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Quantitative Bacteriology of the Typhoid Carrier State^*

John G. Merselis, Jr., Donald Kaye, C. Stephen Connolly AND Edward W. Hook

Thirteen chronic stool carriers of Salmonella typhosa were studied to determine the number of typhoid bacilli in stool, gastric juice, and duodenal aspirate before and after intravenous injection of Pancreozymin®. The number of salmonella excreted ranged from 10⁶ to 10¹⁰ per gram of feces in 42 of 46 specimens from the 13 patients, and only 1 sample was negative for S. typhosa. S. typhosa was recovered from the pre-pancreozymin duodenal aspirates of only 6 of the 13 patients. However, after administration of pancreozymin, S. typhosa in titers of 10⁴ to 10⁸ per ml was recovered from the duodenal aspirate of every patient. In 12 of the 13 patients the number of salmonella in the post-pancreozymin specimen exceeded by at least 10-fold the number in the pre-pancreozymin specimen.

The present studies show that chronic typhoid carriers regularly excrete large numbers of S. typhosa in stool. The evidence strongly suggests that the biliary tract is the primary site of multiplication in those patients.

^* Presented in part at the annual meeting of the American Society for Clinical Investigation, April 28, 1963, Atlantic City, New Jersey. This work was supported by grants from the Health Research Council of New York City (grant U-1107), Bristol Laboratories, the U.S. Public Health Service (grant H-2479), and by FR-47, Division of General Medical Sciences, National Institutes of Health.

This investigation was carried out during the tenure of a post-doctoral fellowship from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, USPHS.

This investigation was carried out during the tenure of a special fellowship from the National Cancer Institute, National Institutes of Health, USPHS.