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Laboratory parameters for predicting Salmonella bacteraemia: a prospective cohort study.
Suhendro Suwarto1, Hadianti Adlani2, Leonard Nainggolan3
11 Senior Lecturer, Division of Tropical and Infectious Diseases, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
Tropical Doctor
|September 30, 2017
Summary
Diagnosing typhoid fever can be slow. This study identified key lab markers like eosinopenia and elevated CRP to predict Salmonella bacteraemia in suspected typhoid fever patients.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Epidemiology
Background:
- Blood cultures are the gold standard for diagnosing typhoid fever but are time-consuming and not always accessible.
- Prompt diagnosis and treatment of typhoid fever are crucial, especially in endemic areas.
- Predictive laboratory markers could aid in early clinical suspicion and management.
Purpose of the Study:
- To identify readily available laboratory parameters that can predict the presence of Salmonella bacteraemia in patients with suspected typhoid fever.
- To offer an alternative or adjunct to blood cultures for early diagnosis.
Main Methods:
- A prospective cohort study was conducted in Jakarta, Indonesia, from October 2014 to December 2016.
- Included were 187 patients admitted with suspected typhoid fever.
- Blood cultures were performed, and various laboratory parameters were analyzed for predictive value.
Main Results:
- Out of 187 participants, 27 tested positive for Salmonella typhi and 12 for Salmonella paratyphi via blood culture.
- Absolute eosinopenia was identified as a significant predictor.
- Elevated aspartate aminotransferase (AST) and C-reactive protein (CRP) levels greater than 40 mg/L were also found to be positive predictors.
Conclusions:
- Absolute eosinopenia, elevated AST, and elevated CRP (>40 mg/L) are useful laboratory predictors for Salmonella bacteraemia in suspected typhoid fever.
- These markers may facilitate earlier clinical suspicion and management of typhoid fever when blood culture results are pending.
