Volume 76, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


A nested polymerase chain reaction (PCR) specific for 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 ( < 0.001) and urine ( = 0.01) were significantly higher, and the sensitivity of the PCR with feces ( > 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.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Velema JP, van Wijnen G, Bult P, Jota S, 1997. Typhoid fever in Ujung Pandang, Indonesia—high risk groups and high risk behaviours. Trop Med Int Health 11 : 1088–1094. [Google Scholar]
  2. Birkhead GS, Morse Levine WC, Fudala JK, Kondracki SF, Chang HG, Shayegani M, Novick L, Blake PA, 1993. Typhoid fever at a resort hotel in New York: a large outbreak with an unusual vehicle. J Infect Dis 167 : 1228–1232. [Google Scholar]
  3. Grunen E, Flepp M, Gabathuler U, 1997. Outbreak of typhoid fever in a non-endemic area: comparison of three molecular typing methods. J Microbiol Methods 28 : 179–185. [Google Scholar]
  4. Luxemburger C, Chau MC, Mai NL, Wain J, Tran TH, Simpson JA, Le HK, Nguyen TT, White NJ, Farrar JJ, 2001. Risk factors for typhoid fever in the Mekong delta, southern Vietnam: a case-control study. Trans R Soc Trop Med Hyg 95 : 19–23. [Google Scholar]
  5. Tran HH, Bjune G, Nguyen BM, Rottingen JA, Grais RF, Guerin PJ, 2005. Risk factors associated with typhoid fever in Son La province, northern Vietnam. Trans R Soc Trop Med Hyg 99 : 819–826. [Google Scholar]
  6. Black RE, Cisneros L, Levine MM, 1985. Case-control study to identify risk factors for paediatric endemic typhoid fever in Santiago, Chile. Bull World Health Organ 63 : 899–904. [Google Scholar]
  7. Luby SP, Faizan MK, Fisher-Hoch SP, Syed A, Mintz ED, Bhutta ZA, McCormick JB, 1998. Risk factors for typhoid fever in an endemic setting, Karachi, Pakistan. Epidemiol Infect 120 : 129–138. [Google Scholar]
  8. Gasem MH, Dolmans WM, Keuter MM, Djokomoeljanto RR, 2001. Poor food hygiene and housing as risk factors for typhoid fever in Semarang, Indonesia. Trop Med Int Health 6 : 484–490. [Google Scholar]
  9. Vollaard AM, Ali S, van Asten HA, Widjaja S, Visser LG, Surjadi C, van Dissel JT, 2004. Risk factors for typhoid and paratyphoid fever in Jakarta, Indonesia. JAMA 29 : 2607–2615. [Google Scholar]
  10. Hosoglu S, Celen MK, Geyik MF, Akalin S, Ayaz C, Acemoglu H, Loeb M, 2006. Risk factors for typhoid fever among adult patients in Diyarbakir, Turkey. Epidemiol Infect 134 : 612–616. [Google Scholar]
  11. Lai CW, Chan RC, Cheng AF, Sung JY, Leung JW, 1992. Common bile duct stones: a cause of chronic salmonellosis. Am J Gastroenterol 87 : 1198–1199. [Google Scholar]
  12. Dutta U, Garg PK, Kumar R, Tandon RK, 2000. Typhoid carriers among patients with gallstones are at increased risk for carcinoma of the gallbladder. Am J Gastroenterol 95 : 784–787. [Google Scholar]
  13. Zavala Trujillo I, Quiroz C, Gutierrez MA, Arias J, Renteria M, 1991. Fluoroquinolones in the treatment of typhoid fever and the carrier state. Eur J Clin Microbiol Infect Dis 10 : 334–341. [Google Scholar]
  14. Boom R, Sol CJ, Salimans MM, Jansen CL, Wertheimvan Dillen PM, van der Noordaa J, 1990. Rapid and simple method for purification of nucleic acids. J Clin Microbiol 29 : 496–503. [Google Scholar]
  15. Boom R, Sol C, Weel J, Lettinga K, Gerrits Y, van Breda A, Wertheimvan Dillen P, 2001. Detection and quantitation of human cytomegalovirus DNA in faeces. J Virol Methods 84 : 1–14. [Google Scholar]
  16. Song JH, Cho H, Park MY, Na DS, Moon HB, Pai CH, 1993. Detection of Salmonella typhi in the blood of patients with typhoid fever by polymerase chain reaction. J Clin Microbiol 31 : 1439–1443. [Google Scholar]
  17. Cruickshank R, 1968. Medical Microbiology: A Guide to the Laboratory Diagnosis and Control of Infection, Edinburgh: E & S Livingstone Ltd.
  18. Frankel G, Newton SM, Schoolnik GK, Stocker BA, 1989. Unique sequences in the region VI of the flagellin gene of Salmonella typhi. Mol Microbiol 13 : 1379–1383. [Google Scholar]
  19. Haque A, Ahmed N, Peerzada A, Raza A, Bashir S, Abbas G, 2001. Utility of PCR in diagnosis of problematic cases of typhoid. Jap J Infect Dis 54 : 237–239. [Google Scholar]
  20. Prakash P, Mishra OP, Singh AK, Gulati AK, Nath G, 2005. Evaluation of nested PCR in diagnosis of typhoid fever. J Clin Microbiol 43 : 431–432. [Google Scholar]
  21. Massi MN, Shirakawa T, Gotoh A, Bishnu A, Hatta M, Kawabata M, 2003. Rapid diagnosis of typhoid fever by PCR assay using one pair of primers from flagellin gene of Salmonella typhi. J Infect Chemother 9 : 233–237. [Google Scholar]
  22. Kumar A, Arora V, Bashamboo A, Ali S, 2002. Detection of Salmonella typhi by polymerase chain reaction: implications in diagnosis of typhoid fever. Infect Genet Evol 2 : 107–110. [Google Scholar]
  23. Chaudhry R, Laxmi BV, Nisar N, Ray K, Kumar D, 1997. Standardisation of polymerase chain reaction for the detection of Salmonella typhi in typhoid fever. J Clin Pathol 50 : 437–439. [Google Scholar]
  24. Wain J, Diep TS, Ho VA, Walsh AM, Nguyen TT, Parry CM, White NJ, 1998. Quantitation of bacteria in blood of typhoid fever patients and relationship between counts and clinical features, transmissibility, and antibiotic resistance. J Clin Microbiol 36 : 1683–1687. [Google Scholar]
  25. Coleman W, Buxton BH, 1907. The bacteriology of the blood in typhoid fever: an analysis of 1602 cases. Am J Med Sci 133 : 896–903. [Google Scholar]
  26. Wain J, Pham VB, Ha V, Nguyen NM, To SD, Walsh AL, Parry CM, Hasserjian RP, Ho VA, Tran TH, Farrar J, White NJ, Day NP, 2001. Quantitation of bacteria in bone marrow from patients with typhoid fever: relationship between counts and clinical features. J Clin Microbiol 39 : 1571–1576. [Google Scholar]
  27. Chaicumpa W, Ruangkunaporn Y, Burr D, Chongsa-Nguan M, Echeverria P, 1992. Diagnosis of typhoid fever by detection of Salmonella typhi antigen in urine. J Clin Microbiol 30 : 2513–2515. [Google Scholar]
  28. Itah AY, Uweh EE, 2005. Bacteria isolated from blood, stool and urine of typhoid patients in a developing country. Southeast Asian J Trop Med Public Health 36 : 673–677. [Google Scholar]
  29. Hatta M, Goris MDA, Heerkens E, Smits HL, 2002. Simple dip-stick assay for the detection of Salmonellla typhi-specific immunoglobulin M antibodies and the evolution of the immune response in patients with typhoid fever. Am J Trop Med Hyg 66 : 416–421. [Google Scholar]
  30. House D, Wain J, Ho VA, Diep TS, Chinh NT, Bay PV, Vinh H, Duc M, Parry CM, Dougan G, White NJ, Hien TT, Farrar JJ, 2001. Serology of typhoid fever in an area of endemicity and its relevance to diagnosis. J Clin Microbiol 39 : 1002–1007. [Google Scholar]
  31. House D, Chinh NT, Diep TS, Parry CM, Wain J, Dougan G, White NJ, Hien TT, Farrar JJ, 2005. Use of paired serum samples for serodiagnosis of typhoid fever. J Clin Microbiol 43 : 4889–4890. [Google Scholar]
  32. Gasem MH, Dolmans WM, Isbandrio BB, Wahyono H, Keuter M, Djokomoeljanto R, 1995. Culture of Salmonella typhi and Salmonella paratyphi from blood and bone marrow in suspected typhoid fever. Trop Geogr Med 47 : 164–167. [Google Scholar]
  33. Akoh JA, 1991. Relative sensitivity of blood and bone marrow cultures in typhoid fever. Trop Doct 21 : 174–176. [Google Scholar]

Data & Media loading...


  • Received : 10 Jul 2006
  • Accepted : 27 Sep 2006

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error