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1.
目的为了探讨伤寒沙门菌spaO基因的关系。方法取本地区伤寒沙门菌流行株5株,副伤寒沙门菌流行株1株,进行了侵袭相关基因(spaO)的PCR产物序列测定,利用NCBI\BLASTn进行DNA序列同源性比较。结果菌株2、5、6、10、11的spaO序列一致,与1995年浙江省伤寒菌株中发现spaO6序列相同,菌株14是我国甲型副伤寒菌株中的类型之一。结论显示本地区伤寒菌株基因变异度较大,存在着多个不同亲缘关系克隆系,应加强分子流行病学基础研究,才能有效控制传染病流行。  相似文献   

2.
目的了解沙门菌在本地区流行的主要血清型和耐药性。方法对临床分离的沙门菌84株进行生化鉴定、血清分型和耐药分析。结果84株沙门菌中,甲型副伤寒沙门菌45株,占53.6%;乙型副伤寒沙门菌4株,占4.7%;丙型副伤寒沙门菌4株,占4.7%;伤寒沙门菌14株,占16.7%;非伤寒沙门菌17株,占20.3%。沙门菌对环丙沙星、左旋氧氟沙星、哌拉西林/他唑巴达、亚胺培南无耐药株。对氨苄西林、复方新诺明、头孢三代均有不同程度的耐药。结论本地区沙门菌感染以甲型副伤寒沙门菌为主。沙门菌对抗生素耐药性有不同程度增加,临床应依药敏用药。  相似文献   

3.
甲型副伤寒沙门菌质粒DNA图谱与耐药性的关系   总被引:1,自引:0,他引:1  
目的 分析甲型副伤寒沙门菌的质粒DNA图谱及其与细菌对药物敏感性的相关性。方法 检测150株获自患者血清标本的甲型副伤寒沙门菌的药物敏感性和分离其质粒DNA进行图谱分析。结果 根据指纹图谱特征可将150株甲型副伤寒沙门菌分为4种指纹图谱类型。其中81.3%菌株具有分子量为3000bp和20000bp的两个质粒,各菌株对菌必治,庆大霉素,氯霉素,环丙沙星,氨苄青霉素,氟哌酸的耐药率分别为8%-81%,但与质粒DNA图谱无明显的相关性。结论 150株甲型副伤寒沙门菌包括4个质粒DNA图谱类型81.3%的菌株具有同源性。在所分离的菌株中以基因Ⅲ型为优势菌株,且对氟哌酸,氨苄青霉素具有较高的耐药性,是引起我市近年甲型副伤寒流行的主要菌株。  相似文献   

4.
应用两对特异性引物同时检测四环素耐药基因tetB和tetC通过对35株沙门菌分离株的四环素耐药性检测,表明所有沙门菌分离株均含tetC基因,与药敏试验结果阳性符合率65.7%,8株同时含有tetB基因,与药敏试验结果阳性符合率100%,tetB基因和tetC基因双阳性的菌株与药敏试验结果阳性符合率也为100%。取其中部分菌株扩增出tetB和tetC基因片段进行序列分析,5株菌的tetB基因扩增产物序列完全相同,与质粒pRT11相应序列同源性达99.7%;14株菌的tetC基因扩增产物与质粒pBR322中的相应序列同源性为100%。证实沙门菌耐药基因普遍存在,且同时含有tetB和tetC基因的菌株表现耐药。多重PCR技术同时检测两种四环素耐药基因,适合大量样本的检测,对开展沙门菌四环素多种耐药基因的分子流行病学监测提供了有效途径。  相似文献   

5.
目的 了解2013至2015年广州地区腹泻患儿非伤寒沙门菌感染的流行病学特征和耐药情况.方法 对2013至2015广东省妇幼保健院门诊及住院的腹泻患儿的粪便标本进行沙门菌培养和血清学分型,采用VITEK-2 Compact进行药物敏感性试验.结果 296株非伤寒沙门菌可分为33种血清型,其中鼠伤寒沙门菌171株(占57.43%),斯坦利沙门菌29株(占9.80%),肠炎沙门菌18株(占6.08%).患儿男女性别比约为1.51∶1(178/118),<1岁的患儿占84.45%,每年的7~ 10月为发病高峰.296株沙门菌除了对碳青霉烯类、左氧氟沙星和三代头孢耐药率较低外,对一、二代头孢、庆大霉素、妥布霉素和复方磺胺甲恶唑耐药较为严重.鼠伤寒沙门菌对三代头孢的耐药率呈现逐年上升的趋势.结论 广州地区儿童非伤寒沙门菌感染性腹泻以<1岁的婴幼儿居多,夏秋季节高发.鼠伤寒沙门菌是本地区最主要的菌型,也是耐药最严重的血清型.临床应根据药敏试验结果合理选用抗生素.  相似文献   

6.
伤寒沙门菌主动外排多重耐药基因acrB与表达水平研究   总被引:6,自引:1,他引:6  
目的调查临床分离伤寒沙门菌对常用抗生素的耐药情况与多重耐药主动外排基因acrB的检测、序列分析及其表达水平。方法根据NCCLS推荐的琼脂二倍稀释法测定7种抗生素对伤寒沙门菌的抗菌活性,以基因库序列为参考设计引物PCR扩增acrB、测序并用RT—PCR方法检测其表达水平。结果32株伤寒沙门菌对氧氟沙星、环丙沙星、头孢噻肟、哌拉西林、氯霉素、四环素、庆大霉素的耐药率分别为0、0、0、28.13%、43.75%、40.63%和12.5%,其中多重耐药菌10株。所有细菌均检测到多重耐药外排基因acrB.测序显示与参考沙门菌序列(No.AL627267)比较,有2处碱基变异。与大肠埃希菌(No.ECU00734)比较,碱基同源性为85.51%(61/421),提示其碱基序列同源性极高。对不同种类抗生素耐药及不耐药部分伤寒沙门菌共16株进行一步法RT—PCR检测acrB表达水平,结果所测伤寒沙门菌均检测到多重耐药外排基因acrB的表达,多重耐药株主动外排的表达较其它菌株明显增强。结论伤寒沙门菌对喹诺酮类、第三代头孢菌素类耐药率低,对哌拉西林、氯霉素、四环素耐药率相对较高,且有多重耐药。伤寒沙门菌中均存在acrAB主动外排系统,acrB与大肠埃希菌同源性高,对不同结构抗生素耐药的种类越多,表达水平越高。主动外排机制可能是伤寒沙门菌多重耐药的主要原因之一。  相似文献   

7.
昆明地区甲型副伤寒沙门菌的耐药性分析   总被引:3,自引:0,他引:3  
目的了解昆明地区甲型副伤寒沙门菌对几种临床常用抗菌药物的耐药现状,分析萘啶酸用于测试肠道外沙门菌感染分离株对氟喹诺酮敏感性减低的临床意义,为临床合理使用抗菌药物提供依据。方法从2002年1月至2005年6月门诊和住院患者血或骨髓标本中培养分离的532株甲型副伤寒沙门菌,对几种临床常用抗菌药物的敏感试验结果作为动态分析,并对其中273例住院患者的病历进行了抗菌药物运用及其疗效的回顾性分析。结果甲型副伤寒沙门菌对萘啶酸耐药率为98.5%;诺氟沙星18.6%;氨苄西林11.5%;复方新诺明8.5%;对头孢曲松、氯霉素、环丙沙星、左旋氧氟沙星敏感性为100%。273例住院患者治疗选用三代头胞(头孢曲松或头孢哌酮)45例;广谱青霉素(氨苄西林或替卡西林)+氟喹诺酮(环丙沙星或左旋氧氟沙星)25例;头孢三代+氟喹诺酮73例;单独使用左旋氧氟沙星130例。273例住院患者除外7例自动出院,其余均治愈出院。结论甲型副伤寒沙门菌感染治疗,推荐首选三代头孢菌素、左旋氧氟沙星;萘啶酸用于测试肠道外沙门菌感染分离株对氟喹诺酮敏感性减低临床意义值得商榷。  相似文献   

8.
林兰  丁宏  崔生辉  张庆生 《中国药事》2011,25(8):836-840,847
目的对我国武汉地区0~3岁临床婴幼儿腹泻沙门菌进行了分离、鉴定、耐药性和分子分型分析。方法超广谱头孢菌素和氟喹诺酮类抗生素是临床上用于治疗侵袭性沙门菌感染的重要抗生素,对这些抗生素的耐药性传播已引起了广泛的重视,本研究从3746例儿科临床门诊病人粪便样本中共检出221(5.9%)株沙门菌,分别属于29个血清型,抗生素的耐药谱在不同血清型间存在明显差异。环丙沙星耐药株多为鼠伤寒沙门菌,且均对4种以上非喹诺酮类抗生素耐药,22株环丙沙星耐药鼠伤寒沙门菌中19株位于同一个脉冲场群中。在18株沙门菌中检出质粒介导的喹诺酮耐药机制aac-(6’)-Ib-cr,其中4株菌中还携带qnr基因。在7株菌中检出质粒介导的超广谱-内酰胺酶类CTX-M-14编码基因,其中2株菌对环丙沙星的敏感性下降。结果与结论氟喹诺酮类抗生素不适于在当地用于侵袭性鼠伤寒沙门菌感染治疗,同时应对头孢曲松耐药-氟喹诺酮敏感性下降的菌株进行积极的主动监测。  相似文献   

9.
江滟  王和 《贵州医药》2006,30(8):682-684
目的探讨细胞壁缺陷沙门菌的细胞多糖组成特点及其变异的生化机制。方法采用分光光度法、鲎血细胞溶解物试验,分别对伤寒沙门菌和甲型副伤寒沙门菌的细胞壁缺陷突变株(CWDM)以及伤寒沙门菌的CWDM返祖菌株的细胞壁多糖、细胞外多糖、脂多糖进行定性、定量实验,检测与分析沙门菌CWDM及其返祖菌株细胞多糖的化学组成特点。结果伤寒沙门菌及甲型副伤寒沙门菌的CWDMs细胞壁多糖与细胞外多糖的含量明显低于其亲代细菌型和伤寒沙门菌粗糙型返祖菌,鲎血细胞溶解物试验定性试验结果显示,两种细菌的CWDMs均表现为阴性反应,但定量试验表明其含量仅为细菌型和伤寒沙门菌返祖菌含量的1/30。结论细胞壁缺陷可导致沙门菌发生细胞壁多糖、细胞外多糖及脂多糖的含量减少。  相似文献   

10.
陈苏巧 《抗感染药学》2021,18(3):401-403
目的:分析食源性腹泻婴幼儿粪便与肛拭子标本中病原菌培养及主要致病菌构成情况与防治对策.方法:选取医院诊疗的食源性腹泻婴幼儿(2016年4月-2020年2月)628例临床资料,分析其粪便与肛拭子标本中病原菌培养结果及其主要致病菌构成情况,并提出干预措施.结果:628例患者标本中,经细菌培养结果显示阳性301例(检出病原菌301株),其阳性率为47.93%;食源性腹泻婴幼儿感染致病菌主要为沙门菌属占41.86%;对沙门菌属分布情况分析发现,其中肠炎沙门菌、鼠伤寒沙门菌、斯坦利沙门菌为主要致病菌.结论:食源性腹泻婴幼儿感染病原菌主要为沙门菌属、副溶血弧菌、致病性大肠埃希菌、志贺菌属;而肠炎沙门菌、鼠伤寒沙门菌、斯坦利沙门菌为沙门菌属中主要致病菌,临床治疗过程中应加强对目标病原菌的监测,积极做好干预措施,以提高其治疗效果与遏制其传播.  相似文献   

11.
目的 探讨甲型副伤寒患者血清C 反应蛋白测定的临床意义。方法 对 90例甲型副伤寒患者的血清C 反应蛋白 (CRP)、血清谷丙转氨酶 (ALT)、血清谷草转氨酶 (AST)、外周血白细胞总数 (WBC)和血小板计数 (PLT)进行测定。用直线回归和相关分析CRP与其他指标的关系。结果  87例 (96 6 7% )血清CRP升高 ,4 3例 (47 78% )血清ALT升高 ,4 6例 (5 1 11% )血清AST升高 ,2 7例 (30 % )血白细胞计数下降 ,2 4例 (2 6 6 7% )血小板计数下降。显示血清CRP浓度与ALT呈低度正直线相关 (r=0 2 4 5 ,P <0 0 1) ,CRP浓度与AST呈中度正直线相关 (r=0 5 72 ,P <0 0 1) ,CRP浓度与血PLT计数呈低度负直线相关 (r=0 2 5 8,P <0 0 5 ) ,CRP浓度与WBC总数不存在直线相关关系 (r=0 10 5 ,P =0 32 6 )。结论 甲型副伤寒中血清CRP升高为一重要指标 ,结合肝功能异常、血小板计数下降及流行病学资料则有助于确立诊断。  相似文献   

12.
BACKGROUND: Enteric fever remains a major cause of fever in travelers. We evaluated new trends in enteric fever. METHODS: We reviewed the epidemiological, clinical, biological, bacteriological data, and outcome of all cases of typhoid and paratyphoid fever seen in our department over the last decade. The inclusion criteria were the presence of signs compatible with enteric fever and isolation of Salmonella typhi or Salmonella paratyphi A, B, or C from blood or stool cultures or any other site. RESULTS: Among the 41 patients, 38 (93%) had travel-associated enteric fever. The main geographic source of contamination was the Indian subcontinent. One patient had been vaccinated with parenteral Vi vaccine 1 year previously. Fever and headaches were the only signs which were present in more than 80% of patients. The Widal test at inclusion was positive in 27%, and a second serological test was found to be positive in 50% of evaluated cases. Blood cultures and stool cultures were positive in 34 cases and 10 cases, respectively. Salmonellae spp were isolated in both hemocultures and stool cultures in 4 cases and in urine in 1 case. Two strains of S. typhi were resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole. One strain of S. typhi and one of S. paratyphi B were nalidixic acid resistant. All evaluable patients were cured with the exception of 2 patients (1 failure, 1 relapse). We observed 3 toxic reactions. No patients died. CONCLUSION: The diagnosis and outcome of enteric fever are hampered by the lack of specificity of clinical and biological signs, the increasing rates of antimicrobial resistance, and the occurrence of toxic reactions during treatment.  相似文献   

13.
Background : Enteric fever in Nepal is caused by infection with Salmonella typhi or Salmonella paratyphi A. The clinical presentation of these two illnesses has never been compared in a population of travelers and expatriates. If the illnesses are clinically comparable, and if S. paratyphi A infection is sufficiently common, the choice of typhoid vaccine for Nepal may have to take into account the vaccine's efficacy in preventing infection with S. paratyphi A.
Methods : NonNepalese patients presenting to the CIWEC Clinic with a history of 3 days of fever or greater were considered eligible for the study. Patients with positive blood or stool cultures for S. typhi or S. paratyphi A were entered into the study (along with three patients who had positive Widal titers only). A questionnaire was administered by a physician to determine signs and symptoms. Treatment with oral chloramphenicol was openly compared to treatment with oral ciprofloxacin.
Results : Forty-five cases of enteric fever were diagnosed during the 2 years of the study. Infection with S. typhi accounted for 20 cases, and S. paratyphi A was isolated in 22 cases. The illnesses were clinically indistinguishable. Treatment with chloramphenicol and ciprofloxacin was clinically comparable.
Conclusions : Infection with S. paratyphi A accounts for a significant percentage of enteric fever presentations among tourists in Nepal, and the illness is comparable to infection with S. typhi. Therefore, the choice of typhoid vaccine for long-term travelers or expatriates in Nepal should take into account the vaccine's potential ability to also prevent S. paratyphi A infection. The only typhoid vaccine that can currently offer this type of cross protection is the whole-cell killed preparation.  相似文献   

14.
Summary

Strains of Salmonella typhi (148) and Salmonella paratyphi A (27) isolated from the blood of patients with clinical features of enteric fever were tested in vitro for their sensitivity to epicillin, ampicillin, chloramphenicol and furazolidone. Results from both the disc and tube dilution methods showed that greater percentages of the two strains were sensitive to epicillin than to the other antibiotics.  相似文献   

15.
During 1984 to 1988, 35 patients with urinary tract infection (UTI) and 37 patients with enteric fever were treated successfully with 400 mg ofloxacin twice a day for 7 to 10 days. Clinical cure or improvement was observed in 31 of the 35 patients with UTI; 32 patients were bacteriologically assessed and eradication was achieved in all of them. Ofloxacin was particularly effective in the treatment of enteric fever in 35 patients; eradication was achieved in all of them; 34 patients were clinically cured within 4 days, however, one patient with bacteraemia due to Salmonella paratyphi A subsequently died, due to his underlying disorder. The MIC90 of the Enterobacteriaceae including Salmonella was less than 0.12 micrograms/ml. Interestingly, beta-lactamase-producing strains of Salmonella and other Enterobacteriaceae in the present study were 28% and 29%, respectively. Ofloxacin therefore offers an effective b.i.d. dosage schedule for enteric fever and UTI due to beta-lactamase-producing bacteria.  相似文献   

16.
甲型副伤寒沙门氏菌主动外排多重耐药基因与表达研究   总被引:3,自引:0,他引:3  
目的 调查临床分离甲型副伤寒沙门氏菌对常用抗生素的耐药情况与多重耐药主动外排基因acrB的检测、序列分析及其表达水平。方法 用琼脂二倍稀释法测定7种抗生素对甲型副伤寒沙门氏菌的抗菌活性。以基因库序列为参考设计引物PCR扩增acrB、测序并用RT-PCR方法检测其表达。结果 12株甲型副伤寒沙门氏菌对氧氟沙星、环丙沙星、头孢噻肟、哌拉西林、氯霉素、四环素、庆大霉素的耐药率除氯霉素为0外。其余均为8.33%。对三类不同种类抗菌药物多种耐药者l株。所有细菌均检测到多重耐药外排基因acrB.测序结果与参考沙门氏菌序列(No.AL627267)比较,有l处碱基差异。与大肠埃希氏菌(No.ECU00734)比较,碱基同源性为84.4l%(70/449),提示其碱基序列同源性均极高。分别选取对两类抗菌药物耐药及敏感甲型副伤寒沙门氏菌各一株进行RT-PCR检测,结果 两株细菌均检测到多重耐药外排基因acrB的表达。结论甲型副伤寒沙门氏菌对喹诺酮类、第三代头孢菌素类等药物耐药率低,但有多重耐药。甲型副伤寒沙门氏菌中均存在acrAB主动外排系统。与大肠埃希氏菌同源性高,可检测到其表达。主动外排机制可能是甲型副伤寒沙门氏菌形成多重耐药的主要原因之一。  相似文献   

17.
《中国抗生素杂志》2021,45(11):1153-1160
目的 分析某三甲医院血培养的细菌分布以及体外药敏结果,提供临床合理使用抗菌药物的依据。方法 回顾性调查云南省第二人民医院2010年1月—2018年12月,住院及门诊送检血培养标本分离培养及药物敏感试验的结果,采用 WHONET5.6软件对血培养分离到细菌的分布及药敏结果进行统计分析。结果 共检出细菌2163株,其中革兰阴性杆菌1379株(63.8%),革兰阳性菌710株(32.8%),真菌74株(3.4%)。在革兰阴性菌中,以大肠埃希菌为主48.1%,其次是肺炎克雷伯菌16.0%以及甲型副伤寒沙门菌11.4%;而革兰阳性菌以凝固酶阴性葡萄球菌61.0%为主,其次是金黄色葡萄球菌16.1%及屎肠球菌5.6%;真菌以白假丝酵母35.1%、近平滑假丝酵母菌20.3%及热带假丝酵母菌17.6%为主,在真菌中检出组织胞浆菌1例;检出率前3位的科室是ICU16.2%、肿瘤科15.0%及创伤中心14.4%。药敏结果显示,耐碳青酶烯酶的肺炎克雷伯菌(CRKP)检出率13.6%,耐碳青酶烯酶的大肠埃希菌(CREC)检出率0.3%,产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌和肺炎克雷伯菌的检出率分别为64.9%和36.7%;耐碳青霉烯类的鲍曼不动杆菌(CRAB)73.6%,耐碳青霉烯类的铜绿假单胞菌(CRPA)47.8%,耐甲氧西林金黄色葡萄球菌(MRSA)检出率38.6%;而检出前几位的大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌及金黄色葡萄球菌对常用的抗菌药物存在较高的耐药率,特别是产碳青霉烯酶(KPC)、产超广谱β-内酰胺酶(ESBLs)株及耐甲氧西林葡萄球菌(MRS)的耐药率较高,产酶株与非产酶株细菌的耐药率存在较大差异(P<0.01),甲型副伤寒沙门菌除对常用的抗菌药物具有较高的敏感性。结论  相似文献   

18.
目的 分析某三甲医院血培养的细菌分布以及体外药敏结果,提供临床合理使用抗菌药物的依据。方法 回顾性调查云南省第二人民医院2010年1月—2018年12月,住院及门诊送检血培养标本分离培养及药物敏感试验的结果,采用 WHONET5.6软件对血培养分离到细菌的分布及药敏结果进行统计分析。结果 共检出细菌2163株,其中革兰阴性杆菌1379株(63.8%),革兰阳性菌710株(32.8%),真菌74株(3.4%)。在革兰阴性菌中,以大肠埃希菌为主48.1%,其次是肺炎克雷伯菌16.0%以及甲型副伤寒沙门菌11.4%;而革兰阳性菌以凝固酶阴性葡萄球菌61.0%为主,其次是金黄色葡萄球菌16.1%及屎肠球菌5.6%;真菌以白假丝酵母35.1%、近平滑假丝酵母菌20.3%及热带假丝酵母菌17.6%为主,在真菌中检出组织胞浆菌1例;检出率前3位的科室是ICU16.2%、肿瘤科15.0%及创伤中心14.4%。药敏结果显示,耐碳青酶烯酶的肺炎克雷伯菌(CRKP)检出率13.6%,耐碳青酶烯酶的大肠埃希菌(CREC)检出率0.3%,产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌和肺炎克雷伯菌的检出率分别为64.9%和36.7%;耐碳青霉烯类的鲍曼不动杆菌(CRAB)73.6%,耐碳青霉烯类的铜绿假单胞菌(CRPA)47.8%,耐甲氧西林金黄色葡萄球菌(MRSA)检出率38.6%;而检出前几位的大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌及金黄色葡萄球菌对常用的抗菌药物存在较高的耐药率,特别是产碳青霉烯酶(KPC)、产超广谱β-内酰胺酶(ESBLs)株及耐甲氧西林葡萄球菌(MRS)的耐药率较高,产酶株与非产酶株细菌的耐药率存在较大差异(P<0.01),甲型副伤寒沙门菌除对常用的抗菌药物具有较高的敏感性。结论 血培养标本中主要细菌是革兰阴性杆菌,不同细菌对抗菌药物的耐药性存在较大差异,对不明原因发热或疑似血流感染的患者抗菌药物使用之前进行血培养和体外药敏试验,对临床诊治血流感染及合理选用抗菌药物具有重要意义。  相似文献   

19.
The in vitro activity of aztreonam, the first monobactam antibiotic, was compared with that of 17 other antimicrobial agents against 79 strains of Salmonella species. The microorganisms were isolated from hospitalized patients, surface waters and seafoods during the decade 1975-1984. They included the following species: Salmonella typhi 63, Salmonella typhimurium 5, Salmonella wien 5, Salmonella heidelberg 2, Salmonella arizonae 2, Salmonella paratyphi B 1 and Salmonella enteritidis 1. The minimum inhibitory concentration (MIC) values of the antibiotics were determined using a serial dilution method in agar. A final inoculum size of 10(5) colony-forming units (CFU) X ml-1 of the tested microorganisms was used. Aztreonam exhibited a superior antimicrobial activity to that of the other antibiotics tested. Aztreonam inhibited 90% of the strains by 0.8 micrograms X ml-1 (MIC range was 0.05 to 1.56 micrograms X ml-1). There was no major difference between minimum bactericidal concentration and MIC values of aztreonam and the effect of inoculum size upon MIC values was observed at 10(7) CFU X ml-1.  相似文献   

20.
Typhoid fever caused by Salmonella typhi, paratyphi A and B, is an important cause of morbidity and mortality in many developing countries. A rapid and sensitive method for the detection of S. typhi is essential for early diagnosis of typhoid fever and effective therapy. In this study 45 febrile patients who were suspected to have enteric fever were enrolled, and the results of blood cultures, widal agglutination tests and Polymerase Chain Reaction in these cases were evaluated. Group I consisted of 11 patients with diseases other than salmonella infections, group II represented 6 patients with positive cultures, and group III represented 28 patients with negative blood cultures negative but who were clinically suspected cases that had a medical history of using variable antimicrobial agents. Two positive PCR results were present; one of them was in culture positive group (16,6%) and the other was in culture negative group (3,5%). In our study widal agglutination tests and cultures were found not to be helpful in differential dignosis. Although PCR based detection of S. typhi is reported to be a sensitive and specific test for the diagnosis of enteric fever, in our study the benefit of this method in the diagnosis of especially patients who were treated with antimicrobial therapy was not clearly determined. Other methods to increase sensitiviy and specificity to levels such as those of real time PCR should be developed and large-scaled studies should be done in endemic and non-epidemic regions.  相似文献   

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