CULTURE OF SALMONELLA-TYPHI AND SALMONELLA-PARATYPHI FROM BLOOD AND BONE-MARROW IN SUSPECTED TYPHOID-FEVER

We studied the yield of blood and bone marrow (BM) cultures in 145 pat ients clinically suspected of typhoid fever (TF) in Indonesia. The obj ectives were to compare the positivity of blood culture using 3 ml ver sus 10 ml of blood and to examine in how far specific antibiotic treat ment for TF interfered with the positivity of BM culture. Blood for cu lture was collected before antibiotic treatment was initiated in hospi tal and BM 1 to 10 days after the start of treatment. Cultures were pe rformed with Oxgall subcultured on SS agar. Seventy-nine per cent of p atients was treated for 14 days or more with oral chloramphenicol, 18% with chloramphenicol followed by ampicillin or cotrimoxazol and 3% wi th other antibiotics. Cultures were positive for Salmonella typhi or S .paratyphi A in 57 of the 145 patients (39.3%) when 3 mi of blood was cultured and in. 58 (40%) when 10 ml of blood was cultured. BM culture was positive despite antibiotic treatment in 70 patients (48.2%); thi s positivity was significantly greater than that of blood cultures (p< 0.05). When we considered the positivity of BM culture in relation to the number of days on antibiotics in hospital, the yield of BM culture remained apparently unchanged during the first 5 days of treatment. T his may be the consequence of slow elimination of S.typhi or S.paratyp hi by the antibiotics used and could be responsible for relapses.