Ghazali, Asmak
(2020)
Detection of salmonella enterica subsp. enterica serovar Typhi from cholecystectomy samples by conventional, serological and molecular methods in Hospital USM.
Masters thesis, Universiti Sains Malaysia.
Abstract
Salmonella enterica subsp. enterica serovar Typhi (S. Typhi) is an agent of
typhoid in human. Typhoid has been reported causing 11-20 million people illnesses
and estimated 128 000 to 161 000 deaths every year. The bacteria were spread by
fecal-oral route through infected food or water. The most common sites of infection
are the gallbladder, liver, ileum, spleen and bone marrow. At the moment, removal of
the gallbladder through cholecystectomy procedure remains the effective option for
typhoid carriers with gallstones. In this study, eighty (80) patients that enrolled for
cholecystectomy and having hepatobiliary disease were chosen as sample. A
convenience study has been performed to isolate S. Typhi by using four culture
techniques; which are direct incubation (technique 1), upper layer collection
(technique 2), vortex (technique 3) and supernatant and pellet separation (technique
4), then proceed to conventional polymerase chain reaction (PCR) test and serology
test using Typhidot-C. Out of 80 samples, eight samples (Gb9, Gb10, Gb11, Gb15,
Gb43, Gb50, Gb64 and Gb74) showed the presence of suspected colonies of
Salmonella species on the Hektoen Enteric (HE) agar and Xylose Lysine
Deoxycholate (XLD) agar by using supernatant and pellet separation technique. All
eight sample of suspected colonies were tested with biochemical test which included
triple sugar iron (TSI) test, urease test, citrate test, indole test and methyl red (MR)
test. The result showed that all suspected colonies were negative for detection of
Salmonella species. Electronic RapID Compendium (ERICTM) test was done and
Citrobacter freundii was detected with probability of 99 per cent. From the eight
samples mentioned, six samples were shown negative detection of Salmonella
species by PCR, meanwhile, two samples were positive by PCR but both samples
were negative for Salmonella by biochemical test. Serology test by using Typhidot-C
were done and the result showed all 37 blood samples were negative for S. Typhi
carrier. As a conclusion, this study not able to isolate and correlate the presence of
the S. Typhi in HUSM patients with hepatobiliary diseases in comparison to other
typhoid endemic countries. As for recommendation, there is a need to refine the
inclusion criteria such as includes the patients that have typhoid history, increase the
sample size and collaborate with many hospitals in collecting the samples.
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