Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Aug 7:14:435.
doi: 10.1186/1471-2334-14-435.

Gastroenteritis due to typhoidal Salmonella: a decade of observation at an urban and a rural diarrheal disease hospital in Bangladesh

Sumon Kumar Das, Mohammod Jobayer Chisti, Mokibul Hassan Afrad, Mohammad Abdul Malek, Shahnawaz Ahmed, Farzana Ferdous, Fahmida Dil Farzana, Jui Das, K M Shahunja, Farzana Afroze, Mohammed Abdus Salam, Tahmeed Ahmed, Abu Syed Golam Faruque  1 , Peter John Baker, Abdullah Al Mamun
Affiliations

Gastroenteritis due to typhoidal Salmonella: a decade of observation at an urban and a rural diarrheal disease hospital in Bangladesh

Sumon Kumar Das et al. BMC Infect Dis. .

Abstract

Background: The study aimed to compare the socio-demographic, host and clinical characteristics, seasonality and antimicrobial susceptibility of Typhoidal Salmonella (Salmonella enterica serovar Typhi and Paratyphi) (TS) with diarrhea between urban and rural Bangladesh.

Methods: Relevant information of 77/25,767 (0.30%) and 290/17,622 (1.65%) patients positive with TS (in stool) were extracted from the data archive of Diarrheal Disease Surveillance System of icddr,b (urban Dhaka and rural Matlab Hospitals respectively) during 2000-2012. Comparison group (diarrhea patients negative for TS) was randomly selected from the database (1:3 ratio). Two poisson regression models were investigated for modelling seasonal effects on the number of cases.

Results: Salmonella Typhi was more frequently isolated in Dhaka than Matlab (57% vs. 5%, p < 0.001); while Salmonella Paratyphi was more frequent in Matlab than Dhaka (96% vs. 43%; p < 0.001). Fever [adj. OR-5.86 (95% CI: 2.16, 15.94)], antimicrobial use at home [5.08 (2.60, 9.90)], and fecal red blood cells [2.53 (1.38, 4.64)] were significantly associated with detection of TS in stool of patient from Dhaka. For Matlab, the correlates were, vomiting [1.88 (1.35, 2.64)], fecal macrophage [1.89 (1.29, 2.74)] in addition to fever and duration of diarrhea and antimicrobial use. At Dhaka, all Salmonella Typhi isolates were susceptible to ceftriaxone; while in Dhaka and Matlab however, for ciprofloxacin it was 45% and 91%, respectively. Susceptibility to chloramphenicol, ampicillin, trimethoprim-sulphamethoxazole and nalidixic acid ranged from 12%-58%. Salmonella Paratyphi were susceptible to ceftriaxone (99%). A significant seasonal trend and year difference (before and after 2007) for Matlab was observed (p < 0.001 for all effects). Dhaka does not show significant year or seasonal effects (p = 0.07 for years and p = 0.81 and p = 0.18 for the cos and sin components, respectively). While not significant, two seasonal peaks were observed in Dhaka (January-February and September-November); while a single peak (August-November) was observed in Matlab.

Conclusions: Proportion of serovar distribution of TS and their clinical characteristics, antimicrobial susceptibility and seasonal pattern were different among diarrhea patients in urban Dhaka and rural Matlab of Bangladesh.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Time trend and seasonal distribution of Typhoidal Salmonella in Dhaka and Matlab (2000–2012).
Figure 2
Figure 2
Antimicrobial susceptibility of Typhoidal Salmonella in urban and rural sites (2000–2012).
See this image and copyright information in PMC

References

    1. Shah D, Choudhury P, Gupta P, Mathew JL, Gera T, Gogia S, Mohan P, Panda R, Menon S. Promoting appropriate management of diarrhea: a systematic review of literature for advocacy and action: UNICEF-PHFI series on newborn and child health. India Indian Pediatr. 2012;49(8):627–649. doi: 10.1007/s13312-012-0134-1. - DOI - PubMed
    1. Dennehy PH. Rotavirus infection: an update on management and prevention. Adv Pediatr. 2012;59(1):47–74. doi: 10.1016/j.yapd.2012.04.002. - DOI - PubMed
    1. Shakoor S, Zaidi AK, Hasan R. Tropical bacterial gastrointestinal infections. Infect Dis Clin North Am. 2012;26(2):437–453. doi: 10.1016/j.idc.2012.02.002. - DOI - PubMed
    1. Sigman M, Luchette FA. Cholera: something old, something new. Surg Infect (Larchmt) 2012;13(4):216–222. doi: 10.1089/sur.2012.127. - DOI - PubMed
    1. Harris JB, LaRocque RC, Qadri F, Ryan ET, Calderwood SB. Cholera. Lancet. 2012;379(9835):2466–2476. doi: 10.1016/S0140-6736(12)60436-X. - DOI - PMC - PubMed
Pre-publication history
    1. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2334/14/435/prepub

Publication types

MeSH terms

Substances