conducted in November 2019. We performed field evaluation of TCV against culture confirmed Salmonella Typhi (S. Typhi) among 9 months to 15 years old children during the catch up campaign in Karachi and Hyderabad.A rapid assessment of blood culture confirmed S. Typhi was performed. Age eligible cases of culture confirmed S. Typhi were identified from the laboratory networks of Aga Khan University Hospital Karachi and Hyderabad, Kharadar General Hospital Karachi, and Liaqat University of MedicalHealth Sciences (LUMHS) Hyderabad. Information on sociodemographic, typhoid vaccination history and antimicrobial resistance was collected using a structured questionnaire. Patient medical records and lab reports were also reviewed to collect information on diagnosis and antimicrobial susceptibility information. Information about the population vaccination coverage during catch-up campaign was obtained from the provincial EPI office. Field performance of TCV in catchup campaign was measured by calculating the effectiveness using rapid screening method which is less resource-intensive technique of calculating vaccine effectiveness (VE).Overall, 968 culture confirmed typhoid cases were enrolled. Among them, 82% (793/968) were from Karachi and 18% (175/968) from Hyderabad. The average age of the participants was 5.68 years, and 54% (523/968) were male. 6% (62/968) of the culture confirmed S. Typhi cases were multidrug resistant (MDR), and 61% (586/968) were extensively drug resistant (XDR). The VE using the TCV coverage data provided by EPI was 98%.TCV is effective against culture confirmed S. Typhi among children aged 9 months to 15 years in the catch-up campaign setting. While typhoid vaccination can significantly decrease the burden of typhoid disease, improvements in sanitation and hygiene are necessary for the prevention of spread of enteric fever. Longer term follow up will be needed to assess the duration of protection and requirement for booster doses of TCV.

Typhax is an investigational typhoid fever vaccine candidate that is comprised of Vi polysaccharide from Salmonella enterica serovar typhi (S. Typhi) non-covalently entrapped in a glutaraldehyde catalyzed, cross-linked α-poly-L-lysine and CRM

This study aims to determine the antibacterial effect of the Ethanol Extract of Cocor bebek leaves (Kalanchoe pinnata) on the growth ofStaphylococcus aureusandSalmonella typhi. The study is a true experimental, using a posttest only control group design with the independent variable being the extract of cocor bebek leaves (Kalanchoe pinnata). This study found that extracts of cocor bebek leaves (Kalanchoe pinnata) with a concentration of 7.5% and 15% had no inhibitory power, while at concentrations of 30% and 60% had weak inhibitory power as the minimum inhibitory power, and a concentration of 100% had inhibitory power, and strong on the growth ofStaphylococcus aureusbacteria. Meanwhile for the growth ofSalmonella typhi, a concentration of 7.5% from 3 repetitions had an average inhibition zone of 1.2 mm. for a concentration of 15% has an average inhibition zone diameter of 3 repetitions of 2.2 mm. concentration of 30% from 3 rolls has an average inhibition zone of 12.6 mm. for a concentration of 60% has an average inhibition zone of 3 repetitions of 19.8mm. There is antibacterial activity of ethanolic extract of cocor bebek leaf (Kalanchoe pinnata) against the growth ofStaphylococcusaureusandSalmonella typhi.

Outer membrane proteins (OMPs) of Gram-negative bacteria have been known as potential vaccine targets due to their antigenic properties and host specificity. Here, we focused on the exploration of the immunogenic potential and protective efficacy of total OMPs of Salmonella enterica serovar Typhi due to their multi epitope properties, adjuvanted with nanoporous chitosan particles (NPCPs). The study was designed to extrapolate an effective, low cost prophylactic approach for typhoid fever being getting uncontrolled in Pakistan due to emergence of extensively drug resistant (XDR) strains.The OMPs of two S. Typhi variants (with and without Vi capsule) alone and with nanoporous chitosan particles as adjuvant were comparatively analyzed for immunogenic potential in mice. Adaptive immunity was evaluated by ELISA and relative quantification of cytokine gene expression (IL4, IL6, IL9, IL17, IL10, TNF, INF and PPIA as house keeping gene) using RT-qPCR. Statistical analysis was done using Welch's test. The protection was recorded by challenging the immunized mice with 50% ×LD50 of S. Typhi. The Vi + ve-OMPs of S. Typhi showed the most promising results by ELISA and significantly high expression of IL-6, IL-10 and IL-17 and 92.5% protective efficacy with no detectable side effects.We can conclude that the OMPs of Vi + ve S. Typhi are the most promising candidates for future typhoid vaccines because of cost effective preparation without expensive purification steps and multi-epitope properties. Chitosan adjuvant may have applications for oral protein based vaccines but found less effective in injectable preparations.

Background/purpose Morbidity and mortality from typhoid and paratyphoid fever remain an important problem for public health authorities in developing countries. In countries with lower incidences, most cases occur in travelers who visit regions in which typhoid and paratyphoid fever are highly endemic. The aim was to evaluate the source and transmission dynamics of typhoid and paratyphoid fever in Taiwan by using genomic analysis. Methods During 2012–2019, 15 clinical isolates of Salmonella Typhi and S. Paratyphi A were collected. Demographic and clinical information of the infections were analyzed. We performed whole genome sequencing and evolutionary analysis on these isolates. Results Clinical and microbiological data from 7 S. Typhi and 8 S. Paratyphi A isolates in Taiwan showed epidemiological and bacterial genomic link to the infection in South and Southeast Asia. The Taiwanese typhoidal isolates also share highly similar genomes with those collected from UK, indicating global circulation of the typhoidal clones. Local transmission of the imported but indigenized international clones was observed. Mutations occurring at gyrA 83 aa, including S83Y and S83F, were identified in the ciprofloxacin-resistant strains. Conclusion Due to the advance of global transportation and communication, the transmission mode of infectious disease has been modified. Domestic typhoid and paratyphoid fever caused by international resistant clones can occur in low-incidence countries. Genome analysis showed that the indigenous clone originally imported from other countries has been circulating in Taiwan for over a decade.

Salmonella Typhi (S. Typhi) is a Gram-negative bacterium and the etiologic agent of typhoid fever. High rates of typhoid were historically associated with urban slums in South Asia with poor sanitation, but recent multicentre surveillance studies have demonstrated that typhoid is also a major problem of urban and rural areas in sub-Saharan Africa. Typhoid necessitates antimicrobial therapy; however, antimicrobial resistance (AMR) poses a serious threat to the effective clinical management of typhoid, particularly in South Asia, where resistance to all oral antimicrobials used to treat typhoid has been reported. New typhoid conjugate vaccines (TCVs) are highly efficacious and two have been prequalified by the World Health Organization (WHO); a small number of countries have introduced TCVs into their national immunization programs. However, many countries lack primary surveillance data to inform decision-making for TCV introduction. Here, aiming to aggregate and analyse globally representative whole genome sequencing (WGS) data to inform public health action, I conducted a genomic investigation of the global distribution and transmission dynamics of AMR S. Typhi. With colleagues from Pakistan and India, I conducted phylogenetic analyses of the first molecularly confirmed azithromycin-resistant S. Typhi isolated in Pakistan and India and put them into context with contemporaneous azithromycin-resistant isolates. I found that single point mutations in acrB (efflux pump) were emerging independently in these settings, potentially associated with selective pressure. AMR in S. Typhi is associated with the H58 lineage, which arose recently before becoming globally dominant within a relatively short time. Given this lineage’s association with AMR, I sought to investigate how, when, and where it emerged. Working with collaborators from the United Kingdom Health Security Agency (UKHSA), we performed phylogenetic and phylodynamic analyses using S. Typhi from returning travellers to the UK between 1980 and 1995. This dataset, which contained the earliest described H58 S. Typhi, indicates that the prototype H58 organisms were MDR, and that they emerged spontaneously in India in 1987 and became radially distributed throughout South Asia. These early organisms were associated with a single long branch and possessed mutations associated with increased bile tolerance, suggesting that the first H58 organism was generated during chronic carriage. The subsequent increased use of fluoroquinolones led to several independent mutations in gyrA, leading to decreased fluoroquinolone susceptibility. The apparent ability of H58 to acquire and maintain AMR genes continues to pose a threat, suggesting that TCVs should be deployed across South Asia to minimise the potential emergence of new drug-resistant variants. I worked with a broad range of collaborators to establish the Global Typhoid Genomics Consortium (GTGC) to encourage sharing of S. Typhi genomic data and standardised metadata, and to enable analysis and visualisation of these data in context to support public health decision-making. Here, I engaged with groups sequencing S. Typhi genomes to analyse and draft a global update paper; the final dataset contained >13,000 sequences. This work provides an updated overview of AMR and genotype distribution and illustrates key international transmission events, with the aim of informing TCV introduction decision-making and treatment guidelines. To create a translational link between laboratory scientists, genomics experts, clinicians, and policy makers, I outlined use cases for WGS in surveillance, diagnostic development, clinical management, and informing vaccine introduction as well as typhoid control. I hope to advance this work by fostering broader participation in the GTGC, and by encouraging funding support for the generation and analysis of S. Typhi WGS data. I also intend to create greater visibility for, and advocate for the value of, such data in conversations with country decision-makers and other policymakers via the WHO.

BACKGROUND: Typhoid intestinal perforation (TIP) remains the most serious complication of typhoid fever. In many countries, the diagnosis of TIP relies on intraoperative identification, as blood culture and pathology capacity remain limited. As a result, many cases of TIP may not be reported as typhoid. This study demonstrates the burden of TIP in sites in Burkina Faso, Democratic Republic of Congo (DRC), Ethiopia, Ghana, Madagascar, and Nigeria. METHODS: Patients with clinical suspicion of nontraumatic intestinal perforation were enrolled and demographic details, clinical findings, surgical records, blood cultures, tissue biopsies, and peritoneal fluid were collected. Participants were then classified as having confirmed TIP, probable TIP, possible TIP, or clinical intestinal perforation based on surgical descriptions and cultures. RESULTS: A total of 608 participants were investigated for nontraumatic intestinal perforation; 214 (35%) participants had surgically-confirmed TIP and 33 participants (5%) had culture-confirmed typhoid. The overall proportion of blood or surgical site Salmonella enterica subspecies enterica serovar Typhi positivity in surgically verified TIP cases was 10.3%. TIP was high in children aged 5-14 years in DRC, Ghana, and Nigeria. We provide evidence for correlation between monthly case counts of S. Typhi and the occurrence of intestinal perforation. CONCLUSIONS: Low S. Typhi culture positivity rates, as well as a lack of blood and tissue culture capability in many regions where typhoid remains endemic, significantly underestimate the true burden of typhoid fever. The occurrence of TIP may indicate underlying typhoid burden, particularly in countries with limited culture capability.

Paratyphoid fever caused by S. Paratyphi A is endemic in parts of South Asia and Southeast Asia. The proportion of enteric fever cases caused by S. Paratyphi A has substantially increased, yet only limited data is available on the population structure and genetic diversity of this serovar. We examined the phylogenetic distribution and evolutionary trajectory of S. Paratyphi A isolates collected as part of the Indian enteric fever surveillance study “Surveillance of Enteric Fever in India (SEFI).” In the study period (2017–2020), S. Paratyphi A comprised 17.6% (441/2503) of total enteric fever cases in India, with the isolates highly susceptible to all the major antibiotics used for treatment except fluoroquinolones. Phylogenetic analysis clustered the global S. Paratyphi A collection into seven lineages (A-G), and the present study isolates were distributed in lineages A, C and F. Our analysis highlights that the genome degradation events and gene acquisitions or losses are key molecular events in the evolution of new S. Paratyphi A lineages/sub-lineages. A total of 10 hypothetically disrupted coding sequences (HDCS) or pseudogenes-forming mutations possibly associated with the emergence of lineages were identified. The pan-genome analysis identified the insertion of P2/PSP3 phage and acquisition of IncX1 plasmid during the selection in 2.3.2/2.3.3 and 1.2.2 genotypes, respectively. We have identified six characteristic missense mutations associated with lipopolysaccharide (LPS) biosynthesis genes of S. Paratyphi A, however, these mutations confer only a low structural impact and possibly have minimal impact on vaccine effectiveness. Since S. Paratyphi A is human-restricted, high levels of genetic drift are not expected unless these bacteria transmit to naive hosts. However, public-health investigation and monitoring by means of genomic surveillance would be constantly needed to avoid S. Paratyphi A serovar becoming a public health threat similar to the S. Typhi of today.

Stress or Heat Shock Proteins (HSPs) have been included in various operations like protein folding, autophagy, and apoptosis. HSP families recognize as protective antigens in a wide range of bacteria because they have been conserved through evolution. Due to their homology as well as antigenicity they are competent for applying in cross-protection against bacterial diseases.In the present study, bioinformatics approaches utilized to design epitope-based construction of Hsp60 (or GroEL) protein. In this regard, potential B-cell and T-cell epitopes except for allergenic sequences were selected by immunoinformatic tools. The structural and functional aspects of the DNA, RNA, and protein levels were assessed by bioinformatics software. Following in silico investigations, recombinant GroEL multi-epitope of Salmonella typhi was expressed, purified, and validated. Mouse groups were immunized with recombinant protein and humoral immune response was measured by enzyme linked immunosorbent assay (ELISA). Animal challenge against Salmonella Typhimurium, Shigella flexneri, and Shigella dysenteriae was evaluated.recombinant protein expression and purification with 14.3 kilodaltons (kDa) was confirmed by SDS-PAGE and western blotting. After animal administration, the immunoglobulins evaluated increase after each immunization. Immunized antisera exhibited 80%, 40%, and 40% protection against the lethal dose infection by S. Typhimurium, S. flexneri, and S. dysenteriae respectively. Passive immunization conferred 50%, 30%, and 30% protection in mice against S. Typhimurium, S. flexneri and S. dysentery respectively. In addition, bacterial organ load had exhibited a significant decrease in colony forming unit (CFU) in the liver and spleen of the immunized mice compared to the control.Our study demonstrates the efficacy of S. Typhi recombinant GroEL multi-epitope to consider as a universal immunogen candidate versus multiple bacterial pathogens.

Objectives: To evaluate the incidence and causes of occult bacteremia and whether clinical profiles and complete blood count could reliably identify high-risk-for-bacteremia children aged 3 to 36 months who had fever without source (FWS).Material and Methods: The medical data of children aged 3 to 36 months who presented with FWS for 1 to 7 days but with no clinical signs of sepsis and were subsequently hospitalized between January 2007 and December 2017 with one or more of the following high risk features, body temperature >39 degrees Celsius, inactive behavior, white blood cell (WBC) count >15,000 cells per cubic millimeter (cells/mm3 ), absolute neutrophil count >10,000 cells/mm3 , or absolute band count >1,500 cells/mm3 , were recorded.Results: Bacteremia was found in 12 of 160 (7.5%) children with one or more of the high-risk features. The pathogens were non-typhoidal Salmonella (5 patients), Streptococcus pneumoniae (4 patients), and Salmonella Typhi (3 patients). None of the high-risk features could differentiate between children with and without bacteremia. Five of the 8 patients with Salmonella septicemia had normal WBC counts leading to delays in prescribing empirical antibiotics and none of them had complications. None of the 117 patients in the non-bacteremia group who did not receive antibiotics or discontinued them after negative hemoculture had complications during hospitalization.Conclusion: High-risk features could not help to identify occult bacteremia in children aged 3-36 months who had FWS.

Objective: To determine the molecular strain typing and drug resistance pattern of Salmonella enterica serovar Typhi prevalent in Northwest Pakistan. Methodology: A total of 2,138 blood samples of ...

Salmonella enterica serovar Typhi is the causative agent of typhoid fever restricted to humans and does not replicate in commonly used inbred mice. Genetic variation in humans is far greater and more complex than that in a single inbred strain of mice. The Collaborative Cross (CC) is a large panel of recombinant inbred strains which has a wider range of genetic diversity than laboratory inbred mouse strains. We found that the CC003/Unc and CC053/Unc strains are permissive to intraperitoneal but not oral route of S. Typhi infection and show histopathological changes characteristic of human typhoid. These CC strains are immunocompetent, and immunization induces antigen-specific responses that can kill S. Typhi in vitro and control S. Typhi in vivo. Our results indicate that CC003/Unc and CC053/Unc strains can help identify the genetic basis for typhoid susceptibility, S. Typhi virulence mechanism(s) in vivo, and serve as a preclinical mammalian model system to identify effective vaccines and therapeutics strategies.

We aimed to detect typhoid carriers by performing duodenal fluid culture in patients in a tertiary care hospital in Pakistan. A cross-sectional study was conducted during 2017 at the Aga Khan University Hospital, Karachi. Patients who underwent upper gastrointestinal endoscopy were included. Participants were interviewed, and duodenal fluid samples were taken for culture to detect Salmonella typhi (S. typhi) and paratyphi. A polymerase chain reaction on 100 randomly selected sub-samples was also conducted. A total of 477 participants were enrolled. The mean age was 42.4±15.5 years. History of typhoid fever was present in 73 (15.3%) participants. Out of the 477 duodenal fluid cultures tested for various micro-organisms, 250 (52.4%) were positive. Neither S. typhi nor paratyphi were isolated. S. typhi was also not detected by PCR. To better detect S. typhi carriage in general population, future studies should target people with gall bladder diseases and screen them using culture and PCR based methods.

Objectives To highlight the importance of molecular testing on characterizing extensively drug-resistant (XDR) Salmonella Typhi (S. Typhi) and link it to the current outbreak in Sindh, Pakistan. Methods We report three travel-related typhoid fever cases caused by XDR S. Typhi that presented between January 2019 and August 2019. Antimicrobial susceptibility and genotyping with pulse-field gel electrophoresis (PFGE) were performed. Whole genome sequencing (WGS) was performed to characterise the genomic clonality in relation to the emerging outbreak of S. Typhi in Sindh, Pakistan and to study the molecular resistance profiles. Results Laboratory testing revealed resistance to all first-line antibiotics (i.e ampicillin, chloramphenicol and trimethoprim-sulfamethoxazole), as well as to quinolones and third-generation cephalosporins, leading the patients’ therapy to be changed to use carbapenems. Classical MLST (cMLST) revealed that the strains were of sequence type 1 (ST1) and the core genome sequence (cgWGS) analysis closely clustered our strains with internationally reported strains from Pakistan, India, and the UK. The strains were found to carry a blaCTX-15 gene-harbouring IncY plasmid, which encodes resistance to ceftriaxone. Conclusions This report alerts clinicians to the use of appropriate empirical treatments in such scenarios and highlights the significance of the global spread of XDR Salmonella Typhi.

Blood and bone marrow cultures are considered the gold standard for the diagnosis of typhoid, but these methods require infrastructure and skilled staff that are not always available in low- and middle-income countries where typhoid is endemic. The objective of the study is to evaluate the sensitivity and specificity of nine commercially available Salmonella Typhi rapid diagnostic tests (RDTs) using blood culture as a reference standard in a multicenter study. This was a prospective and retrospective multicenter diagnostic accuracy study conducted in two geographically distant areas where typhoid is endemic (Pakistan and Kenya; NCT04801602). Nine RDTs were evaluated, including the Widal test. Point estimates for sensitivity and specificity were calculated using the Wilson method. Latent class analyses were performed using R to address the imperfect gold standard. A total of 531 serum samples were evaluated (264 blood culture positive; 267 blood culture negative). The sensitivity of RDTs varied widely (range, 0 to 78.8%), with the best overall performance shown by Enterocheck WB (72.7% sensitivity, 86.5% specificity). In latent class modeling, CTK IgG was found to have the highest sensitivity (79.1%), while the highest overall accuracy was observed with Enterocheck (73.8% sensitivity, 94.5% specificity). All commercially available Salmonella Typhi RDTs evaluated in the study had sensitivity and specificity values that fell below the required levels to be recommended for an accurate diagnosis. There were minimal differences in RDT performances between regions of endemicity. These findings highlight the clear need for new and more-accurate Salmonella Typhi tests.

Capsular polysaccharides are common virulence factors of extracellular, but not intracellular bacterial pathogens, due to the antiphagocytic properties of these surface structures. It is therefore paradoxical that Salmonella enterica subspecies enterica serovar Typhi, an intracellular pathogen, synthesizes a virulence-associated (Vi) capsule, which exhibits antiphagocytic properties. Here, we show that the Vi capsular polysaccharide has different functions when S. Typhi interacts with distinct subsets of host phagocytes. The Vi capsular polysaccharide allowed S. Typhi to selectively evade phagocytosis by human neutrophils while promoting human macrophage phagocytosis. A screen of C-type lectin receptors identified human DC-SIGN as the receptor involved in macrophage binding and phagocytosis of capsulated S. Typhi. Consistent with the anti-inflammatory activity of DC-SIGN, purified Vi capsular polysaccharide reduced inflammatory responses in macrophages. These data suggest that binding of the human C-type lectin receptor DC-SIGN by the Vi capsular polysaccharide contributes to the pathogenesis of typhoid fever. IMPORTANCE Salmonella enterica subspecies enterica serovar Typhi is the causative agent of typhoid fever. The recent emergence of S. Typhi strains which are resistant to antibiotic therapy highlights the importance of vaccination in managing typhoid fever. The virulence-associated (Vi) capsular polysaccharide is an effective vaccine against typhoid fever, but the role the capsule plays during pathogenesis remains incompletely understood. Here, we identify the human C-type lectin receptor DC-SIGN as the receptor for the Vi capsular polysaccharide. Binding of capsulated S. Typhi to DC-SIGN resulted in phagocytosis of the pathogen by macrophages and induction of an anti-inflammatory cytokine response. Thus, the interaction of the Vi capsular polysaccharide with human DC-SIGN contributes to the pathogenesis of typhoid fever and should be further investigated in the context of vaccine development.

Background Typhoid fever causes substantial morbidity and mortality in low- and middle-income countries. We conducted a case-control study in Vellore, southern India, to understand risk factors for transmission of typhoid. Methods From April 2018 to October 2019, households of blood culture-confirmed typhoid cases that occurred within a fever surveillance cohort aged 6 months–15 years, and controls matched for age, sex, geographic location, and socioeconomic status, were recruited. Information on risk factors was obtained using standard questionnaires. Household and environmental samples were collected for detection of Salmonella Typhi using real-time polymerase chain reaction. Multivariable analysis was used to evaluate associations between risk factors and typhoid. Results One hundred pairs of cases and controls were recruited. On multivariable regression analysis, mothers eating food from street vendors during the previous week (odds ratio [OR] = 2.04; 95% confidence interval [CI], 1.03–4.12; P = .04) was independently associated with typhoid, whereas treatment of household drinking water (OR = 0.45; 95% CI, 0.25–0.80; P = .007) was protective. There was no significant difference in S Typhi detection between the environmental samples from case and control households. Conclusions Street-vended food is a risk factor for typhoid in densely populated urban communities of Vellore. Improved sanitation facilities and awareness about point-of-use water treatment are likely to contribute to typhoid control.

Background There is a lack of evident data to explain the true scenario of age-specific enteric fever in India. The current study aimed to evaluate the burden and disease pattern of enteric fever among infants in a tertiary care pediatric hospital. Methods A prospective laboratory-based surveillance was conducted from April 2018 to January 2020 at a children’s hospital in North India, under the Surveillance for Enteric Fever in India study. The study included children Results Of the 10 737 blood cultures from infants, 26 were positive for S. Typhi or S. Paratyphi. The majority of cases occurred in infants aged 6–12 months, with the youngest being 1 month old. Fever with abdominal pain and diarrhea were the common symptoms, with 46% of infants requiring inpatient care. All of the isolates were susceptible to ceftriaxone. Third-generation cephalosporins were used as the first-line therapy for hospitalized infants. The average duration of fever was 8.6 days. The overall case-fatality rate among infants with enteric fever was 7.4%. Conclusions Enteric fever is a major contributor to disease and death among children. Robust surveillance studies are required to understand the true disease burden.

Background Children suffer the highest burden of the typhoid fever, with a considerable proportion shedding Salmonella Typhi in stool, potentially resulting in transmission of S Typhi. Methods We enrolled 70 children with blood culture-confirmed typhoid fever (index cases), from 63 households, during community-based fever surveillance in India. The index cases and their household contacts were followed up with stool samples at multiple time points over 3 weeks and 1 week, respectively. S Typhi was detected using quantitative real-time polymerase chain reaction. Results Fifteen of 70 (21.4%) children with culture-confirmed typhoid fever shed S Typhi in stool after onset of fever. Ten of 15 children shed S Typhi for a median of 11.5 (range, 3–61) days from the day of completion of antibiotics. Of 172 household contacts from 56 of the 63 index case households, 12 (7%) contacts in 11 (19.6%) households had S Typhi in stool. Five of the 12 contacts who were shedding S Typhi were asymptomatic, whereas 7 reported recent fever. Conclusions One in 5 children with typhoid fever shed S Typhi, with shedding persisting even after antibiotics. One in 5 households had at least 1 contact of the child shedding S Typhi, highlighting potential concurrent typhoid infections in households in settings with poor water and sanitation.

Enteric fever (EF) is a major public health problem and a witness of the global health disparities. It is caused by Salmonella enterica serovar Typhi (Salmonella ser. Typhi) and Salmonella enterica serovar Paratyphi A, B, C (Salmonella ser. Paratyphi) and is estimated to infect 12-26 million persons yearly. Paediatric data on enteric fever in Europe are scarce. A case series of EF was analysed to describe the clinical presentation, laboratory characteristics and diagnostic challenges identified in a paediatric population in Brussels. We performed a retrospective study of all lab-confirmed cases of enteric fever in children aged 0-15 years at two Brussels teaching hospitals, between January 2005 and December 2020. We reviewed age, gender, travel history, consultations before diagnosis, hospitalisation duration, clinical symptoms and laboratory findings. There were 34 positive isolates of S. typhi and S. paratyphi: 31 patients had positive blood culture, 1 patient had positive bone aspirate and 2 patients had positive stool culture (one was excluded for missing data). There were 20 girls (60%). Median age was 3.5 years (range 5 months to 14 years). Travel to EF endemic areas was present in 55% of patients. Diagnosis was delayed in 80% of children. Eosinopenia was present in 93% of the cohort. The patients had not received any preventive travel education or vaccination. Conlusion: Enteric fever poses diagnostic challenges to clinicians. Eosinopenia in a febrile patient coming from the tropics should raise suspicion of EF. Travellers to endemic areas should be better educated about EF risks, and typhoid fever vaccination must be promoted. What is Known: • Enteric fever is a global public health problem and includes typhoid and paratyphoid fever. • Typhoid fever is vaccine preventable disease. Paratyphoid fever is not vaccine preventable. What is New: • Enteric fever diagnosis is very challenging in non-endemic settings, and a large proportion of patients may develop serious complications if they receive delayed management. Occurrence of small family clusters is possible and mandates education and monitoring of the families of enteric fever affected children. • We report that the widest majority of our enteric fever affected patients (69%) had aneosinophilia (zero eosinophil count), and almost all patients (93%) had eosinopaenia (less than 50 eosinophil count) during their bacteriaemic phase.

Bit merupakan tanaman berbentuk akar mirip umbi-umbian. Bit sangat bermanfaat untuk dijadikan sebagai tambahan dalam bahan pangan karena mengandung antioksidan tinggi, vitamin C yang tinggi serta memiliki senyawa antibakteri yang mampu menghambat aktivitas pertumbuhan bakteri gram positif dan bakteri gram negatif. Tujuan penelitian ini untuk mengetahui efektivitas kemampuan susu kambing fermentasi menggunakan L. rhamnosus dan penambahan jus bit dalam menghambat pertumbuhan bakteri patogen usus. Penelitian ini menggunakan Rancangan Acak Lengkap (RAL) yang terdiri atas 5 (lima) perlakuan yaitu P0 = Kontrol, P1 = 2% jus bit, P2 = 4% jus bit, P3 = 6% jus bit, dan P4 = 8% jus bit dengan 4 (empat) kali ulangan. Data yang diperoleh dianalisis menggunakan ANOVA (Analysis of Variance), jika terdapat perbedaan yang nyata maka dilanjutkan dengan uji jarak berganda Duncan. Hasil penelitian menunjukan bahwa penambahan jus bit dengan persentase berbeda pada susu kambing fermentasi tidak berpengaruh nyata (P0,05) terhadap kemampuan susu fermentasi untuk menghambat pertumbuhan bakteri Salmonella typhi namun berpengaruh sangat nyata (P0,01) terhadap kemampuan susu fermentasi untuk menghambat pertumbuhan bakteri Escherichia coli.The Effectiveness Fermentation of Goat’s Milk Using Lactobacillus rhamnosus Bacteria with Addition of Beetroot Juice (Beta vulgaris L.) In Inhibiting The Growth of Intestinal Pathogenic BacteriaBeetroot is a root-shaped plant similar to tubers. Beetroot is very useful to be used as an addition in food ingredients because of its content such as high antioxidants, high vitamin C and has antibacterial compounds that are able to inhibit the growth activity of gram-positive bacteria and gram-negative bacteria. The purpose of this study is to find out the effectiveness of fermented goat milk capabilities using L. rhamnosus and the addition of beet juice in inhibiting the growth of pathogenic gut bacteria. This study used a Complete Randomized Design (RAL) consisting of 5 (five) treatments namely P0 = Control, P1 = 2% beet juice, P2 = 4% beet juice, P3 = 6% beet juice, and P4 = 8% beet juice with 4 (four) times the replay. The data obtained was analyzed using ANOVA (Analysis of Variance), if there are noticeable differences then continued with Duncan's multiple distance test. The results showed that the addition of beet juice with a different percentage in fermented goat milk had no real effect (P0.05) on the ability of fermented milk to inhibit the growth of Salmonella typhi bacteria but had a very real effect (P0.01) on the ability of fermented milk to inhibit the growth of Escherichia coli bacteria.

Objective: To assess and compare the frequency of haematological parameter derangements in patients due to non-resistant and extended drug resistant (XDR) typhoid fever. Study Design: Comparative cross-sectional study. Place and Duration of Study: Pathology Department of Combined Military Hospital Quetta, from Jan to Dec 2019. Methodology: A total number of 172 blood culture Salmonella positive patients irrespective of age and gender were included in this study. Salmonella strains were isolated and grouped further according to their drugs sensitivity. 3ml venous blood was collected from these patients in Ethylene diamine tetra acetic acid container and blood complete count was done by semiautomated haematology analyser XP-100. Results: There were 126 (73%) males and 46 (27%) females with mean age of 17.5 ± 10.3 years. Out of 172 subjects, 106 (61.6%) had non-resistant typhoid and rest 66 (38.4%) were diagnosed with extended drug resistant Typhoid. We compared anaemia, leucopenia and thrombocytopenia between two groups and found anaemia statistically significant with the p-value of 0.001. Conclusion: This study has documented that changes in haematological parameters are significant in typhoid fever and early patients diagnosis, management and disease course can be monitored with them. Patients with significant anaemia and not responding to first line therapy should be considered as a case of extended drug resistant (XDR) Salmonella.

Study on the prevalence of co-infection between Plasmodium falciparum and Salmonella typhi among patients in Northern Nigeria was carried out. The study is cross-sectional designed to determine the socio-demographic characteristics as well as the risk factors for malaria and typhoid. A total of 100 consented patients of age group of 21-40 years were recruited for the study. A structured questionnaire was administered, and venous blood samples were collected and analyzed using standard microbiological methods. The isolated salmonella species were biochemically characterized, and subjected to antimicrobial susceptibility test using Kirby-Bauer disc diffusion method. The prevalence of malaria and typhoid was found to be 56% and 68% respectively. The prevalence of malarial parasite and Salmonella typhi infections was 40%. Females recorded low malarial infection of 56.9% compared to their male counterparts 43.1% (P= 0.510). The age group, educational levels and occupations of the study participants were not associated with the likelihood of having malarial parasite infection (P= 0.297, 0.15 and 0.503 respectively). Participants who did not sleep under the insecticide treated nets were more likely to have malaria than those who did (P ≤ 0.0001). The educational levels of the study participants were statistically associated with Salmonella typhi infection (P= 0.026). Water sources, use of pit latrine, hand washing before and after meal were significantly associated with Salmonella typhi infections (P=

Microbial etiology of diarrhea is a significant cause of death, especially in children in developing countries. The presence of microbes that are resistant to current treatment options for diarrhea suggests the need to find newer antimicrobial agents for treatment. Therefore, this study focused on investigating the antimicrobial effect of some Ghanaian chewing sticks commonly used for oral hygiene, Azadirachta indica, Garcinia afzelii, and Garcinia kola, against selected diarrhea-causing organisms. From the stem and bark of each plant, 70% methanolic extract was experimented on Salmonella and Shigella species, namely, Shigella sonnei, Shigella flexeneri, Salmonella typhinirium enterica, Salmonella typhi attenuated, and Klebsiella oxytoca for microbial susceptibility using the agar well diffusion method. Additionally, the antioxidant profile of the methanolic extracts were investigated using 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical, 2,2’-azino-bis (3-ethylbenzthiazoline-6-sulphonic) acid (ABTS) scavenging activities, and ferric-reducing antioxidant potential (FRAP) assays, while the total polyphenolic content was determined using the Folin–Ciocalteau reagent. G. afzelii and A. indica stem demonstrated the highest antimicrobial effect, inhibiting the growth of all test organisms. Additionally, the extracts demonstrated high antioxidant potential and were found to possess significant amounts of phenolic compounds. Therefore, methanolic extracts of G. afzelii and A. indica stem are promising candidates for the identification of safe novel compounds to mitigate diarrheal diseases.

Background Serum IgG anti-Vi titers attained by 327 children 6–23 months of age immunized with Vi polysaccharide-tetanus toxoid conjugate vaccine (Typbar TCV®), of whom 193/327 received a booster dose 2 years post-primary vaccination, were previously reported. Methods Anti-Vi IgG in boosted and unboosted children 3, 5, and 7 years post-primary immunization were monitored using three different enzyme-linked immunosorbent assays (ELISAs): Vacczyme™ kit ELISA (all specimens); “Szu” ELISA (all specimens), and National Institute of Biological Standards NIBSC ELISA (subset). Endpoints analyzed included: persisting seroconversion (titer remaining ≥ 4-fold above baseline), geometric mean titer (GMT), geometric mean-fold rise post-vaccination, and percent exhibiting putative protective anti-Vi level (≥2 µgSzu/ml) using Szu method and National Institutes of Health IgG reference standard. In assessing the persistence of elevated anti-Vi titers stimulated by Typbar-TCV®, four subgroups were compared based on whether or not the initially enrolled children were boosted on day 720 and whether they provided serum on all key timepoints, or if they missed one or more timepoints: i) Among boosted participants, an “All Specimens Cohort” (ASC) comprised 86 children who provided sera on days 42, 720 (booster), 762 (42 days post-booster), 1095, 1825 and 2555, to define kinetics of the Vi antibody response in a fully compliant cohort of boosted children monitored over seven years; ii) Among non-boosted subjects, a compliant All Specimens Cohort of 25 children provided sera on days 0, 42, 720, 1095, 1825, and 2555; iii) Among boosted children, an “Any Available Specimen” (AAS) subgroup consisted of boosted children who provided sera on days 0, 42, and 720 days and also on one or more of days 762, 1095, 1825, or 2555 but not on all those time points; iv) Among the non-boosted subjects, there was also an Any Available Specimen subgroup of 47 children who provided sera on days 0 and 42, of whom 41 subsequently contributed sera on one or more of days 1095, 1825 and 2555. Results Vacczyme™ GMTs among boosted ASC children (N = 86) increased significantly on day 762, and remained 32-fold, 14-fold, and 10-fold over baseline at 3, 5 and 7 years; among unboosted ASC children (N = 25), GMTs remained 21-fold, 8-fold and 5-fold over baseline, respectively. Post-primary vaccination, 72% and 44% of unboosted ASC subjects (N = 25) exhibited persisting seroconversion by Vacczyme™ at 5 and 7 years, respectively; the corresponding numbers for ASC boosted subjects were 84% and 71%. Amongst the four sub-groups, boosted subjects showed higher prevalence of persisting seroconversion at most time points with the gap widening by 7th year, though not statistically significant (except 3rd year). Tested by Szu and also NIBSC ELISAs, 92–100% of unboosted ASC children showed persisting seroconversion at 7 years with 100% also exceeding the Szu protective threshold. Conclusion To extend protection, administering a booster of Typbar TCV® to children ∼5 years after their primary dose, i.e., coinciding with school entry, may be advisable. Typbar TCV® is presently the only WHO pre-qualified Vi conjugate vaccine with reported efficacy, effectiveness, and long-term immunogenicity findings.

Typhoid hepatitis is typhoid fever accompanied by symptoms of jaundice, hepatomegaly and abnormal liver function tests. The incidence varies between 0.4% -26% of typhoid fever patients. We report a case of a 34-year-old male, presented with fever, epistaxis, gastrointestinal symptoms, thrombocytopenia and elevated AST/ ALT, thus the patient was first diagnosed as dengue hemorrhagic fever grade II. On day 9th the signs and symptoms were persisted, Ig M and Ig G Dengue was negative. Then we evaluated the virus marker for hepatitis and blood culture. The results were negative for HBsAg, anti HCV and Ig M anti HAV, but Salmonella typhi detected on blood culture. The patient was treated with ceftriaxone 1000mg bid iv and get better then discharged from hospital.

Myrtaceae fruits (Myrceugenia obtusa, Luma apiculata, and Luma chequen) were used as food and medicine by Chilean indigenous people. This study aimed to evaluate the bioactive properties of these berry-type fruits. The antioxidant capacity determined by the FRAP assay varied between 10.4 and 646.9 mmol Fe+2/g, while the antibacterial activity against Staphylococcus aureus and Salmonella typhi was 0 − 33 mm and 0 − 7.33 mm, respectively. All the extracts were rich in polyphenols and showed low cytotoxicity. Overall, M. obtusa presented dissimilar results compared to those of L. apiculata and L. chequen, encouraging the use of these native fruits as food, nutraceutical, or pharmacological ingredients.

Background: Salmonella enteric serovars Typhi and Paratyphi are known to cause enteric fever. Multidrug resistance in S. Typhi and S.Paratyphi has emerged as a cause of concern. Aims: To evaluate antimicrobial susceptibility patterns of Salmonella enteric serovar Typhi (S. Typhi) and S.Paratyphi obtained from blood culture. Materials and Methods: All S. enteric isolates obtained from blood cultures of clinically suspected cases of enteric fever coming to microbiology laboratory, Nirmal hospital, from January 2015 to September 2017 were included in the study. Antimicrobial susceptibility patterns were determined using commercial antimicrobial disks chloramphenicol (30 g), nalidixic acid (30 g), ampicillin (10 g), azithromycin (15 g), cotrimoxazole (1.25/23.75 g), ciprofloxacin (5 g), and ceftriaxone (30 g). Antimicrobial susceptibility testing was performed in accordance with the Clinical and Laboratory Standards Institute (CLSI) guidelines of respective year by KirbyBauer disc diffusion method. Result: Total 330 isolates of salmonella are there out of that 298 is Salmonella typhi. 32 are Salmonella para A, while 1 is of Salmonella para B. Enteric fever cases pick month are April, May, June and July. Sensitivity to first line drugs are > 80%, Nalidixic acid resistant Salmonella (NARS) are 79%, while Multi drug resistant (resistant to ampicillin, chloramphenicol and co-trimoxazole all three)Salmonella are 3%. Conclusion: Periodic evaluation of antibiotic susceptibility pattern is necessary to see changing pattern of antibiotics. Evaluation of Nalidixic acid resistant Salmonella and periodic evaluation of multi drug resistant Salmonella is also important as emergence of MDR strain is observed in our study. Keywords: Multi drug resistant, Nalidixic acid resistance, Salmonella typhi, Typhoid

This cross-sectional, institutional-based study aimed to determine the prevalence of shigellosis and associated risk factors among Babcock University students in Ogun State, Nigeria. One hundred and twenty (120) undergraduate students, 80 females and 40 males, were asked to provide stool specimen in a sterile leak-proof single-use universal bottle with a screw-capped lid. Standard microbiological techniques were used to analyse the stool samples. A questionnaire was designed to collect demographic and clinical information from participants. The data obtained were statistically analysed using the SPSS Statistics software (version 18.0). The study showed that there was no occurrence of shigellosis among the study participants (0%), but other enteric pathogens infection were present in all participants (100%). The three most common mono-infections found among the study participants included Staphylococcus aureus (40%), followed by Escherichia coli (16.7%), and Salmonella typhi and Bacillus spp. (3.3%, each). While the most common prevalence of dual-infections included Staphylococcus aureus and Escherichia coli (33.3%), followed by Staphylococcus aureus and Salmonella typhi (3.3%). The proportion of participants who were asymptomatic (66.7%) was significantly higher than the symptomatic ones (33.3%). Identified risk factors of non-Shigella enteric infection included consumption of beef, vegetables, fruits, poultry/poultry products, as well as street foods, poor hand hygiene before eating, anal cleaning, and poor hand hygiene after toileting. Although shigellosis did not exist among undergraduate students of Babcock University, this study highlighted the existence of other enteric infections among the study participants. Therefore, the necessary preventive measures should be ensured and sustained.

For decades, the remote island nation of Samoa (population ~200,000) has faced endemic typhoid fever despite improvements in water quality, sanitation, and economic development. We recently described the epidemiology of typhoid fever in Samoa from 2008 to 2019 by person, place, and time; however, the local Salmonella enterica serovar Typhi (S. Typhi) population structure, evolutionary origins, and genomic features remained unknown. Herein, we report whole genome sequence analyses of 306 S. Typhi isolates from Samoa collected between 1983 and 2020. Phylogenetics revealed a dominant population of rare genotypes 3.5.4 and 3.5.3, together comprising 292/306 (95.4%) of Samoan versus 2/4934 (0.04%) global S. Typhi isolates. Three distinct 3.5.4 genomic sublineages were identified, and their defining polymorphisms were determined. These dominant Samoan genotypes, which likely emerged in the 1970s, share ancestry with other 3.5 clade isolates from South America, Southeast Asia, and Oceania. Additionally, a 106-kb pHCM2 phenotypically cryptic plasmid, detected in a 1992 Samoan S. Typhi isolate, was identified in 106/306 (34.6%) of Samoan isolates; this is more than double the observed proportion of pHCM2-containing isolates in the global collection. In stark contrast with global S. Typhi trends, resistance-conferring polymorphisms were detected in only 15/306 (4.9%) of Samoan S. Typhi, indicating overwhelming susceptibility to antibiotics that are no longer effective in most of South and Southeast Asia. This country-level genomic framework can help local health authorities in their ongoing typhoid surveillance and control efforts, as well as fill a critical knowledge gap in S. Typhi genomic data from Oceania.

We applied a new serosurveillance tool to estimate typhoidal Salmonella burden using samples collected during 2020 from a population in Juba, South Sudan. By using dried blood spot testing, we found an enteric fever seroincidence rate of 30/100 person-years and cumulative incidence of 74% over a 4-year period.

En este trabajo se estudió la preparación de diferentes materiales híbridos orgánicos / inorgánicos y su evaluación como bactericidas frente a Escherichia coli (E. coli) y Salmonella typhi (S. typhi). El objetivo principal de la presente investigación fue sintetizar y caracterizar materiales híbridos biocompatibles que inmovilizan moléculas con actividad antibacteriana en matrices lamelares inorgánicas basadas en dobles hidróxidos lamelares inorgánicos y evaluar su actividad antibacteriana frente a Escherichia coli (E. coli) y Salmonella typhi (S. typhi). Los materiales híbridos consisten en la asociación de un doble hidróxido laminar inorgánico, o compuestos tipo hidrotalcita, con moléculas orgánicas con actividad antibacteriana, alojadas en sólidos. Los hidróxidos dobles lamelares (LDH) son estructuras sintéticas formadas por películas de hidróxido metálico con carga positiva que se estabilizan con aniones interlaminares. Se han estudiado diferentes materiales híbridos a partir de compuestos tipo hidrotalcita, como MgAl, ZnAl y MgFeAl, que contienen especies orgánicas de cefalexina sódica y ácidos nalidíxico y pipemídico. La intercalación de los diferentes aniones se realizó mediante uno de los diferentes métodos existentes: la coprecipitación de los compuestos tipo hidrotalcita en presencia de la molécula de interés y por el efecto memoria. La caracterización de los materiales se realizó mediante difracción de rayos X, espectroscopia de IR y resonancia magnética nuclear sólida, analizando específicamente los núcleos 27Al y 13C, y análisis termogravimétrico. La evaluación de la actividad antibacteriana de estos materiales se evaluó en cultivos de cepas de Escherichia coli (E. coli) y Salmonella typhi (S. typhi). La actividad antibacteriana de los sistemas híbridos probados no siempre es una función directa de la cantidad de antibiótico intercalado. Se obtuvo que el LDH ZnAl-NADmem presenta una liberación controlada, ya que cuando el material fue expuesto tres veces contra la bacteria Escherichia coli (E. coli), continuó eliminando bacterias, presentando un efecto bacteriostático en la tercera exposición, ya que no eliminar las bacterias.

Due to the high prevalence of typhoid fever and the periodic nature of Salmonella infections despite the various antimicrobial agents used to treat these infections, the need to open up new strategies for antimicrobial susceptibility rather than the MIC alone arises. This study determines the time-kill curves using four different antimicrobial agents: Gentamicin, Ceftriaxone, Cloxacillin, and Ofloxacin at different concentrations of 1x, 2x, and 4x of their respective MICs. The finding of this study reveals that at 1x MIC, all the antimicrobial agents used, except for Gentamicin, show non-bactericidal activity against the isolates after eight hours of exposure. This study suggests that analyzing the time-kill curves in typhoid fever treatment will help determine the appropriate dose to treat the infection.

Overcoming multi drug resistance is one of the crucial challenges to control enteric typhoid fever caused by Salmonella typhi and Salmonella paratyphi. Overexpression of efflux pumps predominantly causes drug resistance in microorganisms. Therefore, immunotherapy targeting the various efflux pumps antigens could be a promising strategy to increase the success of vaccines. An immunoinformatic approach was employed to design a Salmonellosis multi-epitope subunit vaccine peptide consisting of linear B-cell and T-cell epitopes of multidrug resistance protein families including ATP Binding Cassette (ABC), major facilitator superfamily (MFS), resistance nodulation cell division (RND), small multidrug resistance (SMR), and multidrug and toxin extrusion (MATE). The selected epitopes exhibited conservation in both S. typhi and S. paratyphi and thus could be helpful for cross-protection. Further, the final vaccine construct encompassing the peptides, adjuvants and specific linker sequences showed high immunogenicity, solubility, non-allergenic, nontoxic, and wide population coverage due to strong binding affinity to maximum HLA alleles. The three-dimensional structure was predicted, and validated using various structure validation tools. Additionally, protein-protein docking of the chimeric vaccine construct with the TLR-2 protein and molecular dynamics demonstrated stable and efficient binding. Conclusively, the immunoinformatic study showed that the novel multi epitopic vaccine construct can simulate the both T-cell and B-cell immune responses in typhoidal Salmonella serovars and could potentially be used for prophylactic or therapeutic applications.Communicated by Ramaswamy H. Sarma.

The Southern coastal region is a geographically positioned area with rich source of microbial diversity, of which producing broad spectrum of bioactive compounds. The marine sediments are collected from the various sites of south east coastal region of Tamil nadu and are processed. Out of 78 isolates, the 4 strains of actinomycetes are showing broad spectrum activity against Klebsiella pneumoniae (MTCC 1687), Proteus vulgaris (MTCC 3160), Salmonella typhi (MTCC 3231), Shigella dysenteriae (MTCC 3642) and Vibrio cholerae (MTCC 3906). The bioactive isolates are proceeded for further morphological features like growth pattern and mycelial coloration, biochemical and polyphasic taxonomical characterisation were documented. Isolates are investigated for abiotic stress condition to study the growth rate of isolates. Finally, the 16S rRNA molecular identification and phylogenetic analysis of the isolates were explored. Further, bioactive isolates may be potential source for discovery of molecules with industrial applications.

Enteric fever involves reticuloendothelial system. Most common complications are intestinal perforation, hepatitis, encephalopathy and bleeding ileal ulcers. Apart from known complications we present an interesting case of middle aged female with uncontrolled diabetes presenting with empyema of gall bladder secondary to Salmonella typhi. Both blood and gallbladder tissue bacteriological cultures had Salmonella typhi confirming our diagnosis. It was noteworthy that empyema was found intraoperatively. Patient recovered after cholecystectomy and antibiotics. Considering this rare complication we advise Typhoid conjugate vaccine in tropical countries. This case report paves way to recognize this complication to watch for. Key words: Enteric fever, Empyema, complications, Typhoid vaccine, gall bladder.

Typhoidal salmonella infections remain a challenge in the health care system in sub-Saharan Africa. Carrier status and advent of multi-drug resistant S. Typhi strains have necessitated the search for new drug leads. Hence, this study aims at investigating P. guajava and A. indica leaves for anti-salmonella activities. Guava and neem leaves were extracted by maceration in methanol and fractionated by solvent partitioning. In vitro activities were assessed by agar well diffusion and broth micro-dilution methods. Sixty male rats were randomized to 10 groups of 6 animals each for the in vivo experiments. Groups of rats except, normal control, were induced with 0.5McFarland of S. Typhi suspension orally. Treatment groups received 200 mg/kg body weight of extracts and fractions, and the control groups were treated with 14.29mg/kg body weight of ciprofloxacin and 1%v/v DMSO for 7 days post-infection. Biochemical parameters were determined spectrophotometrically. Hematological parameters were analyzed with automated hematology diagnostic machine. All fractions of P. guajava and three of A. indica inhibited S. Typhi growth with Zone of Inhibition (ZI) ranging from 11-15 mm. Active fractions inhibited 48.60-62.45% of S. Typhi biofilm formation at 25 mg/mL with Minimum Bactericidal Inhibitory Concentration (MBIC) of 0.39-12.5 mg/mL. All fractions improved body weight of treated rats and inhibited bacteremia at 44.75 and 95.94%. Hematological parameters improved in all fractions-treated rats. MDA was not significantly (p

Low- and middle-income countries face a high burden of typhoid and paratyphoid fever due to poor water quality and inadequate sanitation. The World Health Organization (WHO) recommends the use of typhoid conjugate vaccines (TCV) in endemic settings and Gavi, the Vaccine Alliance, supports TCV introduction. There are currently 2 WHO-prequalified TCVs with Typbar TCV introduced in Pakistan, Liberia, and Zimbabwe. Countries should assess disease burden and consider introduction of TCV for programmatic use. Several paratyphoid vaccine candidates are in early stages of development. An effective bivalent vaccine would be the most efficient way to control typhoid and paratyphoid fever.

Latar Belakang: Penyakit infeksi masih merupakan salah satu masalah kesehatan di dunia, termasuk Indonesia. Untuk penanggulangan penyakit infeksi telah banyak digunakan berbagai jenis antibiotika. Salah satu contoh penyakit infeksi yang disebabkan oleh mikroorganisme adalah demam tifoid atau demam enterik yang disebabkan Salmonella typhi (S.typhi.). Sejak tahun 1948 kloramfenikol merupakan drug of choice (obat terpilih) untuk infeksi S.typhi. Tujuan: Untuk membandingkan dan mengetahui potensi antibiotika dari kloramfenikol dan amoksisilin terhadap S.typhi. Diperlukan penelitian untuk menemukan terapi antibiotika pilihan lain yang lebih sensitif. Salah satunya dengan melakukan penelitian ini dengan uji KHM dan KBM. Metode: Untuk melihat potensi antibiotika dilakukan pengujian Konsentrasi Hambat Minimum (KHM) dengan metode pengenceran tabung (tube dilution method) dan Konsentrasi Bunuh Minimum (KBM) menggunakan metode Kirby Bauer. Penelitian ini merupakan jenis penelitian eksperimen laboratorium secara in vitro. Analisis data menggunakan aplikasi SPSS dengan Mann Whitney U Test.Hasil: Penelitian menunjukkan bahwa kloramfenikol memiliki potensi antibotika dengan nilai KHM sebesar 12,50 µg/ml, sedangkan amoksisilin memiliki potensi antibiotika dengan nilai KHM sebesar 6,25 µg/ml. Untuk nilai KBM kloramfenikol dan amoksisilin memiliki nilai yang sama sebesar 25 µg/ml. Kesimpulan: Tidak terdapat perbedaan nilai KHM dan KBM antara antibiotika kloramfenikol dan amoksisilin terhadap S.typhi. Amoksisilin dapat digunakan sebagai salah satu obat alternatif untuk terapi infeksi demam tifoid.

Background Typhoid fever remains a major cause of morbidity and mortality in low-income and middle-income countries. Vi-tetanus toxoid conjugate vaccine (Vi-TT) is recommended by WHO for implementation in high-burden countries, but there is little evidence about its ability to protect against clinical typhoid in such settings. Methods We did a participant-masked and observer-masked cluster-randomised trial preceded by a safety pilot phase in an urban endemic setting in Dhaka, Bangladesh. 150 clusters, each with approximately 1350 residents, were randomly assigned (1:1) to either Vi-TT or SA 14-14-2 Japanese encephalitis (JE) vaccine. Children aged 9 months to less than 16 years were invited via parent or guardian to receive a single, parenteral dose of vaccine according to their cluster of residence. The study population was followed for an average of 17·1 months. Total and overall protection by Vi-TT against blood culture-confirmed typhoid were the primary endpoints assessed in the intention-to-treat population of vaccinees or all residents in the clusters. A subset of approximately 4800 participants was assessed with active surveillance for adverse events. The trial is registered at www.isrctn.com, ISRCTN11643110. Findings 41 344 children were vaccinated in April–May, 2018, with another 20 412 children vaccinated at catch-up vaccination campaigns between September and December, 2018, and April and May, 2019. The incidence of typhoid fever (cases per 100 000 person-years) was 635 in JE vaccinees and 96 in Vi-TT vaccinees (total Vi-TT protection 85%; 97·5% CI 76 to 91, pInterpretation Vi-TT provided protection against typhoid fever to children vaccinated between 9 months and less than 16 years. Longer-term follow-up will be needed to assess the duration of protection and the need for booster doses. Funding The study was funded by the Bill & Melinda Gates Foundation.

The Simargaolgaol ( Aglaonema modestum Schott ex Engl) plant is a plant that grows wild in Barus District, Central Tapanuli, North Sumatra which is used by the community as a medicinal plant. This study aims to determine the antibacterial activity of n-hexane, ethyl acetate and ethanol extracts from Simargaolgaol leaves against Escherichia coli and Salmonella typhi bacteria. The antibacterial activity test of Simargaolgaol leaves was carried out using the disc diffusion method. The results of antibacterial activity showed that the highest inhibitory power of Simargaolgaol leaf extract was ethanol extract (polar), ethyl acetate extract (semi polar) and n-hexane extract (non polar). The inhibitory power of ethanol extract, ethyl acetate, and n-hexane against Escherichia coli bacteria was 13.1 mm (strong); 9.7 mm (medium); 8.0 mm (medium) and for Salmonella typhi bacteria respectively 11.2 mm (strong); 10.7 mm (strong) and 9.3 mm (medium). With the concentration of the extract in the diameter is 10%. Based on this, it can be concluded that Simargaolgaol leaf extract has potential as an antibacterial. Keywords: Aglaonema modestum Schott ex Engl, Antibacterial activity, Escherichia coli , Salmonella typhi

Salmonella typhi is one of the most common causes of typhoid fever in Iraq. The aim of this study was to test the synergistic between different tests for the diagnosis of S. typhi . It was found, there are ability for preparing local Media which can be used instead of Blood agar for diagnosing typhoid fever by using dates, alfalfa and fish extractors. Both fish and dates extractors were used to prepare a local medium as well as alfalfa and fish. The results showed that dates - fish medium are more efficient than blood agar and alfalfa - fish medium to isolate S. typhi. When contrasting culture results with Widal test data of laboratories , it had shown differences in these results because only (57)% from Widal test was confirmed by culture. When Widal test results were evaluated which is done in different health analysing laboratories in Nineveh Governorate by using Widal test (dilution method) the results showed great differences of results whether result type (positive or negative) or kind of antigens which showed positive results. Leukocyte count was done as a test to enhance the diagnosis of this microbe, it was clear that there is a relation between typhoid fever and decreasing white blood cell count.

Salmonella typhi and Salmonella paratyphi, all members of the Enterobacteriaceae family, are the primary causes of typhoid fever. Salmonella enterica serovar and enteritidis are isolated by multiplex quantitative polymerase chain reaction PCR after detailed study. Salmonella nontyphoidal (NTS) is most frequent in infants, although the majority of cases are limited to gastroenteritis. Salmonella is spread by polluted water, raw food, and large groups of sick people, and is most prevalent in heavily populated cities, civil disorder, and inadequate sanitation. It can only be passed from one sick individual to another and humans are the only ones that can spread it. Chickens, milk, and uncommon tortoises are the most common causes of salmonella. The Patients went directly to the Observed Treatment in the Dept. of Medicine, at DMMC, SMHRC Nagpur. Enteric fever is still a major public health concern around the world, particularly in developing countries. Typhoid cases in cities are estimated to be about 800-900 per year, according to studies. While inexpensive and widely available, the Widal exam should be used with caution. Massive public awareness campaigns should be undertaken to inform citizens about the importance of taking preventative measures, vaccines, and seeing a doctor, among other items. Doctors should be aware of the emergence of newer antibacterial agents that are both safe and reliable, as well as the gradual development of antibiotic resistance. Aside from that, the discipline should anticipate newer curative and preventative interventions.

Aim: To determine the prevalence of multidrug (MDR) and extensively drug-resistant (XDR) pathogens from pediatric blood samples Methods: In total, 4543 children's blood samples were processed in the BacT/ALERT system. Confirmation of the isolates and MIC was determined in VITEK® 2 system. Molecular identification of blaIMP, blaVIM and blaOXA-48 was done by PCR. Results: Of 4543 blood cultures, 458 (10%) were positive for bacterial growth and Salmonella Typhi (415; 90%) remained the primary pathogens. Antibiogram revealed 208 (50.1%) and 137 (33%) were MDR and XDR S. Typhi, respectively. Klebsiella pneumoniae displayed 46% resistance to imipenem. One hundred twelve (81.7%) XDR Typhi were positive for blaCTXM, whereas 14 (66.6%) blaVIM were found in carbapenem-resistant bacteria. Conclusion: A high prevalence of MDR and XDR pathogens was found in peads blood culture.