Comparative Study Of  Blood Culture with Rapid Diagnostic Tests for Diagnosis Of Enteric Fever In A Tertiary Centre Of NE-India.

Anjan Sarma; Dipa Barkataki

doi:10.33883/jms.v22i3.474

Anjan Sarma Department of Microbiology, FAAMCH Barpeta Assam
Dipa Barkataki Department of Microbiology, SMCH, Silchar, Assam

DOI: https://doi.org/10.33883/jms.v22i3.474

Keywords: Blood culture, Widal, Typhidot, Sensitivity, Specificity

Abstract

Introduction: Enteric fever is a global health problem and is also endemic in India. The laboratory diagnosis of enteric fever is very important mainly because in post-antibiotic era most cases are treated empirically and investigated for various causes of PUO including enteric fever. A fast, reliable, and easy to perform serodiagnostic test with a higher sensitivity and specificity is required for rapid diagnosis and management of typhoid cases, thereby enabling clinicians to initiate an early therapy, reducing morbidity and its complications.

Aim : The study was performed to evaluate the performance of Widal test and Typhidot, a lateral flow immunoassay test.

Materials and Methods: This study was carried out in the Department of Microbiology in a tertiary care center for 1 year (August 2016– July2017). A total of 110 blood samples were collected from patients (cases) clinically suspected of enteric fever. Culture and Serological tests were done in all the 110 cases. Salmonella isolation was done by conventional methods of culture. Demonstration of presence of anitibodies were done by Widal tests using commercially available kits. Typhidot, a lateral flow immunoassay, was used to test and detect IgM and IgG antibodies against the outer membrane protein (OMP) of the Salmonella Typhi. The performances of the tests were compared, and diagnostic accuracy determined.

Results : Out of 110 cases, highest percentage of positive cases were found by Typhidot test (29.09%) followed by Widal test (23.63%) . 18.18% cases were confirmed by blood culture. Taking blood culture as gold standard , it was found that Widal test had a sensitivity of 30% and specificity of 78% and Typhidot had a sensitivity of 75% and specificity of 81%.

Conclusion : Though definitive diagnosis of enteric fever is isolation of the causative organism from the patient, Widal test and Typhidot test are important diagnostic tools in the medical set up. Typhidot is fast becoming a practical alternative to Widal test. Typhidot test had a fairly good sensitivity and specificity, whereas Widal test had good specificity but a lower sensitivity.

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Author Biography

Dipa Barkataki, Department of Microbiology, SMCH, Silchar, Assam

M.D., Professor

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