Role of Gallstones in Typhoid Carriage in Egyptian Patients

Year 2012, Volume: 2 Issue: 04, 142 - 149, 01.12.2012

Marwa Abdelazim Mansour Tarik Zaher Amany Ibrahim Amira Ahmed Islam Ibrahim Ashraf Goda Nehad Ahmed

https://doi.org/10.5799/jmid.123127

Abstract

Keywords

-

Role of Gallstones in Typhoid Carriage in Egyptian Patients

Abstract

Objectives: Salmonella typhi forms biofilm on the surface of gallstones promoting colonization and carrier state. The aims are to detect its frequency in chronic calcular cholecystitis patients, to find out their antibiotic resistance pattern, and also to examine biofilm on the surface of gallstones and detect its correlation to antibiotic susceptibility pattern. Materials and methods: The study group included 257 patients with chronic calcular cholecystitis. S. typhi was isolated from gall bladder specimens. Antibiotics susceptibility tests of the isolates were done. Biofilm on surface of gallstones were visualized using scanning electron microscopy. Virulence (Vi) antibodies against S. typhi were studied in sera of 257 healthy controls. Results: 10.9% of patients were chronic typhoid carriers compared to only 3.5% of the controls (OR= 3.37, p=0.002). Multidrug resistance was detected in 35.7% of isolates. S. typhi biofilms on the surface of the 21/28 (75%) gallstones were detected. Ninety percent of the strains that produced maximum amount of biofilm were multidrug-resistant. Conclusion: Chronic calcular cholecystitis patients are more prone to typhoid carriage due to biofilm formation of S. typhi on the surface of gallstones.

Keywords

Gallstones, thyphoid carriage

References

• Hatta M, Smits H. Detection of Salmonella typhi by nested polymerase chain reaction in blood, urine and stool samples. Am J Trop Med Hyg 2007; 76:139-143.
• Zhou L, Pollard A. A fast and highly sensitive blood culture PCR method for clinical detection of Salmonella enterica se- rovar typhi. Ann Clin Microbiol Antimicrob 2010; 9:14.
• Ghenghesh KS, Franka E, Tawil K, et al. Enteric fever in Medi- terranean North Africa. J Infect Dev Ctries 2009; 3:753-761.
• Levine MM, Black RE, Lanata C, Chilean Typhoid committee. Precise estimation of the numbers of chronic carriers of Sal- monella typhi in Santiago, Chile, an endemic area. J Infect
• Lai CW, Chan RC, Cheng AF, Sung JY, Leung JW. Common bile duct stones: A cause of chronic salmonellosis. Am J Gastroenterol 1992; 87:1198-1199.
• Sharma V, Chauhan VS, Nath G, Kumar A, Shukla VK. Role of bile bacteria in gallbladder carcinoma. Hepatogastroenterol- ogy 2007;54 :1622-1625.
• Vaishnavi C, Kochar R, Singh G, Kumar S, Singh S, Singh K. Epidemiology of typhoid carriers among blood donors and patients with biliary, gastrointestinal and other related dis- eases. Microbiol Immunol 2005; 49: 107-112.
• Shukla VK, Singh H, Pandey M, Upadhyay SK, Nath G. Carci- noma of the gallbladder is it a sequel of typhoid? Dig Dis Sci 2000; 45:900-903.
• Elwood D. Cholecystitis. Surg Clin North Am 2008; 88:1241- 1252.
• Monds RD, O’Toole GA. The developmental model of micro- bial biofilms: ten years of a paradigm up for review. Trends Microbiol 2009; 17:73-87.
• Maurer KJ, Carey MC, Fox JG. Roles of infection, inflamma- tion, and the immune system in cholesterol gallstone forma- tion. Gastroenterology 2009; 136:425-440.
• Prouty AM, Schwesinger WH, Gunn JS. Biofilm formation and interaction with the surfaces of gallstones by Salmonella spp. Infect Immun 2002; 70:2640-2649.
• Crawford W, Gibson DL, Kay WW, Gunn, JS. Identification of a bile-induced exopolysaccharide required for Salmonella biofilm formation on gallstone surfaces. Infect Immun 2008; 76:5341-5349.
• Papavasileiou K, Papavasileiou E, Tseleni-Kotsovili A, et al. Comparative antimicrobial susceptibility of biofilm versus planktonic forms of Salmonella enterica strains isolated from children with gastroenteritis. Eur J Clin Microbiol Infect Dis 2010;29:1401-1405.
• Nath G, Singh YK, Maurya P, Gulati AK, Srivastava RC, Tripathi SK. Does Salmonella typhi primarily reside in the liver of chronic typhoid carriers? J Infect Dev Ctries 2010; 4: 259-261.
• Paecock JL, Paecock PJ. Oxford handbook of medical statis- tics. Oxford University Press 2011.
• Montasser M, El-Sayed MK. Chronic salmonellosis in cases of chronic cholecystitis subjected to cholecystectomy. Sci Med J Cai Med Synd 1990; 2:17-25.
• Eslami G, Nowruzi J, Fllah F, et al. Detection of bacteria re- sponsible for gallbladder inflammation and gallstones. Ira- nian J Clin Infect Dis 2007; 2:139-141.
• Forbes B, Sahm D and Weissfeld J. Overview of bacterial identification, methods and strategies. In: Baily and Scott’s Diagnostic Microbiology. Belly A and Forbes B (eds). 12th ed. Mosby, New York; 2007:221-245.
• Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. Document M100-S18, Wayne, PA19087 USA, 2008.
• Srikantiah P, Girgis FY, Luby SP, et al. Population-based sur- veillance of typhoid fever in Egypt. Am J Trop Med Hyg 2006; 74:114-119.
• Song JH, Cho H, Park MY, et al. Detection of Salmonella ty- phi in the blood of patients with typhoid fever by polymerase chain reaction. J Clin Microbiol 1993; 31:1439-1443.
• Frankel G, Newton SM, Schoolnik GK, Stocker BA. Unique sequences in the region VI of the flagellin gene of Salmo- nella typhi. Mol Microbiol 1989; 13:1379-1383.
• Crawford RW, Rosales-Reyes R, Ramírez-Aguilar M et al. Gallstones play a significant role in Salmonella spp. gallblad- der colonization and carriage. Proc Natl Acad Sci USA 2010; 107:4353-4358.
• Vaishnavi C, Singh S, Kochhar R, Bhasin D, Singh G, Singh K. Prevalence of Salmonella enterica serover typhi in bile and stool of patients with biliary diseases and those requir- ing biliary drainage for other purposes. Jpn J Infect Dis 2005; 58:363-365.
• Al-Sulaimaini SH, Alam MK, Sangupta H, et al. Incidence of cholelithiasis in patients attending King Abdul Aziz University Hospital. Saudi Med J 1986; 7:261-265.
• Bell GD. Gallstones. Medical Education International Ltd. P. 1982:694-699.
• Nath G, Maurya P, Gulati AK, et al. Comparison of Vi serol- ogy and nested PCR in diagnosis of chronic typhoid carriers in two different study populations in typhoid endemic area of India. Southeast Asian J Trop Med Public Health 2010; 41:636-640.
• Prakash P, Mishra OP, Singh AK. Evaluation of nested PCR in diagnosis of typhoid fever. J Clin Microbiol 2005; 43: 431- 432.
• Safaeian M, Gao Y, Sakoda L, et al. Chronic typhoid infection and the risk of biliary tract cancer and stones in Shanghai, China. Infect Agent Cancer 2011; 6:6.
• Mirza SH, Hart CA. Plasmid encoded multi drug resistance in Salmonella typhi from Pakistan. Ann Trop Med Parasitol 1993; 87:373-377.
• Senthilkumar B, Prabakaran G. Multidrug resistant Salmo- nella typhi in asymptomatic typhoid carriers among food handlers in Namakkal District, Tamil Nadu. Indian J Med Mi- crobiol 2005; 23:92-94.
• Whichard JM, Kathryn G, Stevenson JE, et al. Human Sal- monella and concurrent decreased susceptibility to quino- lones and extended-spectrum cephalosporins. Emerg Infect
• Bhattacharya SS, Das U, Choudhury BK. Occurrence & an- tibiogram of Salmonella typhi & S. paratyphi A isolated from Rourkela, Orissa. Indian J Med Res 2011; 133: 431-433.
• Raza A, Haque A, Khurshid S, et al. In vitro relationship be- tween differing levels of virulence and antibiotic resistance in Salmonella typhi. Int J Agri Biol 2003; 5:566-570.