Evaluation of an Electricity-free, Culture-based Approach for Detecting Typhoidal Salmonella Bacteremia during Enteric Fever in a High Burden, Resource-limited Setting
Publication Date
June 27, 2013
Journal
PLOS Neglected Tropical Diseases
Authors
Jason R. Andrews, Krishna G. Prajapati, Elizabeth Eypper, Poojan Shrestha, et al
Volume
7
Issue
6
Pages
e2292
DOI
https://dx.plos.org/10.1371/journal.pntd.0002292
Publisher URL
http://journals.plos.org/plosntds/article?id=10.1371%2Fjournal.pntd.0002292
PubMed
http://www.ncbi.nlm.nih.gov/pubmed/23853696
PubMed Central
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3694822
Europe PMC
http://europepmc.org/abstract/MED/23853696
Web of Science
000321201300043
Scopus
84879509108
Mendeley
http://www.mendeley.com/research/evaluation-electricityfree-culturebased-approach-detecting-typhoidal-salmonella-bacteremia-during-en
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Mendeley | Further Information

{"title"=>"Evaluation of an Electricity-free, Culture-based Approach for Detecting Typhoidal Salmonella Bacteremia during Enteric Fever in a High Burden, Resource-limited Setting", "type"=>"journal", "authors"=>[{"first_name"=>"Jason R.", "last_name"=>"Andrews", "scopus_author_id"=>"15058787200"}, {"first_name"=>"Krishna G.", "last_name"=>"Prajapati", "scopus_author_id"=>"55777948100"}, {"first_name"=>"Elizabeth", "last_name"=>"Eypper", "scopus_author_id"=>"55751281700"}, {"first_name"=>"Poojan", "last_name"=>"Shrestha", "scopus_author_id"=>"55777126900"}, {"first_name"=>"Mila", "last_name"=>"Shakya", "scopus_author_id"=>"55777839700"}, {"first_name"=>"Kamal R.", "last_name"=>"Pathak", "scopus_author_id"=>"55778068700"}, {"first_name"=>"Niva", "last_name"=>"Joshi", "scopus_author_id"=>"55777295400"}, {"first_name"=>"Priyanka", "last_name"=>"Tiwari", "scopus_author_id"=>"55777267100"}, {"first_name"=>"Manisha", "last_name"=>"Risal", "scopus_author_id"=>"55777436900"}, {"first_name"=>"Samir", "last_name"=>"Koirala", "scopus_author_id"=>"26532953100"}, {"first_name"=>"Abhilasha", "last_name"=>"Karkey", "scopus_author_id"=>"26532900700"}, {"first_name"=>"Sabina", "last_name"=>"Dongol", "scopus_author_id"=>"22134108000"}, {"first_name"=>"Shawn", "last_name"=>"Wen", "scopus_author_id"=>"55777279900"}, {"first_name"=>"Amy B.", "last_name"=>"Smith", "scopus_author_id"=>"55547130630"}, {"first_name"=>"Duncan", "last_name"=>"Maru", "scopus_author_id"=>"57198370498"}, {"first_name"=>"Buddha", "last_name"=>"Basnyat", "scopus_author_id"=>"7006354669"}, {"first_name"=>"Stephen", "last_name"=>"Baker", "scopus_author_id"=>"7403308306"}, {"first_name"=>"Jeremy", "last_name"=>"Farrar", "scopus_author_id"=>"7103292979"}, {"first_name"=>"Edward T.", "last_name"=>"Ryan", "scopus_author_id"=>"7201794159"}, {"first_name"=>"Elizabeth", "last_name"=>"Hohmann", "scopus_author_id"=>"7003511042"}, {"first_name"=>"Amit", "last_name"=>"Arjyal", "scopus_author_id"=>"9037027600"}], "year"=>2013, "source"=>"PLoS Neglected Tropical Diseases", "identifiers"=>{"issn"=>"19352735", "scopus"=>"2-s2.0-84879509108", "sgr"=>"84879509108", "pui"=>"369208196", "isbn"=>"1935-2735", "pmid"=>"23853696", "doi"=>"10.1371/journal.pntd.0002292"}, "id"=>"3e56deb6-9eed-3ae2-90ca-53b567d4ba29", "abstract"=>"BACKGROUND: In many rural areas at risk for enteric fever, there are few data on Salmonella enterica serotypes Typhi (S. Typhi) and Paratyphi (S. Paratyphi) incidence, due to limited laboratory capacity for microbiologic culture. Here, we describe an approach that permits recovery of the causative agents of enteric fever in such settings. This approach involves the use of an electricity-free incubator based upon use of phase-change materials. We compared this against conventional blood culture for detection of typhoidal Salmonella.\\n\\nMETHODOLOGY/PRINCIPAL FINDINGS: Three hundred and four patients with undifferentiated fever attending the outpatient and emergency departments of a public hospital in the Kathmandu Valley of Nepal were recruited. Conventional blood culture was compared against an electricity-free culture approach. Blood from 66 (21.7%) patients tested positive for a Gram-negative bacterium by at least one of the two methods. Sixty-five (21.4%) patients tested blood culture positive for S. Typhi (30; 9.9%) or S. Paratyphi A (35; 11.5%). From the 65 individuals with culture-confirmed enteric fever, 55 (84.6%) were identified by the conventional blood culture and 60 (92.3%) were identified by the experimental method. Median time-to-positivity was 2 days for both procedures. The experimental approach was falsely positive due to probable skin contaminants in 2 of 239 individuals (0.8%). The percentages of positive and negative agreement for diagnosis of enteric fever were 90.9% (95% CI: 80.0%-97.0%) and 96.0% (92.7%-98.1%), respectively. After initial incubation, Salmonella isolates could be readily recovered from blood culture bottles maintained at room temperature for six months.\\n\\nCONCLUSIONS/SIGNIFICANCE: A simple culture approach based upon a phase-change incubator can be used to isolate agents of enteric fever. This approach could be used as a surveillance tool to assess incidence and drug resistance of the etiologic agents of enteric fever in settings without reliable local access to electricity or local diagnostic microbiology laboratories.", "link"=>"http://www.mendeley.com/research/evaluation-electricityfree-culturebased-approach-detecting-typhoidal-salmonella-bacteremia-during-en", "reader_count"=>52, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>3, "Librarian"=>1, "Researcher"=>12, "Student > Doctoral Student"=>2, "Student > Ph. D. Student"=>6, "Student > Postgraduate"=>6, "Student > Master"=>10, "Other"=>5, "Student > Bachelor"=>3, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>3, "Librarian"=>1, "Researcher"=>12, "Student > Doctoral Student"=>2, "Student > Ph. D. Student"=>6, "Student > Postgraduate"=>6, "Student > Master"=>10, "Other"=>5, "Student > Bachelor"=>3, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>1, "Agricultural and Biological Sciences"=>8, "Philosophy"=>1, "Chemistry"=>1, "Computer Science"=>1, "Earth and Planetary Sciences"=>1, "Biochemistry, Genetics and Molecular Biology"=>2, "Nursing and Health Professions"=>2, "Mathematics"=>1, "Medicine and Dentistry"=>28, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Social Sciences"=>1, "Immunology and Microbiology"=>4}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>28}, "Social Sciences"=>{"Social Sciences"=>1}, "Mathematics"=>{"Mathematics"=>1}, "Unspecified"=>{"Unspecified"=>1}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}, "Chemistry"=>{"Chemistry"=>1}, "Earth and Planetary Sciences"=>{"Earth and Planetary Sciences"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>4}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>8}, "Computer Science"=>{"Computer Science"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>2}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>2}, "Philosophy"=>{"Philosophy"=>1}}, "reader_count_by_country"=>{"Netherlands"=>1, "Norway"=>1, "United States"=>1, "United Kingdom"=>2, "Australia"=>1}, "group_count"=>6}

Scopus | Further Information

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Figshare

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  • {"files"=>["https://ndownloader.figshare.com/files/1103697"], "description"=>"<p>Flow diagram of patients recruited and enrolled in the study.</p>", "links"=>[], "tags"=>["Diagnostic medicine", "Clinical laboratory sciences", "Global health", "Infectious diseases", "Bacterial diseases", "Salmonella", "diagram", "patients", "recruited", "enrolled"], "article_id"=>733557, "categories"=>["Medicine"], "users"=>["Jason R. Andrews", "Krishna G. Prajapati", "Elizabeth Eypper", "Poojan Shrestha", "Mila Shakya", "Kamal R. Pathak", "Niva Joshi", "Priyanka Tiwari", "Manisha Risal", "Samir Koirala", "Abhilasha Karkey", "Sabina Dongol", "Shawn Wen", "Amy B. Smith", "Duncan Maru", "Buddha Basnyat", "Stephen Baker", "Jeremy Farrar", "Edward T. Ryan", "Elizabeth Hohmann", "Amit Arjyal"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0002292.g003", "stats"=>{"downloads"=>1, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Flow_diagram_of_patients_recruited_and_enrolled_in_the_study_/733557", "title"=>"Flow diagram of patients recruited and enrolled in the study.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-06-27 03:10:16"}
  • {"files"=>["https://ndownloader.figshare.com/files/1103698"], "description"=>"<p>Bacteria isolated among participants in the study according to culture method (either, conventional, or experimental).</p>", "links"=>[], "tags"=>["Diagnostic medicine", "Clinical laboratory sciences", "Global health", "Infectious diseases", "Bacterial diseases", "Salmonella"], "article_id"=>733558, "categories"=>["Medicine"], "users"=>["Jason R. Andrews", "Krishna G. Prajapati", "Elizabeth Eypper", "Poojan Shrestha", "Mila Shakya", "Kamal R. Pathak", "Niva Joshi", "Priyanka Tiwari", "Manisha Risal", "Samir Koirala", "Abhilasha Karkey", "Sabina Dongol", "Shawn Wen", "Amy B. Smith", "Duncan Maru", "Buddha Basnyat", "Stephen Baker", "Jeremy Farrar", "Edward T. Ryan", "Elizabeth Hohmann", "Amit Arjyal"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0002292.t001", "stats"=>{"downloads"=>1, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Bacteria_isolated_among_participants_in_the_study_according_to_culture_method_either_conventional_or_experimental_/733558", "title"=>"Bacteria isolated among participants in the study according to culture method (either, conventional, or experimental).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-06-27 03:10:16"}
  • {"files"=>["https://ndownloader.figshare.com/files/1103699"], "description"=>"*<p>The experimental blood culture was positive in two additional patients that were negative by conventional blood culture, but the organisms were probable skin contaminants. These are captured in percent agreement calculations.</p>", "links"=>[], "tags"=>["Diagnostic medicine", "Clinical laboratory sciences", "Global health", "Infectious diseases", "Bacterial diseases", "Salmonella", "enteric"], "article_id"=>733559, "categories"=>["Medicine"], "users"=>["Jason R. Andrews", "Krishna G. Prajapati", "Elizabeth Eypper", "Poojan Shrestha", "Mila Shakya", "Kamal R. Pathak", "Niva Joshi", "Priyanka Tiwari", "Manisha Risal", "Samir Koirala", "Abhilasha Karkey", "Sabina Dongol", "Shawn Wen", "Amy B. Smith", "Duncan Maru", "Buddha Basnyat", "Stephen Baker", "Jeremy Farrar", "Edward T. Ryan", "Elizabeth Hohmann", "Amit Arjyal"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0002292.t002", "stats"=>{"downloads"=>1, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Culture_confirmed_diagnosis_of_enteric_fever_by_conventional_blood_culture_in_comparison_with_results_from_the_experimental_procedure_/733559", "title"=>"Culture-confirmed diagnosis of enteric fever by conventional blood culture in comparison with results from the experimental procedure.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-06-27 03:10:16"}
  • {"files"=>["https://ndownloader.figshare.com/files/1103700"], "description"=>"<div><p>Background</p><p>In many rural areas at risk for enteric fever, there are few data on <i>Salmonella enterica</i> serotypes Typhi (<i>S.</i> Typhi) and Paratyphi (<i>S.</i> Paratyphi) incidence, due to limited laboratory capacity for microbiologic culture. Here, we describe an approach that permits recovery of the causative agents of enteric fever in such settings. This approach involves the use of an electricity-free incubator based upon use of phase-change materials. We compared this against conventional blood culture for detection of typhoidal <i>Salmonella</i>.</p><p>Methodology/Principal Findings</p><p>Three hundred and four patients with undifferentiated fever attending the outpatient and emergency departments of a public hospital in the Kathmandu Valley of Nepal were recruited. Conventional blood culture was compared against an electricity-free culture approach. Blood from 66 (21.7%) patients tested positive for a Gram-negative bacterium by at least one of the two methods. Sixty-five (21.4%) patients tested blood culture positive for <i>S.</i> Typhi (30; 9.9%) or <i>S.</i> Paratyphi A (35; 11.5%). From the 65 individuals with culture-confirmed enteric fever, 55 (84.6%) were identified by the conventional blood culture and 60 (92.3%) were identified by the experimental method. Median time-to-positivity was 2 days for both procedures. The experimental approach was falsely positive due to probable skin contaminants in 2 of 239 individuals (0.8%). The percentages of positive and negative agreement for diagnosis of enteric fever were 90.9% (95% CI: 80.0%–97.0%) and 96.0% (92.7%–98.1%), respectively. After initial incubation, <i>Salmonella</i> isolates could be readily recovered from blood culture bottles maintained at room temperature for six months.</p><p>Conclusions/Significance</p><p>A simple culture approach based upon a phase-change incubator can be used to isolate agents of enteric fever. This approach could be used as a surveillance tool to assess incidence and drug resistance of the etiologic agents of enteric fever in settings without reliable local access to electricity or local diagnostic microbiology laboratories.</p></div>", "links"=>[], "tags"=>["Diagnostic medicine", "Clinical laboratory sciences", "Global health", "Infectious diseases", "Bacterial diseases", "Salmonella", "culture-based", "detecting", "typhoidal", "bacteremia", "enteric", "resource-limited"], "article_id"=>733560, "categories"=>["Medicine"], "users"=>["Jason R. Andrews", "Krishna G. Prajapati", "Elizabeth Eypper", "Poojan Shrestha", "Mila Shakya", "Kamal R. Pathak", "Niva Joshi", "Priyanka Tiwari", "Manisha Risal", "Samir Koirala", "Abhilasha Karkey", "Sabina Dongol", "Shawn Wen", "Amy B. Smith", "Duncan Maru", "Buddha Basnyat", "Stephen Baker", "Jeremy Farrar", "Edward T. Ryan", "Elizabeth Hohmann", "Amit Arjyal"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0002292", "stats"=>{"downloads"=>5, "page_views"=>20, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Evaluation_of_an_Electricity_free_Culture_based_Approach_for_Detecting_Typhoidal_Salmonella_Bacteremia_during_Enteric_Fever_in_a_High_Burden_Resource_limited_Setting/733560", "title"=>"Evaluation of an Electricity-free, Culture-based Approach for Detecting Typhoidal <i>Salmonella</i> Bacteremia during Enteric Fever in a High Burden, Resource-limited Setting", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-06-27 03:10:16"}
  • {"files"=>["https://ndownloader.figshare.com/files/1103691"], "description"=>"<p>a. packets containing a phase-change material are heated in water or direct sunlight. b. after heating the phase change packet (right), the material appears as a clear liquid (left). c. phase change packets and bottles, containing blood from typhoid suspects and vancomycin additive, are placed into a insulated container. d. bottles are inspected every 24 hours for color change of a CO<sub>2</sub> detector, which distinguishes positive (left) from negative (right) cultures.</p>", "links"=>[], "tags"=>["Diagnostic medicine", "Clinical laboratory sciences", "Global health", "Infectious diseases", "Bacterial diseases", "Salmonella", "typhoid", "diagnostic"], "article_id"=>733551, "categories"=>["Medicine"], "users"=>["Jason R. Andrews", "Krishna G. Prajapati", "Elizabeth Eypper", "Poojan Shrestha", "Mila Shakya", "Kamal R. Pathak", "Niva Joshi", "Priyanka Tiwari", "Manisha Risal", "Samir Koirala", "Abhilasha Karkey", "Sabina Dongol", "Shawn Wen", "Amy B. Smith", "Duncan Maru", "Buddha Basnyat", "Stephen Baker", "Jeremy Farrar", "Edward T. Ryan", "Elizabeth Hohmann", "Amit Arjyal"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0002292.g001", "stats"=>{"downloads"=>1, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Electricity_free_typhoid_diagnostic_approach_/733551", "title"=>"Electricity-free typhoid diagnostic approach.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-06-27 03:10:16"}

PMC Usage Stats | Further Information

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  • {"unique-ip"=>"2", "full-text"=>"2", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"10"}
  • {"unique-ip"=>"5", "full-text"=>"4", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"11"}
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  • {"unique-ip"=>"3", "full-text"=>"3", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"4"}
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  • {"unique-ip"=>"1", "full-text"=>"0", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"6"}
  • {"unique-ip"=>"2", "full-text"=>"2", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"7"}
  • {"unique-ip"=>"7", "full-text"=>"7", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"8"}
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  • {"unique-ip"=>"9", "full-text"=>"6", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"10"}
  • {"unique-ip"=>"7", "full-text"=>"4", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"11"}
  • {"unique-ip"=>"11", "full-text"=>"11", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"12"}
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Relative Metric

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