Materiały źródłowe

• #1 Diagnostics for invasive Salmonella infections: current challenges and future directions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4469564/

  Invasive Salmonellosis caused by Salmonella enterica serotype Typhi or Paratyphi A, B, C, or invasive non-typhoidal Salmonella serotypes, is an immensely important disease cluster for which reliable, rapid diagnostic tests are not available. Blood culture remains the gold standard but is insensitive, slow, and resource-intensive. Existing molecular diagnostics have poor sensitivity due to the low organism burden in bodily fluids. Commercially available serologic tests for typhoidal Salmonella have had limited sensitivity and specificity. […] This diagnostic gap leads to under-diagnosis as well as inaccurate, over-diagnosis of enteric fever especially, the latter of which may lead to inappropriate and excessive antibiotic use. This results in selective pressure for the emergence of resistant bacteria, at a time in which highly resistant Gram-negative infections, including Salmonella, threaten to undermine reductions in case fatality rates for bacterial infections.

• #1 Clinical Overview of Salmonellosis | Salmonella Infection | CDC

  https://www.cdc.gov/salmonella/hcp/clinical-overview/index.html

  Laboratory testing, particularly culture, is recommended for the diagnosis of salmonellosis. […] Laboratory testing is necessary to confirm a diagnosis of salmonellosis, and is recommended when salmonellosis is suspected, especially if antibiotic treatment will be prescribed. […] Culture (e.g., stool, urine, blood) is the gold standard for diagnosis. Resulting isolates can provide additional information used for patient care (such as virulence and antimicrobial resistance) and public health practice (such as outbreak identification). […] If Salmonella is identified by a PCR multiplex panel or other culture-independent diagnostic test (CIDT), follow-up (reflex) culture is recommended to obtain an isolate for antimicrobial susceptibility testing. […] Antimicrobial susceptibility testing is recommended to guide the choice of antibiotic if antibiotic treatment is needed. […] Salmonellosis should be considered in the differential diagnosis of patients with acute diarrhea, particularly if fever is present or the patient traveled internationally before becoming ill.

• #1 Salmonella Infection (Salmonellosis) Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/228174-workup

  Modern blood culture systems are 80-100% accurate in detecting bacteremia. As the disease duration increases, the sensitivity of blood cultures decreases, while the sensitivity of stool isolation increases. […] Freshly passed stool is the preferred specimen for isolation of nontyphoidal Salmonella species. Since stool carriage of S typhi may be prolonged, the interpretation of positive results merits caution, and the diagnosis should be established only when accompanied by clinical findings that are typical of infection. […] Bone marrow aspirate and culture is superior to blood culture, since the bacterial concentration in bone marrow is 10 times that of peripheral blood. In patients who received antibiotic therapy prior to hospitalization, bone marrow aspirate may still be positive for Salmonella even if blood culture results are negative.

• #1 Salmonella: Outbreaks, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15697-salmonella

  Salmonella is diagnosed with a test of your stool (poop), blood or other sample. Your healthcare provider will give you a physical exam and ask you about your symptoms and health history. […] You usually give a sample of your poop (stool) from the privacy of your own home. Your healthcare provider will give you a sterile container and instructions on how to collect a sample. A lab will test the sample for signs of Salmonella bacteria. […] Your provider will collect blood with a needle from your arm. A lab will culture (try to grow) Salmonella bacteria from your blood sample. […] Your provider might use other body fluids or tissues, like pee (urine) or a sample taken from a wound (abscess) to test for Salmonella.

• #1 Salmonella: Properties, Disease, Lab Diagnosis • Microbe Online

  https://microbeonline.com/salmonella-disease-properties-pathogenesis-and-laboratory-diagnosis/

  Blood culture is the mainstay for the diagnosis of Typhoid fever. Presence of specific antibodies against Salmonella and or presence of characteristics signs symptoms can be suggestive of typhoid fever but not definitive. […] Definitive diagnosis of typhoid fever depends on the isolation of S.typhi from blood or bone marrow aspirate culture. […] Salmonella is present in the blood of more than 80% of patients with typhoid fever. The overall volume of blood cultured is critical to increase yield (isolation rate) of the causative pathogen. Reducing the blood volume reduces the sensitivity of the blood culture. […] Blood for culture should be taken before the patient is given antimicrobial therapy. Patients with a history of fever for 7 to 10 days are more likely than others to have a positive blood culture.

• #1 Salmonella – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK8435/

  Salmonellosis should be considered in any acute diarrheal or febrile illness without obvious cause. The diagnosis is confirmed by isolating the organisms from clinical specimens (stool or blood). […] The diagnosis of salmonellosis requires bacteriologic isolation of the organisms from appropriate clinical specimens. Laboratory identification of the genus Salmonella is done by biochemical tests; the serologic type is confirmed by serologic testing. Feces, blood, or other specimens should be plated on several nonselective and selective agar media (blood, MacConkey, eosin-methylene blue, bismuth sulfite, Salmonella-Shigella, and brilliant green agars) as well as into enrichment broth such as selenite or tetrathionate. Any growth in enrichment broth is subsequently subcultured onto the various agars. The biochemical reactions of suspicious colonies are then determined on triple sugar iron agar and lysine-iron agar, and a presumptive identification is made. Biochemical identification of salmonellae has been simplified by systems that permit the rapid testing of 10-20 different biochemical parameters simultaneously. The presumptive biochemical identification of Salmonella then can be confirmed by antigenic analysis of O and H antigens using polyvalent and specific antisera. Fortunately, approximately 95% of all clinical isolates can be identified with the available group A-E typing antisera. Salmonella isolates then should be sent to a central or reference laboratory for more comprehensive serologic testing and confirmation.

• #1 Salmonella Infection (Salmonellosis) Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/228174-workup

  Numerous polymerase chain reaction (PCR) based multiplex GI pathogen identification panels have been marketed for use with primary stool specimens. These panels allow rapid identification of Salmonella, Shigella, and Yersinia from primary stool specimens and offer substantially improved turnaround time for primary laboratory diagnosis compared with culture-based methods. Recovery of isolates from culture still is required for taxonomic classification and susceptibility testing. […] Serological tests used in the diagnosis of enteric fever yield limited sensitivity and specificity. The Widal test is used to measure antibodies against O and H antigens of S typhi. Newer diagnostic tests (Typhidot, Tubex) allow direct detection of immunoglobulin M (IgM) antibodies against specific S typhi antigens. These tests are promising but need further evaluation in large community settings. […] Nested PCR using H1-d primers has been used to amplify specific genes of S typhi, with high sensitivity and specificity. This may eventually replace blood culture as the criterion standard.

• #1

  https://www.rapidmicrobiology.com/test-method/salmonella-detection-and-identification-methods

  For this reason a substantial number of alternative rapid screening methods have been developed to produce results more quickly for food and environmental samples. Many of these are available commercially and have been successfully validated by the AOAC and/or AFNOR. […] Almost all rapid test protocols include a selective enrichment stage, and then apply concentration and/or rapid detection techniques to replace culture on selective agars and further confirmatory tests. Most can claim to produce a result in approximately 48 hours or less, depending on the enrichment protocol. […] There are well established confirmation and identification procedures for Salmonella spp. Preliminary identification based on colony appearance on chromogenic and other selective agar media is traditionally confirmed using classical biochemical tests for Salmonella and serological testing. […] Many rapid confirmation and identification methods have been developed for Salmonella and a large number have been developed into commercial products.

• #1 UNLOCKING TYPHOID DIAGNOSIS: COMPARING WIDAL, SALMONELLA RAPID TEST, AND TUBEX TESTS | Isotekindo

  https://www.isotekindo.co.id/article/details/387

  The Salmonella Rapid Test is a rapid testing tool designed to detect Salmonella typhi antigens directly from a patients blood. This method provides results in a short time, usually between 15 and 30 minutes, making it a suitable option for the early detection of typhoid fever. […] The primary advantage of the Salmonella Rapid Test is its ability to deliver faster results compared to the Widal test. Additionally, this method is more specific because it directly detects antigens, which reduces the likelihood of false-positive results. […] The Tubex test is a diagnostic assay that detects specific IgM antibodies against the O9 antigen of Salmonella typhi using the principle of magnetic agglutination inhibition. This method is designed to provide higher sensitivity and specificity compared to the Widal test and the Salmonella Rapid Test.

• #1 How is Salmonella Infection Diagnosed? | Marler Clark

  https://marlerclark.com/foodborne-illnesses/salmonella/salmonella-diagnosis

  Culturing of organisms such as Salmonella has been the mainstay of diagnostic testing conducted at clinical laboratories. Isolates obtained from culture are forwarded from clinical laboratories to public health laboratories, where additional testing is performed, including serotyping, antimicrobial susceptibility, and genetic testing. Results of these additional tests allow epidemiologists to monitor trends and detect outbreaks. […] Increasingly, hospitals and clinical laboratories are using culture-independent diagnostic tests (CIDTs) rather than culture-based testing to detect enteric pathogens such as Salmonella. Commonly used CIDT testing methods include testing by polymerase chain reaction (PCR) and enzyme immunoassay (EIA) testing. CIDTs have a rapid turnaround time, can detect multiple pathogens in one test, and cost less than traditional testing procedures such as culture, which often require specialized media and years of training. Clinicians are thus able to identify and provide appropriate treatment in a shorter amount of time.

• #1 Diagnostics for invasive Salmonella infections: current challenges and future directions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4469564/

  The sensitivity of culture varies substantially according to the specific fluid and volume assayed, age of the affected individual, prior antimicrobial use, and stage of the illness. Bone marrow cultures have the highest sensitivity (80%) and are relatively unaffected by antibiotics; however, this diagnostic procedure is not commonly performed in clinical settings where typhoid is endemic due to its invasive nature and the need for training and specialized, sterile equipment. […] The Widal agglutination test, in which killed Salmonella Typhi and Paratyphi A antigen is reacted with serum to measure agglutinating antibodies to the flagellar (H) and lipopolysaccharide (O) antigens, was developed in the 1890s, modified and standardized in the 1950s, and today remains in widespread use throughout typhoid-endemic settings.

• #1 Typhoid fever – Wikipedia

  https://en.wikipedia.org/wiki/Typhoid_fever

  The Widal test is used to identify specific antibodies in the serum of people with typhoid by using antigen-antibody interactions. […] In this test, the serum is mixed with a dead bacterial suspension of Salmonella with specific antigens. […] Rapid diagnostic tests such as Tubex, Typhidot, and Test-It have shown moderate diagnostic accuracy. […] Typhidot is based on the presence of specific IgM and IgG antibodies to a specific 50Kd OMP antigen. […] The Tubex test contains two types of particles: brown magnetic particles coated with antigen and blue indicator particles coated with O9 antibody.

• #1 Salmonella Diagnosis And Treatment – Klarity Health Library

  https://my.klarity.health/salmonella-diagnosis-and-treatment/

  Salmonella infections (salmonellosis) are classified into two groups major and minor: minor salmonellosis is characterized by self-limiting diarrhoea and is usually caused by non-typhoid Salmonella strains, and major salmonellosis is represented by typhoid fever, which could be fatal if left untreated. […] A medical professional will take the patients history and assess their symptoms to narrow down the possible diagnosis. […] However, because Salmonella infection presents non-specific symptoms that are similar to other illnesses, the only way to confirm the diagnosis is through lab tests. […] A stool test can be done to look for the presence of blood in stool, which confirms whether an infection is causing the symptoms or if there are any other gastrointestinal abnormalities. […] Since there are two groups of Salmonella, a specific stool test is required to identify the type of Salmonella responsible for the symptoms.

• #1 Laboratory diagnosis of salmonella | PPT

  https://www.slideshare.net/slideshow/laboratory-diagnosis-of-salmonella/47466314

  1. The document discusses the laboratory diagnosis of Salmonella, which causes enteric fever and gastroenteritis in humans. Blood culture is the best specimen for diagnosis in the first week, while stool and urine cultures are optimal in later weeks. […] 2. Serological tests like the Widal test detect antibodies against Salmonella, while rapid tests like Typhidot and IDL Tubex detect IgM antibodies. […] 3. Isolation of Salmonella from stool requires plating on selective media followed by biochemical tests and serotyping using slide agglutination to identify the serovar. Antimicrobial susceptibility testing helps guide treatment. […] […] […] 4. Confirmed case of typhoid fever is defined(WHO), as a patient with fever ( 38C) that has lasted for at least three days, with a laboratory confirmed positive culture of S.Typhi.

• #1 Salmonellosis in Animals – Digestive System – Merck Veterinary Manual

  https://www.merckvetmanual.com/digestive-system/salmonellosis/salmonellosis-in-animals

  Salmonellosis is infection with Salmonella spp bacteria. […] Diagnosis is confirmed by isolating the pathogen. […] Salmonellosis is diagnosed either by repeated isolation of the pathogen from feces, suggesting a carrier status, or by a single isolation of the pathogen from feces, blood, or any tissue specimen in the presence of clinical signs consistent with the disease. […] Fecal cultures lack sensitivity. In chronically infected patients or subclinical carriers, only low numbers of bacteria may be shed intermittently. Repeated sampling is required when testing a patient for Salmonella carrier status to decrease the likelihood of a false-negative result. […] The pathogen is identified by conventional culture, followed by serotyping and further subdivision on the basis of susceptibility to selected bacteriophages (phage typing), by PCR assay, and by lateral flow immunoassays.

• #1 Salmonellosis in Animals – Digestive System – Merck Veterinary Manual

  https://www.merckvetmanual.com/digestive-system/salmonellosis/salmonellosis-in-animals

  PCR assay is highly sensitive and is recommended for samples with presumptively low bacterial loads. […] Serological tests to identify specific antibodies in serum or milk are increasingly used in salmonellae surveillance and control programs. […] The clinical presentation of salmonellosis in each species is usually characteristic but must be differentiated from other similar diseases.

• #1 Salmonella enterocolitis: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000294.htm

  Salmonella infection is one of the most common types of food poisoning. It occurs when you eat food or drink water that contains Salmonella bacteria. […] Tests that may be done include: […] Stool culture for Salmonella. […] Your health care provider will perform a physical exam. You may have a tender abdomen and develop tiny pink spots, called rose spots, on your skin. […] People who have been treated for Salmonella may continue to shed the bacteria in their stool for months to a year after the infection. Food handlers who carry Salmonella in their body can pass the infection to the people who eat the food they have handled.

• #1 Salmonella infection – including symptoms, treatment and prevention | SA Health

  https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/salmonella+infection/salmonella+infection+-+including+symptoms+treatment+and+prevention

  Salmonella infection is a notifiable condition. […] Diagnosis is made by growing Salmonella bacteria from a faecal specimen or by detecting Salmonella in a faecal sample using a PCR (polymerase chain reaction) test in a pathology laboratory.

• #1

  https://www.rapidmicrobiology.com/test-method/salmonella-detection-and-identification-methods

  Salmonella Detection and Identification Methods for Food Processors […] Traditional detection and confirmation methods are long established and typically take 3-5 days to obtain a result […] Rapid detection and confirmation methods are widely available and are capable of reducing detection times to 48 hours or less […] Given the long history of foodborne salmonellosis, it is not surprising that the need for microbiological testing of food ingredients and food products is very significant. A substantial number of methods, both traditional and rapid, have been developed over the years for the detection and identification of Salmonella. […] There is a current ISO horizontal method, ISO 6579: 2002, for the detection Salmonella spp. in food and animal feed. The method was amended in 2007 to include testing of animal faeces and environmental samples from primary production.

• #1 Salmonella | Pioneering Diagnostics

  https://www.biomerieux.com/us/en/education/resource-hub/scientific-library/food-safety-library/salmonella.html

  Salmonella detection methods in the food industry are mostly cultural but also based on alternative automatized technologies like PCR tests or ELISA tests, which takes a shorter time to present results amongst other benefits. […] Proper cleaning and sanitizing procedures, handwashing procedures and contamination prevention procedures must be implemented. […] Your Hazard Analysis and Critical Control Points Plan (HACCP plan) should detail the specific approaches that your facility will use to prevent Salmonella contamination. […] Salmonella is one of the main causes of diarrhoeal (diarrheal) diseases and foodborne illnesses with large outbreaks or sporadic cases. […] Electrolyte replacement and rehydration are the most common treatment for salmonella poisoning. Antimicrobials are administered only in extreme cases. […] Salmonellosis in humans is generally contracted through the consumption of contaminated food of animal origin, mainly eggs, meat, poultry, and milk, although other foods, including fruits and vegetables, have been implicated in its transmission.

• #1 Salmonella Infection, Prevention, and Control | Pioneering Diagnostics

  https://www.biomerieux.com/us/en/education/resource-hub/scientific-library/food-safety-library/salmonella-scientific-library.html

  EU and US regulations specifically require that food business operators perform microbiological testing as appropriate when they are validating and verifying the effectiveness of their HACCP and GHP -based control systems (EU 852/2004; FDA, 2011). […] Different microbiological methods either traditional or molecular (PCR or Whole Genome sequencing) for the detection of Salmonellaspp and/or serotyping ofSalmonella EnteritidisorTyphimurium have been described, notably: […] bioMrieux provides the food safety managers with proven standardized or validated methods for the management of Salmonellaspp. orS. Enteritidis S. Typhimurium along the Food Chain.

• #1 Salmonellosis: An Overview of Epidemiology, Pathogenesis, and Innovative Approaches to Mitigate the Antimicrobial Resistant Infections

  https://www.mdpi.com/2079-6382/13/1/76

  Salmonella is a major foodborne pathogen and a leading cause of gastroenteritis in humans and animals. Salmonella is highly pathogenic and encompasses more than 2600 characterized serovars. The transmission of Salmonella to humans occurs through the farm-to-fork continuum and is commonly linked to the consumption of animal-derived food products. Among these sources, poultry and poultry products are primary contributors, followed by beef, pork, fish, and non-animal-derived food such as fruits and vegetables. While antibiotics constitute the primary treatment for salmonellosis, the emergence of antibiotic resistance and the rise of multidrug-resistant (MDR) Salmonella strains have highlighted the urgency of developing antibiotic alternatives. Effective infection management necessitates a comprehensive understanding of the pathogen’s epidemiology and transmission dynamics. Therefore, this comprehensive review focuses on the epidemiology, sources of infection, risk factors, transmission dynamics, and the host range of Salmonella serotypes. This review also investigates the disease characteristics observed in both humans and animals, antibiotic resistance, pathogenesis, and potential strategies for treatment and control of salmonellosis, emphasizing the most recent antibiotic-alternative approaches for infection control.

• #1 Diagnosis and Treatment | General Information | Salmonella | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/salmonella/general/diagnosis.html

  Diagnosing salmonellosis requires testing a clinical specimen (such as stool or blood) from an infected person to distinguish it from other illnesses that can cause diarrhea, fever, and abdominal cramps. Once Salmonella is identified in the specimen, additional testing can be done to further characterize the Salmonella. […] Laboratory scientists identify Salmonella infection by culturing a patients sample. If Salmonella bacteria grow, then the diagnosis is confirmed, or in laboratory-terms, culture confirmed. […] Clinical diagnostic laboratories report the test results to the treating clinician and submit Salmonella isolates to state and territorial public health laboratories for serotyping and DNA fingerprinting. […] In addition to serotyping, state public health laboratories routinely subtype Salmonella isolates using pulsed-field gel electrophoresis (PFGE) to create a DNA fingerprint.

• #1 Diagnostics for invasive Salmonella infections: current challenges and future directions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4469564/

  Several serologic tests have been developed for point-of-care diagnosis of enteric fever. The two that have been most widely studied are TUBEX TF and Typhidot. […] A number of studies have assessed the yield of nucleic acid amplification tests for enteric fever diagnosis; flagellin genes have been most commonly targeted, but an array of alternative PCR gene targets have been assessed. […] For culture-based and molecular diagnostics, similar challenges present with typhoidal Salmonella – low bacterial burden in blood may confound sensitive diagnosis of iNTS. […] In contrast with typhoidal Salmonella, there is more limited experience with serologic assays for iNTS. […] All of the currently available diagnostic approaches for invasive Salmonellosis have limitations in terms of speed, sensitivity, infrastructure requirements, and suitability to point-of-care application. […] A number of promising approaches are under development, which may address many of the limitations of the existing diagnostics.

• #2 Clinical Overview of Salmonellosis | Salmonella Infection | CDC

  https://www.cdc.gov/salmonella/hcp/clinical-overview/index.html

  Laboratory testing, particularly culture, is recommended for the diagnosis of salmonellosis. […] Laboratory testing is necessary to confirm a diagnosis of salmonellosis, and is recommended when salmonellosis is suspected, especially if antibiotic treatment will be prescribed. […] Culture (e.g., stool, urine, blood) is the gold standard for diagnosis. Resulting isolates can provide additional information used for patient care (such as virulence and antimicrobial resistance) and public health practice (such as outbreak identification). […] If Salmonella is identified by a PCR multiplex panel or other culture-independent diagnostic test (CIDT), follow-up (reflex) culture is recommended to obtain an isolate for antimicrobial susceptibility testing. […] Antimicrobial susceptibility testing is recommended to guide the choice of antibiotic if antibiotic treatment is needed. […] Salmonellosis should be considered in the differential diagnosis of patients with acute diarrhea, particularly if fever is present or the patient traveled internationally before becoming ill.

• #2 Salmonella – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK8435/

  Salmonellosis should be considered in any acute diarrheal or febrile illness without obvious cause. The diagnosis is confirmed by isolating the organisms from clinical specimens (stool or blood). […] The diagnosis of salmonellosis requires bacteriologic isolation of the organisms from appropriate clinical specimens. Laboratory identification of the genus Salmonella is done by biochemical tests; the serologic type is confirmed by serologic testing. Feces, blood, or other specimens should be plated on several nonselective and selective agar media (blood, MacConkey, eosin-methylene blue, bismuth sulfite, Salmonella-Shigella, and brilliant green agars) as well as into enrichment broth such as selenite or tetrathionate. Any growth in enrichment broth is subsequently subcultured onto the various agars. The biochemical reactions of suspicious colonies are then determined on triple sugar iron agar and lysine-iron agar, and a presumptive identification is made. Biochemical identification of salmonellae has been simplified by systems that permit the rapid testing of 10-20 different biochemical parameters simultaneously. The presumptive biochemical identification of Salmonella then can be confirmed by antigenic analysis of O and H antigens using polyvalent and specific antisera. Fortunately, approximately 95% of all clinical isolates can be identified with the available group A-E typing antisera. Salmonella isolates then should be sent to a central or reference laboratory for more comprehensive serologic testing and confirmation.

• #2 How is Salmonella Infection Diagnosed? | Marler Clark

  https://marlerclark.com/foodborne-illnesses/salmonella/salmonella-diagnosis

  Salmonella bacteria can be detected by stool culture. In cases of bacteremia or invasive illness, the bacteria can also be cultured from blood, urine, or, on rare occasions, from other body tissues. A fecal, blood, or other sample is placed in nutrient broth or on agar and incubated for up to 2-3 days. After that time, a trained microbiologist can identify the bacteria, if present, and confirm its identity by looking at biochemical reactions. Typically, this test is conducted at a hospital or clinical laboratory. Isolates obtained from culture are forwarded from clinical laboratories to public health laboratories. […] Treatment with antibiotics before collecting a specimen for testing can affect bacterial growth in culture and lead to a negative test result even when Salmonella causes the infection. Thus, it is important to collect a specimen for laboratory testing before antibiotics are given.

• #2 Salmonella: Properties, Disease, Lab Diagnosis • Microbe Online

  https://microbeonline.com/salmonella-disease-properties-pathogenesis-and-laboratory-diagnosis/

  Blood culture is the mainstay for the diagnosis of Typhoid fever. Presence of specific antibodies against Salmonella and or presence of characteristics signs symptoms can be suggestive of typhoid fever but not definitive. […] Definitive diagnosis of typhoid fever depends on the isolation of S.typhi from blood or bone marrow aspirate culture. […] Salmonella is present in the blood of more than 80% of patients with typhoid fever. The overall volume of blood cultured is critical to increase yield (isolation rate) of the causative pathogen. Reducing the blood volume reduces the sensitivity of the blood culture. […] Blood for culture should be taken before the patient is given antimicrobial therapy. Patients with a history of fever for 7 to 10 days are more likely than others to have a positive blood culture.

• #2 Diagnostics for invasive Salmonella infections: current challenges and future directions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4469564/

  The sensitivity of culture varies substantially according to the specific fluid and volume assayed, age of the affected individual, prior antimicrobial use, and stage of the illness. Bone marrow cultures have the highest sensitivity (80%) and are relatively unaffected by antibiotics; however, this diagnostic procedure is not commonly performed in clinical settings where typhoid is endemic due to its invasive nature and the need for training and specialized, sterile equipment. […] The Widal agglutination test, in which killed Salmonella Typhi and Paratyphi A antigen is reacted with serum to measure agglutinating antibodies to the flagellar (H) and lipopolysaccharide (O) antigens, was developed in the 1890s, modified and standardized in the 1950s, and today remains in widespread use throughout typhoid-endemic settings.

• #2 Salmonella and Shigella, Culture | Test Detail | Quest Diagnostics

  https://testdirectory.questdiagnostics.com/test/test-detail/10019/salmonella-and-shigella-culture?p=r&cc=MASTER

  Salmonella and Shigella, Culture – Salmonella and shigella represent two of the most common bacterial causes of diarrhea. If other common causes of diarrhea are suspected, they must be ordered individually. For many patients, the cause of gastrointestinal infection is not identified. […] If culture is positive, an identification will be performed at an additional charge (CPT code(s): 87077). Antibiotic susceptibilities are only performed when appropriate (CPT code(s): 87186). […] Bacterial Culture • Aerobic isolation and identification procedures […] Preferred Specimen(s) Stool collected in Cary-Blair stool culture transport medium […] Alternative Specimen(s) Rectal swab in Amies or Cary-Blair stool culture transport medium […] Minimum Volume 1 gram or 1 mL […] Collection Instructions Collect in clean, dry container and then transfer a minimum of 1 gram or 1 mL into a Cary-Blair stool culture transport medium. Fluid level should reach line on vial.

• #2 Salmonella Infection (Salmonellosis): Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/228174-overview

  Salmonellae can be isolated in the microbiology laboratory using numerous low-selective media (MacConkey agar, deoxycholate agar), intermediate-selective media (Salmonella-Shigella [SS] agar, Hektoen [HE] agar), and highly selective media (selenite agar with brilliant green). […] Individual isolates can then be distinguished with serogrouping, pulsed-field gel electrophoresis, and bacteriophage serotyping techniques. […] Salmonellosis is caused by all nontyphoid serotypes of the Salmonella genus except for S typhi and Salmonella paratyphi A, B, and C. […] Salmonella infection may result from direct contact with infected animals or indirect contact via their environment. […] Transmission of salmonellae to a susceptible host usually occurs via consumption of contaminated foods. […] The most common sources of salmonellae include beef, poultry, and eggs.

• #2 Salmonellosis- Food Infection and Food Poisoning by Salmonella

  https://microbenotes.com/salmonellosis/

  Laboratory Diagnosis of Salmonellosis […] 1. Culture method […] The commonly used lab media for the isolation of Salmonella species are Desoxycholate Citrate Agar or XLD agar, Salmonella Shigella agar and MacConkey agar. If the sample is minimum, enrichment media are used such as tetrathionate or selenite F broth. […] 2. Serology test […] Widal agglutination test is done which measures the antibodies against the antigens of the pathogen. It is determined against the somatic (O) and flagellar (H) antigens of the organism. High somatic (O) antibody titre specifies acute infection whereas high flagellar (H) antibody indicates enteric fever. But Widal test lacks specificity mostly in developing countries which may be due to cross-reaction with other pathogens. Now, this method has been replaced by the ELISA technique which is more specific and sensitive.

• #2 Salmonella: Properties, Disease, Lab Diagnosis • Microbe Online

  https://microbeonline.com/salmonella-disease-properties-pathogenesis-and-laboratory-diagnosis/

  The optimum ratio of the volume of blood to traditional culture broth is 1:10 (e.g. 5 ml blood in 45 ml broth). […] Check the inoculated culture bottles for turbidity, gas formation, and other evidence of growth after 1, 2, 3, and 7 days. […] For days 1, 2, and 3, only bottles showing signs of positive growth are cultured on agar plates (commonly used media for subculturing are Blood Agar, Chocolate Agar, and MacConkey Agar). […] Subculture plates should be incubated at 37C for 18-24 hours in an aerobic incubator. If growth is observed in the culture plates, colony morphology should be noted and biochemical tests performed to identify the isolate. […] Isolated Salmonellae can be characterized by detecting the presence of their somatic (O) and flagellar (H) antigens using a specific antiserum. Specific O antigen for S.typhi is O9, O2 for S.paratyphi A, O4 for S.paratyphi B, and O6/7 for S.paratyphi C. […] This test has only moderate sensitivity and specificity. It can be negative in up to 30% of culture-proven cases of typhoid fever. Widal test measures agglutinating antibody levels against O and H antigens.

• #2 Diagnostics for invasive Salmonella infections: current challenges and future directions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4469564/

  Several serologic tests have been developed for point-of-care diagnosis of enteric fever. The two that have been most widely studied are TUBEX TF and Typhidot. […] A number of studies have assessed the yield of nucleic acid amplification tests for enteric fever diagnosis; flagellin genes have been most commonly targeted, but an array of alternative PCR gene targets have been assessed. […] For culture-based and molecular diagnostics, similar challenges present with typhoidal Salmonella – low bacterial burden in blood may confound sensitive diagnosis of iNTS. […] In contrast with typhoidal Salmonella, there is more limited experience with serologic assays for iNTS. […] All of the currently available diagnostic approaches for invasive Salmonellosis have limitations in terms of speed, sensitivity, infrastructure requirements, and suitability to point-of-care application. […] A number of promising approaches are under development, which may address many of the limitations of the existing diagnostics.

• #2 Salmonella: Infection, Symptoms, Causes, Treatment & Prevention

  https://www.metropolisindia.com/blog/health-wellness/salmonella-symptoms-diagnosis-treatment-prevention

  Salmonella infection can be contracted through the following agents: […] Early diagnosis can help prevent and control the spread of this infection. […] For diagnosis of typhoid fever blood culture and serological tests, detecting antibodies, are usually done. Blood culture is considered the gold standard. […] Serological tests including Widal test and Typhidot test (IgM antibody detection) are used in diagnosis of typhoid. […] A PCR test to detect DNA of salmonella is also available. This is the most sensitive out of all the tests. […] For diagnosis of salmonellosis a stool culture test is done. […] Salmonella infections are generally curable if diagnosed in a timely manner and appropriate treatment is given.

• #2 Diagnosis and Treatment | General Information | Salmonella | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/salmonella/general/diagnosis.html

  New methods for diagnosis. CDC is also working to adapt its processes to important changes in how Salmonella is diagnosed in patients. Until recently, culture (laboratory procedures to grow living Salmonella from patient specimens) was the diagnostic standard and the cornerstone of public health surveillance. […] The Food and Drug Administration (FDA) has recently approved new culture independent diagnostic testing (CIDT) methods for diagnosing Salmonella infections, but they are not widely used yet. These new methods do not depend on culturing the specimen, so they do not yield an isolate for serotyping or PFGE.

• #2 Typhoid fever – Wikipedia

  https://en.wikipedia.org/wiki/Typhoid_fever

  Diagnosis is performed by culturing and identifying S. Typhi from patient samples or detecting an immune response to the pathogen from blood samples. […] Recently, new advances in large-scale data collection and analysis have allowed researchers to develop better diagnostics, such as detecting changing abundances of small molecules in the blood that may specifically indicate typhoid fever. […] Diagnostic tools in regions where typhoid is most prevalent are quite limited in their accuracy and specificity, and the time required for a proper diagnosis, the increasing spread of antibiotic resistance, and the cost of testing are also hardships for under-resourced healthcare systems. […] Diagnosis is made by any blood, bone marrow, or stool cultures and with the Widal test (demonstration of antibodies against Salmonella antigens O-somatic and H-flagellar).

• #2 UNLOCKING TYPHOID DIAGNOSIS: COMPARING WIDAL, SALMONELLA RAPID TEST, AND TUBEX TESTS | Isotekindo

  https://www.isotekindo.co.id/article/details/387

  The Salmonella Rapid Test is a rapid testing tool designed to detect Salmonella typhi antigens directly from a patients blood. This method provides results in a short time, usually between 15 and 30 minutes, making it a suitable option for the early detection of typhoid fever. […] The primary advantage of the Salmonella Rapid Test is its ability to deliver faster results compared to the Widal test. Additionally, this method is more specific because it directly detects antigens, which reduces the likelihood of false-positive results. […] The Tubex test is a diagnostic assay that detects specific IgM antibodies against the O9 antigen of Salmonella typhi using the principle of magnetic agglutination inhibition. This method is designed to provide higher sensitivity and specificity compared to the Widal test and the Salmonella Rapid Test.

• #2 Salmonella Infection (Salmonellosis) Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/228174-workup

  Numerous polymerase chain reaction (PCR) based multiplex GI pathogen identification panels have been marketed for use with primary stool specimens. These panels allow rapid identification of Salmonella, Shigella, and Yersinia from primary stool specimens and offer substantially improved turnaround time for primary laboratory diagnosis compared with culture-based methods. Recovery of isolates from culture still is required for taxonomic classification and susceptibility testing. […] Serological tests used in the diagnosis of enteric fever yield limited sensitivity and specificity. The Widal test is used to measure antibodies against O and H antigens of S typhi. Newer diagnostic tests (Typhidot, Tubex) allow direct detection of immunoglobulin M (IgM) antibodies against specific S typhi antigens. These tests are promising but need further evaluation in large community settings. […] Nested PCR using H1-d primers has been used to amplify specific genes of S typhi, with high sensitivity and specificity. This may eventually replace blood culture as the criterion standard.

• #2 Salmonella enterocolitis: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000294.htm

  Salmonella infection is one of the most common types of food poisoning. It occurs when you eat food or drink water that contains Salmonella bacteria. […] Tests that may be done include: […] Stool culture for Salmonella. […] Your health care provider will perform a physical exam. You may have a tender abdomen and develop tiny pink spots, called rose spots, on your skin. […] People who have been treated for Salmonella may continue to shed the bacteria in their stool for months to a year after the infection. Food handlers who carry Salmonella in their body can pass the infection to the people who eat the food they have handled.

• #2 Laboratory diagnosis of salmonella | PPT

  https://www.slideshare.net/slideshow/laboratory-diagnosis-of-salmonella/47466314

  5. Probable case of typhoid fever is a patient with fever ( 38C) that has lasted for 3 days, with a positive serodiagnosis or antigen detection test but without S.Typhi isolation. […] 6. Chronic carrier is determined as excretion of S.Typhi in stools or urine for longer than one year after the onset of acute typhoid fever. […] […] […] 7. Ideal specimen First week Blood (culture) Second week Serum (Antibodies) Third week Stool Fourth week Urine […] 8. Chance of isolation Specimens First week Third week Blood 50 to 80% 30% Feces 40 to 50% 80% Urine – 25% […] […] […] 9. Blood culture Volume of blood : 10 to 15 ml from adults and adolescents , 2 to 4 ml in children Ratio of blood to bile broth: 1:10 Or add saponin to BHI broth with 0.05% SPS Inoculate the blood immediately Transport immediately, never store under 15degC Incubate as soon as possible

• #2 Salmonellosis

  https://www.health.vic.gov.au/infectious-diseases/salmonellosis

  Salmonellosis is a routine notifiable condition and must be notified by medical practitioners and pathology services in writing within 5 days of diagnosis. […] Infection is diagnosed by isolation of Salmonella spp. from faeces, blood or other clinical specimens. […] Salmonella infection occurs worldwide, and only a small proportion of cases are detected and reported. […] Approximately 2,000 cases of salmonellosis are reported in Victoria each year. […] The emergence of strains resistant to single or multiple antibiotics is of increasing concern worldwide. […] Treatment is supportive, and antibiotics are not indicated in uncomplicated gastroenteritis because they may prolong the carrier state and promote antibiotic resistance. […] For systemic disease, the choice of antibiotic should be based on the antibiograms of the relevant serovar and local antibiotic guidelines.

• #2 Rapid diagnostic testing for salmonella in clinical practice (Proceedings)

  https://www.dvm360.com/view/rapid-diagnostic-testing-salmonella-clinical-practice-proceedings

  Salmonella enterica is commonly associated with epidemic disease in veterinary hospitals and on-farm environmental contamination. […] Unfortunately, testing techniques for the detection of Salmonella in fecal and environmental samples is variable among laboratories and current testing methodology generally lacks in sensitivity. […] Consequently, testing strategies generally test multiple samples, use lengthy enrichment steps, and may take 3-5 days to obtain results. […] The reliability of bacterial culture for S. enterica detection can be affected by the type of sample (feces, swab, or rectal biopsy), heterogeneity of target organism in the sample, sample weight, intermittent shedding, bacterial culture method, and laboratory proficiency. […] This is likely due to intermittent shedding of relatively few organisms per gram of feces, as well as the heterogeneous distribution of organisms within fecal samples.

• #2 For health professionals: Salmonellosis (Salmonella) – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/salmonellosis-salmonella/health-professionals.html

  Confirm diagnosis by: […] isolation or culture identification from stool or blood […] serotyping to identify the serotype. […] Salmonella can also be detected through a culture-independent diagnostic test (CIDT). To identify the serotype of Salmonella detected through a CIDT, a follow-up (reflex) culture is needed. […] If non-typhoidal Salmonella bacteremia is suspected, blood cultures should be collected and sent to a laboratory for testing. Serology doesn’t provide adequate information for diagnosis of infection. […] To identify asymptomatic infections, fecal material should be inoculated into an appropriate enrichment medium. Specimen collection should be carried out over several days, as excretion of Salmonella organisms may be intermittent. […] If Salmonella is identified by a CIDT, request a follow-up (reflex) culture for antimicrobial susceptibility testing.

• #2 Salmonella Infection, Prevention, and Control | Pioneering Diagnostics

  https://www.biomerieux.com/us/en/education/resource-hub/scientific-library/food-safety-library/salmonella-scientific-library.html

  EU and US regulations specifically require that food business operators perform microbiological testing as appropriate when they are validating and verifying the effectiveness of their HACCP and GHP -based control systems (EU 852/2004; FDA, 2011). […] Different microbiological methods either traditional or molecular (PCR or Whole Genome sequencing) for the detection of Salmonellaspp and/or serotyping ofSalmonella EnteritidisorTyphimurium have been described, notably: […] bioMrieux provides the food safety managers with proven standardized or validated methods for the management of Salmonellaspp. orS. Enteritidis S. Typhimurium along the Food Chain.

• #2 Salmonellosis: An Overview of Epidemiology, Pathogenesis, and Innovative Approaches to Mitigate the Antimicrobial Resistant Infections

  https://www.mdpi.com/2079-6382/13/1/76

  Salmonella is a major foodborne pathogen and a leading cause of gastroenteritis in humans and animals. Salmonella is highly pathogenic and encompasses more than 2600 characterized serovars. The transmission of Salmonella to humans occurs through the farm-to-fork continuum and is commonly linked to the consumption of animal-derived food products. Among these sources, poultry and poultry products are primary contributors, followed by beef, pork, fish, and non-animal-derived food such as fruits and vegetables. While antibiotics constitute the primary treatment for salmonellosis, the emergence of antibiotic resistance and the rise of multidrug-resistant (MDR) Salmonella strains have highlighted the urgency of developing antibiotic alternatives. Effective infection management necessitates a comprehensive understanding of the pathogen’s epidemiology and transmission dynamics. Therefore, this comprehensive review focuses on the epidemiology, sources of infection, risk factors, transmission dynamics, and the host range of Salmonella serotypes. This review also investigates the disease characteristics observed in both humans and animals, antibiotic resistance, pathogenesis, and potential strategies for treatment and control of salmonellosis, emphasizing the most recent antibiotic-alternative approaches for infection control.

• #2 Salmonellosis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/817

  Salmonellosis is a very common cause of gastroenteritis in the developed world and invasive disease in the developing world. […] Diagnosis relies on isolation of the organism from stool cultures or by detection of pathogen-specific nucleic acid. […] Key diagnostic factors include nausea/vomiting, diarrhea, and fever. […] 1st tests to order include stool studies. […] Tests to consider include blood cultures and imaging studies.

• #2 How is Salmonella Infection Diagnosed? | Marler Clark

  https://marlerclark.com/foodborne-illnesses/salmonella/salmonella-diagnosis

  Culturing of organisms such as Salmonella has been the mainstay of diagnostic testing conducted at clinical laboratories. Isolates obtained from culture are forwarded from clinical laboratories to public health laboratories, where additional testing is performed, including serotyping, antimicrobial susceptibility, and genetic testing. Results of these additional tests allow epidemiologists to monitor trends and detect outbreaks. […] Increasingly, hospitals and clinical laboratories are using culture-independent diagnostic tests (CIDTs) rather than culture-based testing to detect enteric pathogens such as Salmonella. Commonly used CIDT testing methods include testing by polymerase chain reaction (PCR) and enzyme immunoassay (EIA) testing. CIDTs have a rapid turnaround time, can detect multiple pathogens in one test, and cost less than traditional testing procedures such as culture, which often require specialized media and years of training. Clinicians are thus able to identify and provide appropriate treatment in a shorter amount of time.

• #2 UNLOCKING TYPHOID DIAGNOSIS: COMPARING WIDAL, SALMONELLA RAPID TEST, AND TUBEX TESTS | Isotekindo

  https://www.isotekindo.co.id/article/details/387

  The selection of the appropriate diagnostic method should take into account several factors, including patient condition, severity of the infection, and availability of resources. […] In practice, a combination of testing methods may be applied to enhance diagnostic accuracy and ensure appropriate treatment for patients with typhoid fever.

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