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DETECTION OF SALMONELLA TYPHI BY NESTED POLYMERASE CHAIN REACTION IN BLOOD, URINE, AND STOOL SAMPLES

A nested polymerase chain reaction (PCR) specific for Salmonella enterica serovar Typhi was used for the detection of the pathogen in blood, urine, and stool samples from 131 patients with clinical suspicion of typhoid fever. The sensitivity of blood culture, the PCRs with blood, urine, and feces, and the Widal test were 61.8%, 84.5%, 69.3%, 46.9%, and 39.0%, respectively. The sensitivity of the PCRs with blood (P < 0.001) and urine (P = 0.01) were significantly higher, and the sensitivity of the PCR with feces (P > 0.05) was similar to that of blood culture. Combined, the PCRs on urine and feces showed positive results for 16 (70%) of 23 typhoid patients with negative results with blood culture and PCR with blood. These results show that the PCR with blood is a sensitive method for the diagnosis of typhoid fever, and that the PCRs with urine and feces could be useful complementary tests.

Received July 10, 2006. Accepted for publication September 27, 2006.

Acknowledgments: We thank Mr. Romi Usman and Mr. Marwani for technical assistance. We also thank the staff at the Department of Microbiology of the Hasanuddin University Hospital, Makassar, the District Hospital, and the Primary Health Care Centre at Gowa District, South Sulawesi, Indonesia for enthusiastic and valuable support of this study, and Dr. G. Frankel for providing the primers.

Financial support: This study was supported by European Union grant no. IC18CT9980381.

^* Address correspondence to Henk L. Smits, Department of Biomedical Research, Koninklijk Instituut voor de Tropen Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen, Amsterdam, The Netherlands. E-mail: h.smits{at}kit.nl

Authors’ addresses: Mochammad Hatta, Department of Medical Microbiology, Faculty of Medicine, Hasanuddin University, Kampus Tamalanrea, Km 10, Makassar, Indonesia, Telephone and Fax: 62-411-586-971, E-mail: hattaram{at}indosat.net.id. Henk L. Smits, Department of Biomedical Research, Koninklijk Instituut voor de Tropen Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen, Amsterdam, The Netherlands, Telephone: 31-20-566-5470, Fax: 31-20-697-1841, E-mail: h.smits{at}kit.nl.