Cause Of Typhoid Fever Research Articles

From acute to persistent infection: revealing phylogenomic variations in Salmonella Agona.

Salmonella enterica serovar Agona (S. Agona) has been increasingly recognised as a prominent cause of gastroenteritis. This serovar is a strong biofilm former that can undergo genome rearrangement and enter a viable but non-culturable state whilst remaining metabolically active. Similar strategies are employed by S. Typhi, the cause of typhoid fever, during human infection, which are believed to assist with the transition from acute infection to chronic carriage. Here we report S. Agona's ability to persist in people and examine factors that might be contributing to chronic carriage. A review of 2233 S. Agona isolates from UK infections (2004-2020) and associated carriage was undertaken, in which 1155 had short-read sequencing data available. A subset of 207 isolates was selected from different stages of acute and persistent infections within individual patients. The subset underwent long-read sequencing and genome structure (GS) analysis, as well as phenotyping assays including carbon source utilisation and biofilm formation. Associations between genotypes and phenotypes were investigated to compare acute infections to those which progress to chronic. GS analysis revealed the conserved arrangement GS1.0 in 195 isolates, and 8 additional GSs in 12 isolates. These rearranged isolates were typically associated with early, convalescent carriage (3 weeks- 3 months). We also identified an increase in SNP variation during this period of infection. We believe this increase in genome-scale and SNP variation reflects a population expansion after acute S. Agona infection, potentially reflecting an immune evasion mechanism which enables persistent infection to become established.

A novel phospholipase A2 is a core component of the typhoid toxin genetic islet

S. Typhi, the cause of typhoid fever, is a bacterial pathogen of substantial global importance. Typhoid toxin is a secreted AB-type toxin that is a key S. Typhi virulence factor encoded within a 5-gene genetic islet. Four genes in this islet have well-defined roles in typhoid toxin biology, however the function of the fifth gene is unknown. Here, we investigate the function of this gene, which we name ttaP. We show that ttaP is co-transcribed with the typhoid toxin subunit cdtB, and we perform genomic analyses that indicate that TtaP is very highly conserved in typhoid toxin islets found in diverse salmonellae. We show that TtaP is a distant homolog of group XIV secreted phospholipase A2 (PLA2) enzymes, and experimentally demonstrate that TtaP is a bona fide PLA2. Sequence and structural analyses indicate that TtaP differs substantially from characterized PLA2s, and thus represents a novel class of PLA2. Secretion assays revealed that TtaP is neither co-secreted with typhoid toxin, nor is it required for toxin secretion. Although TtaP is a phospholipase that remains associated with the S. Typhi cell, assays that probed for altered cell envelope integrity failed to identify any differences between wild-type S. Typhi and a ttaP deletion strain. Collectively, this study identifies a biochemical activity for the lone uncharacterized typhoid toxin islet gene and lays the groundwork for exploring how this gene factors into S. Typhi pathogenesis. This study further identifies a novel class of PLA2, enzymes that have a wide range of industrial applications.

ANALYSIS OF COST EFFECTIVENESS OF ANTIBIOTIC USE IN TYPHOD FEVER PATIENTS AT KARTINI RANGKASBITUNG HOSPITAL IN 2022

The high prevalence rate of typhoid fever is one of the health problems in Indonesia. Antibiotic therapy is the only therapy that can be used to treat the main cause of typhoid fever. Antibiotics are a type of drug therapy that requires a lot of budgets to procure. This study aims to find out the most cost-effective type of antibiotic for treating typhoid fever. This research was conducted at Kartini Rangkasbitung Hospital using observational research methods with a cross-sectional approach. The data used uses secondary data conducted retrospectively. This research uses medical record data and cost data. This study was divided into three groups, namely ciprofloxacin tablets, intravenous ceftriaxone, levofloxacin tablets and intravenous levofloxacin. Based on the calculation results, the ACER value of ceftriaxone is IDR 2,955,250, the ACER value of IV levofloxacin is IDR 2,727,306, and the ACER value of levofloxacin tablets is IDR 3,047,337. The ICER value from the comparison between levofloxacin tablets and ceftriaxone is IDR 43,250. The most cost-effective antibiotic is the antibiotic levofloxacin in intravenous form.

A retrospective investigation of the population structure and geospatial distribution of Salmonella Paratyphi A in Kathmandu, Nepal.

Salmonella Paratyphi A, one of the major etiologic agents of enteric fever, has increased in prevalence in recent decades in certain endemic regions in comparison to S. Typhi, the most prevalent cause of enteric fever. Despite this increase, data on the prevalence and molecular epidemiology of S. Paratyphi A remain generally scarce. Here, we analysed the whole genome sequences of 216 S. Paratyphi A isolates originating from Kathmandu, Nepal between 2005 and 2014, of which 200 were from patients with acute enteric fever and 16 from the gallbladder of people with suspected chronic carriage. By exploiting the recently developed genotyping framework for S. Paratyphi A (Paratype), we identified several genotypes circulating in Kathmandu. Notably, we observed an unusual clonal expansion of genotype 2.4.3 over a four-year period that spread geographically and systematically replaced other genotypes. This rapid genotype replacement is hypothesised to have been driven by both reduced susceptibility to fluoroquinolones and genetic changes to virulence factors, such as functional and structural genes encoding the type 3 secretion systems. Finally, we show that person-to-person is likely the most common mode of transmission and chronic carriers seem to play a limited role in maintaining disease circulation.

TESTING FOR ANTIBACTERIAL ACTIVITY OF FRUIT SKIN ETHANOL EXTRACT DUKU (Lansium domesticum Corr) AGAINST BACTERIA Salmonella Typhi

Salmonella typhimurium bacteria is the cause of typhoid fever. One of the herbal plants that can be used as an antibacterial drug is duku fruit peel (Lansium domesticum Corr). Phytochemical tests were carried out on duku fruit peel extract which was soaked in 96% ethanol solvent. The aim of this test is to identify secondary metabolites found in duku fruit skin. There are alkaloids, flavonoids, saponins, tannins and triterpenoids in the ethanol extract of duku fruit peel. This study involved four treatment groups with extract concentrations of 25 percent, 50 percent, and 75 percent, along with a positive control (chloramphenicol) and a negative control (distilled water). With inhibition zone diameters of 10.22 mm, 11.94 mm, and 13 mm, the ethanol extract of duku fruit peel showed antibacterial activity against Salmonella enterica bacteria. The results of univariate data analysis showed that the ethanol extract of duku fruit peel showed antibacterial activity at 25%, 50% and 75%. The results of univariate data analysis showed that the ethanol extract of duku fruit peel showed antibacterial activity against Salmonella typhi bacteria. In addition, the bacterial concentration increases with the width of the inhibition zone.

Antimicrobial Susceptibility Patterns of Salmonella Typhi and Salmonella Paratyphi in Tertiary Care Hospitals

Background: Salmonella typhi and Salmonella paratyphi are significant causes of enteric fever, posing substantial public health challenges globally. Monitoring their antimicrobial susceptibility patterns is crucial for guiding treatment strategies and combating antimicrobial resistance, particularly in tertiary care hospitals where severe cases are managed. Aim: To determine the antibiogram profile of Salmonella typhi and Salmonella paratyphi isolated from blood cultures of paediatrics patients presenting in Lady Reading Hospital Peshawar. Methodology: The study examined the prevalence, clinical characteristics, and antibiotic susceptibility patterns of Salmonella typhi and Salmonella paratyphi infections among 530 participants aged 13 to 18 years presenting in Lady Reading Hospital Peshawar. Over the course of two years using a prospective observational cohort design. Recruitment, clinical evaluations, and laboratory validation using accepted methods were all part of the data gathering process. Testing for antibiotic susceptibility was done, and statistical analysis was done using SPSS version 28. Both informed consent and ethical approval were obtained. Results: The research included 530 instances of enteric fever, of which 318 cases (or 60%) were due to Salmonella typhi and 212 cases (or 40%) to Salmonella Paratyphi. There were 40.25% female cases and 59.75% male cases among them. The age group of 15–16 years old accounted for the largest percentage of cases (38.68%), followed by 13–14 years old (33.02%) and 17–18 years old (28.30%). Different patterns emerged from antimicrobial susceptibility tests; drugs such as ampicillin (66.04%), azithromycin (74.26%), cefixime (87.47%), ceftriaxone (92.77%), chloramphenicol (91.51%), ciprofloxacin (92.40%), and co-trimoxazole (55.03%) showed substantial susceptibility rates. Compared to Salmonella typhi, Salmonella paratyphi showed notably greater sensitivity rates for azithromycin (94.47%) and ceftriaxone (95.45%). Practical implication: This research provided the community with important advantages and practical consequences. The study helps healthcare professionals choose efficient treatment plans by identifying the antibiotic susceptibility patterns of Salmonella typhi and Salmonella paratyphi, particularly in tertiary care facilities. Conclusion: This study highlights the importance of continuous surveillance and species-specific treatment strategies to combat antimicrobial resistance and improve patient outcomes in enteric fever, particularly in tertiary care settings. Keywords:Antimicrobial susceptibility, Salmonella typhi, Salmonella Paratyphi, Tertiary care hospitals

Antibacterial effect of eucalyptus (Melaleuca leucadendra) ecoenzyme produced by Lamongan’s MSMEs against Salmonella Typhi

Typhoid fever is a disease with extensive epidemiological distribution, causing high morbidity and mortality. The lack of effectiveness in prevention and treatment contributes to its continued mass occurrence. Salmonella Typhi bacteria are the main etiological cause of typhoid fever and have demonstrated resistance to various typhoidal antibiotics. This study aims to explore alternative possibilities for these issues, both curatively and preventively. Eucalyptus (Melaleuca leucadendra) is known to contain numerous antibacterial compounds, with 1.8 cineole as the main antibacterial compound. This compound exerts antibacterial effects by disrupting bacterial cell membranes and walls. Ecoenzyme are also recognized for their antibacterial effects, containing antibacterial compounds such as acetic acid, citric acid, lipase enzyme, trypsin enzyme, and amylase enzymes. This research is a laboratory experimental study conducted using the agar-well diffusion method on Mueller Hinton agar media, with the diameter of the inhibition zone as the test result. The findings indicate that all tested concentrations of eucalyptus ecoenzyme (10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, and 100%) show no inhibitory zone in all three test replications. This result suggests that eucalyptus (Melaleuca leucadendra) ecoenzyme produced by Lamongan’s MSMEs does not exhibit antibacterial effects on Salmonella Typhi.

Assessing the global risk of typhoid outbreaks caused by extensively drug resistant Salmonella Typhi

Since its emergence in 2016, extensively drug resistant (XDR) Salmonella enterica serovar Typhi (S. Typhi) has become the dominant cause of typhoid fever in Pakistan. The establishment of sustained XDR S. Typhi transmission in other countries represents a major public health threat. We show that the annual volume of air travel from Pakistan strongly discriminates between countries that have and have not imported XDR S. Typhi in the past, and identify a significant association between air travel volume and the rate of between-country movement of the H58 haplotype of S. Typhi from fitted phylogeographic models. Applying these insights, we analyze flight itinerary data cross-referenced with model-based estimates of typhoid fever incidence to identify the countries at highest risk of importation and sustained onward transmission of XDR S. Typhi. Future outbreaks of XDR typhoid are most likely to occur in countries that can support efficient local S. Typhi transmission and have strong travel links to regions with ongoing XDR typhoid outbreaks (currently Pakistan). Public health activities to track and mitigate the spread of XDR S. Typhi should be prioritized in these countries.

Escherichia coli and Salmonella sp. on some lettuce in the traditional market of Banyuwangi Regency

Escherichia coli is the main pathogenic bacteria which causes diarrhea in humans and the fourth highest cause of death which occurs all age groups. Salmonella sp is the cause of typhoid fever and findings of 350-810 cases each year. Diarrhea and typhoid fever are closely related to the consumption of raw vegetables, such as lettuce. This study aimed to analyze the contamination of E. coli and Salmonella sp on some lettuces in Traditional Markets of Banyuwangi Regency. This research was an analytic descriptive study using a cross-sectional design at the Laboratory of Microbiology, STIKES Banyuwangi from 6 to 11 June 2022 using 6 lettuces as research samples which were selected by accidental sampling. All (100%) lettuce samples in this study were contaminated with >1,100 CFU/ml E. coli. All (100%) samples in this study were positively contaminated by Salmonella sp with various contamination number, such as: 0.82x104; 0.47x104, 1.90x105, 2.05x106, 1.00x105 and 1.25x106 CFU/ml, respectively. All six lettuces obtained from the Traditional Market of Banyuwangi Regency did not meet the microbiological quality specified by SNI, indicating that they were not suitable for direct (raw) consumption.

Zingerone inhibits biofilm formation and enhances antibiotic efficacy against Salmonella biofilm

Zingerone inhibits biofilm formation and enhances antibiotic efficacy against Salmonella biofilm

Antimicrobial Effect of Silver Nanoparticles and Combination with Cotrimoxazole against Salmonella Typhi in Vitro and in Animal Model

Introduction: Salmonella typhi is a large group of gram-negative bacilli with Enterobacteriaceae and common pathogens between humans and animals, which is the main cause of typhoid fever in humans. One of the most common antibiotics in the treatment of Salmonella is cotrimoxazole, but due to the widespread use of antibiotics, bacterial resistance has developed. The aim of this study was to investigate the antibacterial effect of silver nanoparticles and its combination with the antibiotic cotrimoxazole to produce a more effective antimicrobial drug against Salmonell typhi.
 Methods: In this experimental study, the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) for silver nanoparticles and combination with cotrimoxazole, was performed based on microdilution method. Then, their antibacterial effects were investigated in infected mouse model. In order to analyze the results statistically, SPSS software version 16 was used. In this test, P< 0.05 was considered as a significant level.
 Results: MIC and MFC of silver nanoparticles for Salmonella typhi were 4 ppm and 8 ppm respectively, composition of silver nanoparticles with cotrimoxazole for Salmonella typhi were 62 ppm and 125 ppm and cotrimoxazole for Salmonella typhi were 500 ppm and 1000 ppm. Mouse model to study the antibacterial effect of silver nanoparticles and combination with cotrimoxazole against Salmonella typhi infection was confirmed., Silver nanoparticles had the highest antibacterial effect and cotrimoxazole has the lowest antibacterial effect than other groups.
 Conclusion: Silver nanoparticles are very effective compared to other groups, especially the antibacterial cotrimoxazole.

Upaya Pengelolaan Demam Tifoid Dengan Pendekatan Pelayanan Dokter Keluarga

A 17-month-old female patient was brought by her family to the emergency room at the Lhoksukon Health Center with complaints of weakness for the last 2 days. Weakness was felt to be burdensome since the patient had a fever on the 5th day. Fever is felt up and down throughout the day. The fever is accompanied by chills, sweating, and restlessness. On the first day of fever, the patient was given fever medicine by the patient's mother at home, but the fever did not subside. The patient also experiences nausea and vomiting. Nausea appears sometimes when eating. Vomiting is in the form of food that is eaten but the vomit volume is not much. The patient's appetite also decreases. Primary data were obtained through alloanamnesa, physical examination, supporting examinations, as well as making home visits, filling out family folders, and filling out patient files. The assessment was carried out based on the initial holistic diagnosis, process and end of the visit both quantitatively and qualitatively. Interventions carried out include education about the causes of typhoid fever to their families, education about hygiene and handling of the disease and explaining complications that may arise from the patient's illness so that they can make efforts to prevent and treat it if it recurs.

Bacterial shedding and serologic responses following an outbreak of Salmonella Typhi in an endemic cohort

BackgroundSalmonella enterica serovar Typhi (Salmonella Typhi) is the cause of typhoid fever. Salmonella Typhi may be transmitted through shedding in the stool, which can continue after recovery from acute illness. Shedding is detected by culturing stool, which is challenging to co-ordinate at scale. We hypothesised that sero-surveillance would direct us to those shedding Salmonella Typhi in stool following a typhoid outbreak.MethodsIn 2016 a typhoid outbreak affected one in four residents of a Nursing School in Malosa, Malawi. The Department of Health asked for assistance to identify nursing students that might spread the outbreak to other health facilities. We measured IgG antibody titres against Vi capsular polysaccharide (anti-Vi IgG) and IgM / IgG antibodies against H:d flagellin (anti-H:d) three and six months after the outbreak. We selected participants in the highest and lowest deciles for anti-Vi IgG titre (measured at visit one) and obtained stool for Salmonella culture and PCR. All participants reported whether they had experienced fever persisting for three days or more during the outbreak (in keeping with the WHO definitions of ‘suspected typhoid’). We tested for salmonellae in the Nursing School environment. ResultsWe obtained 320 paired serum samples from 407 residents. We cultured stool from 25 residents with high anti-Vi IgG titres and 24 residents with low titres. We did not recover Salmonella Typhi from stool; four stool samples yielded non-typhoidal salmonellae; one sample produced a positive PCR amplification for a Salmonella Typhi target. Median anti-Vi and anti-H:d IgG titres fell among participants who reported persistent fever. There was a smaller fall in anti-H:d IgG titres among participants who did not report persistent fever. Non-typhoidal salmonellae were identified in water sampled at source and from a kitchen tap.ConclusionHigh titres of anti-Vi IgG did not identify culture-confirmed shedding of Salmonella Typhi. There was a clear serologic signal of recent typhoid exposure in the cohort, represented by waning IgG antibody titres over time. The presence of non-typhoidal salmonellae in drinking water indicates sub-optimal sanitation. Developing methods to detect and treat shedding remains an important priority to complement typhoid conjugate vaccination in efforts to achieve typhoid elimination.

Salmonella Typhi whole genome sequencing in Rwanda shows a diverse historical population with recent introduction of haplotype H58.

Salmonella enterica serovar Typhi (S. Typhi) is the cause of typhoid fever, presenting high rates of morbidity and mortality in low- and middle-income countries. The H58 haplotype shows high levels of antimicrobial resistance (AMR) and is the dominant S. Typhi haplotype in endemic areas of Asia and East sub-Saharan Africa. The situation in Rwanda is currently unknown and therefore to reveal the genetic diversity and AMR of S. Typhi in Rwanda, 25 historical (1984-1985) and 26 recent (2010-2018) isolates from Rwanda were analysed using whole genome sequencing (WGS). WGS was locally implemented using Illumina MiniSeq and web-based analysis tools, thereafter complemented with bioinformatic approaches for more in-depth analyses. Whereas historical S. Typhi isolates were found to be fully susceptible to antimicrobials and show a diversity of genotypes, i.e 2.2.2, 2.5, 3.3.1 and 4.1; the recent isolates showed high AMR rates and were predominantly associated with genotype 4.3.1.2 (H58, 22/26; 84,6%), possibly resulting from a single introduction in Rwanda from South Asia before 2010. We identified practical challenges for the use of WGS in endemic regions, including a high cost for shipment of molecular reagents and lack of high-end computational infrastructure for the analyses, but also identified WGS to be feasible in the studied setting and giving opportunity for synergy with other programs.

A study of etiopathogenesis, clinical and laboratory profile evaluation of typhoid fever in paediatric age group in Bijapur

Background: Salmonella typhi causes typhoid illness. In India, it is a huge public health issue. Several impoverished nations have endemic typhoid fever. The wide range of clinical symptoms of typhoid fever makes diagnosis difficult. The purpose of this study was to better understand the vast range of clinical symptoms, comorbidities, and drug sensitivity patterns associated with typhoid fever in children. Methods: From March 2021 to October 2022, 100 children hospitalised to the paediatric unit at Al-Ameen Medical College and Hospital in Bijapur with proven typhoid fever were included in the study. Age, gender, presenting complaint, laboratory tests, and antibiotic sensitivity pattern are all gathered and analysed in each patient. Results: There were 58 men (58%) and 42 females (42%) among the 100 cases. The most typical age range was 5 to 15 years. Fever was the most prevalent symptom, occurring in 100% of patients, headache (80%), coated tongue (100%), vomiting (45%), and abdominal pain (70%). In 68% of cases, the most prevalent indication was a toxic look, and hepatomegaly in 44%. In 28% of instances, leukocytopenia was discovered. In every case, the blood culture proved positive. The length of hospital stay ranged from 3 to 10 days. There was no recorded death. Conclusions: Unhygienic habits and consuming meals from the outside are the main causes of typhoid fever. By raising people's understanding of disease transmission and its many preventative methods, this serious public health issue can be resolved.

Human variation impacting MCOLN2 restricts Salmonella Typhi replication by magnesium deprivation

Human genetic diversity can reveal critical factors in host-pathogen interactions. This is especially useful for human-restricted pathogens like Salmonella enterica serovar Typhi (S. Typhi), the cause of typhoid fever. One key defense during bacterial infection is nutritional immunity: host cells attempt to restrict bacterial replication by denying bacteria access to key nutrients or supplying toxic metabolites. Here, a cellular genome-wide association study of intracellular replication by S. Typhi in nearly a thousand cell lines from around the world-and extensive follow-up using intracellular S. Typhi transcriptomics and manipulation of magnesium availability-demonstrates that the divalent cation channel mucolipin-2 (MCOLN2 or TRPML2) restricts S. Typhi intracellular replication through magnesium deprivation. Mg2+ currents, conducted through MCOLN2 and out of endolysosomes, were measured directly using patch-clamping of the endolysosomal membrane. Our results reveal Mg2+ limitation as a key component of nutritional immunity against S. Typhi and as a source of variable host resistance.

Mekanisme Antibakteri Ekstrak Etanol Daun Kemangi (Ocimum basilicum L.) terhadap Salmonella typhi

Infectious diseases are conditions that can be brought on by a variety of different organisms, including bacteria, viruses, fungi, and parasites. Typhoid fever is an example of an infectious disease that frequently causes the body's defenses to come under attack. The fever associated with typhoid is a leading cause of death around the world. Infection with the bacterium Salmonella typhi is considered to be one of the potential causes of typhoid fever. When antibiotics are used to treat bacterial infections, there is a risk that the bacteria will become resistant to the medication. In day-to-day life, basil leaves are utilized both as a cooked vegetable and as a fresh vegetable. The antibacterial properties of kemangi leaves have yet to be fully uncovered. The purpose of this study was to investigate the various mechanisms that are involved in antibacterial activity. These mechanisms include cell leakage, minimum inhibitory concentration, minimum killing concentration, and antibiofilm activity. The minimum inhibitory concentration (MIC) was determined with the agar diffusion method, the minimum biofilm forming concentration (MBC) was determined with the staining method, and cell leakage was determined with UV-VIS spectrophotometry at wavelengths of 260 nm (DNA) and 280 nm (protein). Additionally, the formation of anti-biofilms was determined with microtiter plates and gentian violet staining. In the moderate category, the MIC value tests showed a concentration of 0.3125% with an inhibition zone value of 6.80 0.05 mm. These results were obtained from the MIC value. Because there was no detectable bacterial growth on the streaked medium, KBM was obtained at a concentration of 10%. At wavelengths of 260 and 280 nanometers, leakage cells show absorbance absorption. The percentage of biofilm activity that is measured when the concentration is increased to 25% is 44.82%. In conclusion, the ethanol extract of basil leaves possesses a possible antibacterial mechanism against Salmonella typhi. This was discovered through testing.

Typhoid toxin sorting and exocytic transport from Salmonella Typhi-infected cells.

Typhoid toxin is an essential virulence factor for Salmonella Typhi, the cause of typhoid fever in humans. This toxin has an unusual biology in that it is produced by Salmonella Typhi only when located within host cells. Once synthesized, the toxin is secreted to the lumen of the Salmonella-containing vacuole from where it is transported to the extracellular space by vesicle carrier intermediates. Here, we report the identification of the typhoid toxin sorting receptor and components of the cellular machinery that packages the toxin into vesicle carriers, and exports it to the extracellular space. We found that the cation-independent mannose-6-phosphate receptor serves as typhoid toxin sorting receptor and that the coat protein COPII and the GTPase Sar1 mediate its packaging into vesicle carriers. Formation of the typhoid toxin carriers requires the specific environment of the Salmonella Typhi-containing vacuole, which is determined by the activities of specific effectors of its type III protein secretion systems. We also found that Rab11B and its interacting protein Rip11 control the intracellular transport of the typhoid toxin carriers, and the SNARE proteins VAMP7, SNAP23, and Syntaxin 4 their fusion to the plasma membrane. Typhoid toxin's cooption of specific cellular machinery for its transport to the extracellular space illustrates the remarkable adaptation of an exotoxin to exert its function in the context of an intracellular pathogen.

Gambaran Sanitasi Lingkungan pada Santriwati Penderita Demam Tifoid di Pondok Modern Darussalam Gontor Putri 3

Good environmental sanitation will bear a good aesthetic and healthy environment. If the sanitation level is low then people around the neighborhood will be susceptible to disease. Environmental sanitation includes clean water supplying, the density of flies, garbage disposal facilities and sewage facilities (latrines). The purpose of this study was to determine the environmental sanitation strikes in Darussalam Gontor For Girls 3 and determine the cause of typhoid fever in Gontor For Girls 3. This study uses observation method with a descriptive approach. This research was conducted in Gotor for Girls 3 with the number of respondents as many as 42 people. Retrieval of data from respondents was conducted in January 2020 until February 2020.The results of this study was sanitation in Gontor For girls Campus 3 entered in both categories with the acquisition value of percentage as much as 66%. The factors that cause typhoid fever maybe of garbage disposal facilities, the level of flies density, water supplying and sewerage facilities (latrines), and the percentage of value about 46%.

The molecular basis of extensively drug-resistant Salmonella Typhi isolates from pediatric septicemia patients.

Sepsis is a syndromic response to infections and is becoming an emerging threat to the public health sector, particularly in developing countries. Salmonella Typhi (S. Typhi), the cause of typhoid fever, is one primary cause of pediatric sepsis in typhoid endemic areas. Extensively drug-resistant (XDR) S. Typhi is more common among pediatric patients, which is responsible for over 90% of the reported XDR typhoid cases, but the majority of antibiotic resistance studies available have been carried out using S. Typhi isolates from adult patients. Here, we characterized antibiotic-resistance profiles of XDR S. Typhi isolates from a medium size cohort of pediatric typhoid patients (n = 45, 68.89% male and 31.11% female) and determined antibiotic-resistance-related gene signatures associated with common treatment options to typhoid fever patients of 18 XDR S. Typhi representing all 45 isolates. Their ages were 1–13 years old: toddlers aging 1–2 years old (n = 9, 20%), pre-schoolers aging 3–5 years old (n = 17, 37.78%), school-age children aging 6–12 years old (n = 17, 37.78%), and adolescents aging 13–18 years old (n = 2, 4.44%). Through analyzing blaTEM1, dhfR7, sul1, and catA1genes for multidrug-resistance, qnrS, gyrA, gyrB, parC, and parE for fluoroquinolone-resistance, blaCTX-M-15 for XDR, and macAB and acrAB efflux pump system-associated genes, we showed the phenotype of the XDR S. Typhi isolates matches with their genotypes featured by the acquisitions of the genes blaTEM1, dhfR7, sul1, catA1, qnrS, and blaCTX-M-15 and a point mutation on gyrA. This study informs the molecular basis of antibiotic-resistance among recent S. Typhi isolates from pediatric septicemia patients, therefore providing insights into the development of molecular detection methods and treatment strategies for XDR S. Typhi.