Diagnostic Validity of Flagellin Gene (fliC) in Urine for the Detection of Typhoid Fever

Bangladesh Journal of Medical Microbiology Pub Date : 2023-10-10 DOI:10.3329/bjmm.v17i1.68173

Nasreen Jahan, Naila Huq, Md Abdullah Yusuf, Md Shahed Morshed, Farida Khatun Chhobi, S M Shamsuzzaman

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Abstract

Background: Accurate diagnosis of typhoid fever is important issue for the treatment of the patients. Objective: The purpose of the present study was to evaluate the nested PCR for the diagnosis of suspected cases of typhoid fever targeting the flagellin gene (fliC) of Salmonella Typhi from urine. Methodology: This cross sectional study was conducted in the Department of Microbiology of Dhaka Medical College (DMC), Dhaka. Specimens were collected from OPD of DMCH, Dhaka Shishu Hospital (DSH), Dhaka and National Institute of Neurosciences and Hospital (NINSH), Dhaka from July 2013 to June 2014 for a period of one year. All suspected patients of typhoid fever irrespective of age, sex and history of antibiotic intake who attended the OPD of DMCH, DSH and NINSH were selected for this study. Diagnosed cases of febrile illness other than typhoid fever were excluded from the study. Blood and urine were collected and all isolates were tested for antimicrobial susceptibility by Kirby-Bauer modified disc-diffusion technique. Widal test and CRP were performed. Nested PCR was performed in the urine and blood to detect the DNA of Salmonella Typhi. Results: Among 72 typhoid fever patients, 33(45.8%) were Widal test positive and 42(55.5%) were blood culture positive. Out of 30 blood culture negative patients nested PCR in urine was positive in 5(16.7%) cases. The sensitivity, specificity, PPV, NPV and accuracy of nested PCR in urine were 97.6%, 83.3%, 89.1%, 96.1% and 91.7% respectively. Conclusion: In conclusion the nested PCR for the diagnosis of typhoid fever targeting the flagellin gene (fliC) of Salmonella Typhi from urine may be very useful diagnostic tool. Bangladesh Journal of Medical Microbiology, January 2023;17(1):34-39

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尿中鞭毛蛋白基因(fliC)检测伤寒的诊断有效性

背景:准确诊断伤寒是治疗伤寒患者的重要问题。目的:探讨巢式PCR检测尿液中伤寒沙门菌鞭毛蛋白基因(fliC)对伤寒疑似病例的诊断价值。方法:本横断面研究在达卡医学院微生物学系进行。标本采集于2013年7月至2014年6月，分别于达卡DMCH门诊、达卡Shishu医院(DSH)和达卡国立神经科学与医院研究所(NINSH)采集，为期一年。所有在DMCH、DSH和NINSH的门诊就诊的伤寒疑似患者，不论年龄、性别和抗生素摄入史，均被选为本研究的对象。除伤寒外，诊断为发热性疾病的病例被排除在研究之外。采集血样和尿液，采用改良的Kirby-Bauer纸片扩散法检测所有分离株的抗菌药物敏感性。进行维达尔试验和CRP。采用巢式PCR对尿和血进行伤寒沙门氏菌DNA检测。结果:72例伤寒患者中，维达尔试验阳性33例(45.8%)，血培养阳性42例(55.5%)。30例血培养阴性患者中，尿巢式PCR阳性5例(16.7%)。巢式PCR检测尿液的敏感性为97.6%，特异性为83.3%，PPV、NPV和准确性分别为89.1%、96.1%和91.7%。结论:针对尿中伤寒沙门菌鞭毛蛋白基因(fliC)的巢式PCR诊断是一种非常有用的诊断工具。孟加拉医学微生物学杂志，2023年1月;17(1):34-39

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Bangladesh Journal of Medical Microbiology

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