Chapter 8 : Salmonella Serotype Typhi and Salmonella Serotype Paratyphi A, B, and C

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Salmonella Serotype Typhi and Salmonella Serotype Paratyphi A, B, and C, Page 1 of 2

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The epidemiology of serotype Typhi in industrialized countries is relatively simple. Recent outbreaks of serotype Paratyphi A, characterized by severe disease, have occurred in India and Thailand. Most typhoid fever infections, whether sporadic or epidemic, occur in children 5 to 19 years of age. Treatment with high levels of ciprofloxacin (750 mg orally twice daily) for 28 days is effective in eliminating chronic carriage. Blood culture, the standard method for the diagnosis of enteric fever, is positive in 30 to 90% of patients depending upon bacteremic levels and the stage of disease. serotype Paratyphi B is negative for L-tartrate (also known as Jordan’s or phenol red tartrate), while the antigenically identical serotype previously known as serotype Java is L-tartrate positive. serotype Typhi and some strains of serotype Paratyphi C possess a capsule, the Vi Ag, which envelops the somatic or cell surface Ag. The results of multilocus enzyme electrophoresis and other methods (e.g., analysis of outer membrane proteins), in fact, suggest that serotype Typhi strains from different geographical areas are derived from only two clones, one restricted to west Africa and the other of worldwide distribution. In the United States, the Food and Drug Administration (FDA) currently licenses the parenteral Vi capsular polysaccharide and the oral serotype Typhi Ty21a vaccines. Adverse events after receipt of either vaccine are largely self limited, with frequent reports of gastrointestinal symptoms occasionally requiring hospitalization.

Citation: Janda J, Abbott S. 2006. Salmonella Serotype Typhi and Salmonella Serotype Paratyphi A, B, and C, p 105-114. In The Enterobacteria, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817541.ch8

Key Concept Ranking

Outer Membrane Proteins
Peyer's Patches
Salmonella enterica
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Phage typing of serotype Typhi, type C .

Citation: Janda J, Abbott S. 2006. Salmonella Serotype Typhi and Salmonella Serotype Paratyphi A, B, and C, p 105-114. In The Enterobacteria, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817541.ch8
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1. Ackers, M.-L.,, N. D. Puhr,, R. V. Tauxe,, and E. D. Mintz. 2000. Laboratory-based surveillance of Salmonella serotype Typhi infections in the United States. JAMA 283:26682673.
2. Aldrey, J. M.,, A. Fernandez-Rial,, F. J. Lopez-Gonzalez,, J. C. Doval,, and R. dela Fuente-Fernandez. 1999. Guillain-Barre syndrome as first manifestation of typhoid fever. Clin. Infect. Dis. 28:11711172.
3. Anderson, E. S.,, and A. Fraser. 1955. The influence of the factors determining Vi- type specificity in Salmonella typhi on the adaptation of Vi-phage II. J. Gen. Bacteriol. 13:519532.
4. Begier, E. M.,, D. R. Burwen,, P. Haber,, and R. Ball, for the Vaccine Adverse Event Reporting System Working Group. 2004. Postmarketing safety surveillance for typhoid fever vaccines from the vaccine adverse event reporting system, July 1990 through June 2002. Clin. Infect. Dis. 38:771779.
5. Birkhead, G. S.,, D. L. Morse,, W. C. Levine,, J. K. Fudala,, S. F. Kondracki,, H.-G. Chang,, M. Shayegani,, L. Novick,, and P. A. Blake. 1993. Typhoid fever at a resort hotel in New York: a large outbreak with an unusual vehicle. J. Infect. Dis. 167:12281232.
6. Cassar, R.,, and P. Cuschieri. 2003. Comparison of Salmonella chromogenic medium with DCLS agar for isolation of Salmonella species from stool specimens. J. Clin. Microbiol. 41:32293232.
7. Chandel, D. S.,, and R. Chaudhry. 2001. Enteric fever treatment failures: a global concern. Emerg. Infect. Dis. 7:762763.
8. Chanh, N. Q.,, P. Everest,, T. T. Khoa,, D. House,, S. Murch,, C. Parry,, P. Connerton,, P. V. Bay,, T. S. Diep,, P. Mastroent,, N. J. White,, T. T. Hien,, V. V. Ho,, G. Dougan,, J. J. Farrar,, and J. Wain. 2004. A clinical, microbiological, and pathological study of intestinal perforation associated with typhoid fever. Clin. Infect. Dis. 39:6167.
9. Crump, J. A.,, T. J. Barrett,, J. T. Nelson,, and F. J. Angulo. 2003. Reevaluating fluoroquinolone breakpoints for Salmonella enterica serotype Typhi and for non-typhi salmonellae. Clin. Infect. Dis. 37:7581.
10. Crump, J. A.,, S. P. Luby,, and E. D. Mintz. 2004. The global burden of typhoid fever. Bull. WHO 82:346353.
11. Edelman, R.,, and M. M. Levine. 1986. Summary of an international workshop on typhoid fever. Rev. Infect. Dis. 8:329349.
12. Escamilla, J.,, H. Florez-Ugarte,, and M. E. Kilpatirick. 1986. Evaluation of blood clot cultures of Salmonella typhi, Salmonella paratyphi-A, and Brucella melitensis. J. Clin. Microbiol. 24:388390.
13. Fadell, M. A.,, J. A. Crump,, F. J. Mahoney,, I. A. Nakhla,, A. M. Mansour,, B. Reyad,, D. El Melegi,, Y. Sultan,, E. D. Mintz,, and W. F. Bibb. 2004. Rapid diagnosis of typhoid fever by enzyme-linked immunosorbent assay detection of Salmonella serotype Typhi antigens in urine. Am. J. Trop. Med. Hyg. 70:323328.
14. Faundez, G.,, L. Aron,, and F. C. Cabella. 1990. Chromosomal DNA, iron-transport systems, outer membrane proteins, and entertoxin (heat labile) production in Salmonella typhi strains. J. Clin. Microbiol. 28:894897.
15. Ferreccio, C.,, J. G. Morris, Jr.,, C. Valdivieso,, I. Prenzel,, V. Sotomayor,, G. L. Drusano,, M. M. Levine. 1988. Efficacy of ciprofloxacin in the treatment of chronic typhoid carriers. J. Infect. Dis. 157:12351239.
16. Fica, A. E.,, S. Prat-Miranda,, A. Fernandez-Ricci,, K. D’Ottone,, and F. C. Cabello. 1996. Epidemic typhoid in Chile: analysis by molecular and conventional methods of Salmonella typhi strains diversity in epidemic (1977 and 1981) and nonepidemic (1990) year. J. Clin. Microbiol. 34:17011707.
17. Franco, A.,, C. Gonzalez,, O. S. Levine,, R. Lagos,, R. H. Hall,, S. L. Hoffman,, M. A. Moechtar,, E. Gotuzzo,, M. M. Levine,, D. M. Hone,, and J. G. Morris, Jr. 1992. Further consideration of the clonal nature of Salmonella typhi: evaluation of molecular and clinical characteristics of strains from Indonesia and Peru. J. Clin. Microbiol. 30:21872190.
18. Goldberg, M. B.,, and R. H. Rubin. 1988. The spectrum of Salmonella infection. Infect. Dis. Clin. North Am. 2:571598.
19. Guerrant, R. L.,, and M. Kosek. 2001. Polysaccharide conjugate typhoid vaccine. N. Engl. J. Med. 344:13221323.
20. Haefeli, W. E.,, R. Ott,, A. J. Bircher,, and A. P. Burnens. 1995. Hair loss following typhoid fever: a forgotten phenomenon. Clin. Infect. Dis. 20:723724.
21. House, D.,, J. Wain,, V. A. Ho,, T. S. Diep,, N. T. Chinh,, P. V. Bay,, H. Vinh,, M. Duc,, C. M. Parry,, G. Dougan,, N. J. White,, T. T. Hien,, and J. J. Farrar. 2001. Serology of typhoid fever in an area of endemicity and its relevance to diagnosis. J. Clin. Microbiol. 39:10021007.
22. Ivanoff, B.,, and M. M. Levine. 1997. Typhoid fever: continuing challenges from a resilient bacterial foe. Bull. Inst. Pasteur 95:129142.
23. Katz, D. J.,, M. A. Cruz,, M. J. Trepka,, J. A. Suarez,, P. D. Fiorella,, and R. M. Hammond. 2002. An outbreak of typhoid fever in Florida associated with an imported frozen fruit. J. Infect. Dis. 186:234239.
24. Khan, M.,, Y. M. Coovadia,, C. Connolly,, and A. W. Sturm. 1999. Influence of sex on clinical features, laboratory findings, and complications of typhoid fever. Am. J. Trop. Med. Hyg. 61:4146.
25. LeMinor, L., 1984. Salmonella Lignieres 1900, 389AL, p. 427458. In N. R. Krieg, and J. G. Holt (ed.), Bergey’s Manual of Systematic Bacteriology. Williams & Wilkins, Baltimore, Md.
26. LeMinor, L.,, and M. Y. Popoff. 1987. Request for an opinion: designation of Salmonella enterica sp. nov., nom. rev., as the type and only species of the genus Salmonella. Int. J. Syst. Bacteriol. 37:465468.
27. Lin, F. Y. C.,, V. A. Ho,, H. B. Khiem,, D. D. Trach,, P. V. Bay,, T. C. Thanh,, Z. Kossaczka,, D. A. Bryla,, J. Shiloach,, J. B. Robbins,, R. Schneerson,, and S. C. Szu. 2001. The efficacy of a Salmonella typhi Vi conjugate vaccine in two-to-five-year-old children. N. Engl. J. Med. 17:12631269.
28. Liu, S.,, T. Ezaki,, H. Miura,, K. Matsui,, and E. Yabuuchi. 1988. Intact motility as a Salmonella typhi invasion-related factor. Infect. Immun. 56:19671973.
29. Liu, Y.,, M.-A. Lee,, E.-E. Ooi,, Y. Mavis,, A.-L. Tan,, and H.-H. Quek. 2003. Molecular typing of Salmonella enterica serovar Typhi isolates from various countries in Asia by a multiplex PCR assay on variable-number tandem repeats. J. Clin. Microbiol. 41:43884394.
30. Mathai, E.,, T. J. John,, M. Rani,, D. Mathai,, N. Chacko,, V. Nath,, and A. M. Cherian. 1995. Significance of Salmonella typhi bacteriuria. J. Clin. Microbiol. 33:17911792.
31. Mirza, S. H.,, N. J. Beeching,, and C. A. Hart. 1996. Multidrug resistant typhoid: a global problem. J. Med. Microbiol. 44:317319.
32. Murdoch,, N. A. Banatvala,, A. Bone,, B. I. Shoismatulioev,, L. R. Ward,, and E. J. Threlfall. 1998. Epidemic ciprofloxacin-resistant Salmonella typhi in Tajikistan. Lancet 351:339.
33. Nair, S.,, E. Schreiber,, K.-L. Thong,, T. Pang,, and M. Altwegg. 2000. Genotypic characterization of Salmonella typhi by amplified fragment length polymorphism fingerprinting provides increased discrimination as compared to pulsed-field gel electrophoresis and ribotyping. J. Microbiol. Methods 41:3543.
34. Navarro, F.,, T. Llovet,, M. A. Echeita,, P. Coll,, A. Aladuena,, M. A. Usera,, and G. Prats. 1996. Molecular typing of Salmonella enterica serovar Typhi. J. Clin. Microbiol. 34:28312834.
35. Oh, H. M. L.,, Z. Masaya,, and S. K. Chew. 1997. Typhoid fever in hospitalized children in Singapore. J. Infect. 34:237242.
36. Olsen, S. J.,, J. Pruckler,, W. Bibb,, N. T. M. Thanh,, T. M. Trinh,, N. T. Minh,, S. Sivapalasingam,, A. Gupta,, P. T. Phuong,, N. T. Chinh,, N. V. Chau,, P. D. Cam,, and E. D. Mintz. 2004. Evaluation of rapid diagnostic tests for typhoid fever. J. Clin. Microbiol. 42:18851889.
37. Pang, T.,, M. M. Levine,, B. Ivanoff,, J. Wain,, and B. B. Finlay. 1998. Typhoid fever—important issues still remain. Trends Microbiol. 6:131133.
38. Parry, C. M.,, T. T. Hien,, G. Dougan,, N. J. White,, and J. J. Farrar. 2002. Typhoid fever. N. Engl. J. Med. 347:17701782.
39. Parry, C.,, J. Wain,, N. T. Chinh,, H. Vinh,, and J. J. Farrar. 1998. Quinolone-resistant Salmonella typhi in Vietnam. Lancet 351:1289.
40. Pegues, D. A.,, E. L. Hohlmann,, and S. I. Miller,. 1995. Salmonella including S. typhi, p. 785809. In M. J. Blaser,, P. D. Smith,, J. I. Ravdin,, H. B. Greenberg,, and R. L. Guerrant (ed.), Infections of the Gastrointestinal Tract. Raven Press, New York, N.Y.
41. Perez, J. M.,, P. Cavalli,, C. Roure,, R. Renac,, Y. Gille,, and A. M. Freydiere. 2003. Comparison of four chromogenic media and Hektoen agar for detection and presumptive identification of Salmonella strains in human stools. J. Clin. Microbiol. 41:11301134.
42. Reed, R. P.,, and K. P. Klugman. 1994. Neonatal typhoid fever. Pediatr. Infect. Dis. J. 3:774777.
43. Reeves, M. W.,, G. M. Evins,, A. A. Heiba,, B. D. Plikaytis,, and J. J. FarmerIII. 1989. Clonal nature of Salmonella typhi and its genetic relatedness to other salmonellae as shown by multilocus enzyme electrophoresis, and proposal of Salmonella bongori comb. nov. J. Clin. Microbiol. 27:313320.
44. Reller, M. E.,, S. J. Olsen,, A. B. Kressel,, T. D. Moon,, K. A. Kubota,, M. P. Adcock,, S. F. Nowicki,, and E. D. Mintz. 2003. Sexual transmission of typhoid fever: a multistate outbreak among men who have sex with men. Clin. Infect. Dis. 37:141144.
45. Rowe, B.,, L. R. Ward,, and E. J. Threlfall. 1997. Multidrugresistant Salmonella typhi: a worldwide epidemic. Clin. Infect. Dis. 24(Suppl. 1):S106S109.
46. Roy, S. K.,, P. Speelman,, T. Butler,, S. Nath,, H. Rahman,, and B. J. Stoll. 1985. Diarrhea associated with typhoid fever. J. Infect. Dis. 151:11381143.
47. Rubin, F. A.,, P. D. McWhirter,, D. Burr,, N. H. Punjabi,, E. Lane,, S. Kumala,, P. Sudarmono,, S. P. Pulungsih,, M. Lesmana,, P. Tjaniadi,, N. Sukri,, and S. L. Hoffman. 1990. Rapid diagnosis of typhoid fever through identification of Salmonella typhi within 18 hours of specimen acquisition by culture of the mononuclear cell-platelet fraction of blood. J. Clin. Microbiol. 28:825827.
48. Saha, S. K.,, S. Saha,, M. Ruhulamin,, M. Hanif,, and M. Islam. 1997. Decreasing trend of multiresistant Salmonella typhi in Bangladesh. J. Antimicrob. Chemother. 39:554556.
49. Selander, R. K.,, P. Beltran,, N. H. Smith,, R. Helmuth,, F. A. Rubin,, D. J. Kopecko,, K. Ferris,, B. D. Tall,, A. Cravioto,, and J. M. Musser. 1990. Evolutionary genetic relationships of clone of Salmonella serovars that cause human typhoid and other enteric fevers. Infect. Immun. 58:22622275.
50. Sinha, A.,, S. Sazawai,, R. Kumar,, S. Sood,, V. P. Reddaiah,, B. Singh,, M. Rao,, A. Naficy,, J. D. Clemens,, and M. K. Bhan. 1999. Typhoid fever in children aged less than 5 years. Lancet 354:734737.
51. Song, J.-H.,, H. Cho,, M. Y. Park,, D. S. Na,, H. B. Moon,, and C. H. Pai. 1993. Detection of Salmonella typhi in the blood of patients with typhoid fever by polymerase chain reaction. J. Clin. Microbiol. 31:14391443.
52. Sood, S.,, A. Kapil,, B. Das,, Y. Jain,, and S. K. Kabra. 1999. Reemergence of chloramphenicol sensitive Salmonella typhi. Lancet 353:12411242.
53. Taylor, D. N.,, R. A. Pollard,, and P. A. Blake. 1983. Typhoid in the United States and the risk to the international traveler. J. Infect. Dis. 148:599602.
54. Taylor, J. P.,, W. X. Shandera,, T. G. Betz,, K. Schraitle,, L. Chaffee,, L. Lopez,, R. Henley,, C. N. Rothe,, R. F. Bell,, and P. A. Blake. 1984. Typhoid fever in San Antonio, Texas: an outbreak traced to a continuing source. J. Infect. Dis. 149:553557.
55. van Basten, J. P.,, and R. Stockenbrugger. 1994. Typhoid perforation. Trop. Geogr. Med. 46:336339.
56. van de Wetering, J.,, L. G. Visser,, M. A. van Buchem,, and J. G. van der Hoeven. 1995. A case of typhoid fever complicated by unexpected diffuse cerebral edema. Clin. Infect. Dis. 21:10571058.
57. Wain, J.,, P. V. B. Bay,, H. Vinh,, N. M. Duong,, T. S. Diep,, A. L. Walsh,, C. M. Parry,, R. P. Hasserjian,, V. A. Ho,, T. T. Hien,, J. Farrar,, N. J. White,, and N. P. J. Day. 2001. Quantitation of bacteria in bone marrow from patients with typhoid fever: relationship between counts and clinical features. J. Clin. Microbiol. 39:15711576.
58. Wain, J.,, T. S. Diep,, V. A. Ho,, A. M. Walsh,, N. T. T. Hoa,, C. M. Parry,, and N. J. White. 1998. Quantitation of bacteria in blood of typhoid fever patients and relationship between counts and clinical features, transmissibility, and antibiotic resistance. J. Clin. Microbiol. 36:16831687.
59. Wain, J.,, T. T. Hien,, P. Connerton,, T. Ali,, C. M. Parry,, N. T. T. Chinh,, H. Vinh,, C. X. T. Phoung,, V. A. Ho,, T. S. Diep,, J. J. Farrar,, N. J. White,, and G. Dougan. 1999. Molecular typing of multiple-antibiotic-resistant Salmonella enterica serovar Typhi from Vietnam: application to acute and relapse cases of typhoid fever. J. Clin. Microbiol. 37:24662472.
60. Wasfy, M. O.,, R. Frenck,, T. F. Ismail,, H. Mansour,, J. L. Malone,, and F. J. Mahoney. 2002. Trends of multiple-drug resistance among Salmonella serotype Typhi isolates during a 14-year period in Egypt. Clin. Infect. Dis. 35:12651268.
61. Weiss, K.,, and M. Laverdiere. 1995. Salmonella typhi osteomyelitis in an immunocompetent patient. Clin. Microbiol. Newsl. 17:135136.
62.World Health Organization. 1978. Dynamics of acute bacterial diseases. Part II: typhoid fever. Bull. W. H. O. 56:4563.
63. Zhu, Q.,, C. K. Lim,, and Y. N. Chan. 1996. Detection of Salmonella typhi by polymerase chain reaction. J. Appl. Bacteriol. 80:244251.


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Table 1

Characteristics of untreated enteric fever

Citation: Janda J, Abbott S. 2006. Salmonella Serotype Typhi and Salmonella Serotype Paratyphi A, B, and C, p 105-114. In The Enterobacteria, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817541.ch8
Generic image for table
Table 2

Reactions of serotypes Typhi and Paratyphi A, B, and C in screening media

Citation: Janda J, Abbott S. 2006. Salmonella Serotype Typhi and Salmonella Serotype Paratyphi A, B, and C, p 105-114. In The Enterobacteria, Second Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817541.ch8

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