Classification & Nomenclature (inical classficat > Typhoical salmonella - Salmonella Typhi & Salmonella Paratyphi > Non typhoidal salmonelta- all other rematning serotypes Classification within genus based on presence of different sematic (0) and flagellar (H) antiga > Detected by agglutination with respective antisera Serogroups- based on © antigen + Serotype -serogroups are further clasified into serotypes based on the typeof flagelaréngenwhite Scheme Serogroups Serotype Antigen 0 Antigen H New od Phase Phase2 2 A S.ParatyphiA 1,212 a 4B 5, ParatyphiB 1,4,5,12 b 442 Tyohimurium 154,512 1 42 Chester 4,5, 12 she Cholerasuis 6,7 15 Muenchen 6,8 42 Typhi 9,12 Enteritidis 4,9, 12 Gallinarum 1,9, 12 S.anatum 3,10 s 8 5 g ° S.ParatyphiC 6,7,Mi 4,5 5. s s s ‘.Laboratory diagnosis - Tests depend First. + Blood week + Bone marrow * ile end ciot culture Second Serum week Second Stool ad urine tnd third week g on duration c eres Culture + Conventional method { Castaneda method) + Automated systems (BACTEC or BacT/ALERT) Antibody detection by Widal test Culture + Use of selective media ike + kylose Lysine Deoxycholate media (XLD) * Deoxycholate citrate agar (OCA) Crs Naa oeBlood culture bottle > Castaneda’s biphasic medium > Contains Bil agar slope & BHI broth > Aduts- medica lat botte with 50 ml of BHI roth > Paediatric age - universal container with 20 mi of BHI broth > Sample amount » 5to10 ml for adults » 1 to2mi for pacdatric age group oe > lution factor 1:10Blood culture bottlesEnrichment broth - Selenite F b > Selective enrichment media for cultivation of salmonella and shigella spp. present in small numbers competing with intestinal flora Inhibits coliforms while allowing salmone(la and shigetia spp to grow Not to be autoclaved Once prepared steamed at 100°C for 30 minutes Contents: Co ceed Nannitoh- 4Selective media Special substances added to the solid media Supresses the growth of unwanted organisms Allows the growth of selected organisms > MILD - MacConkey agar fr Gram Negative Bacteria > High -TCBS use for Vibrio choleraeXylose Lysine Deoxycholate media > Selective and differential fie medi for Salmonella & . Uninocutated | Shigella spo. Detects the H25 production E.coli black centre ieee sinnela |Biochemical reactions of salmonella sp Indole Negative bot otve Glucose Fermented with gas 1 (Except. Typhi) = Lactose Not fermented Sucrose Not fermented Mannitol Positive Urea Not hydrolysed Citrate Positive utilisation. (S, Typhi and S. Paratyphi A) Notitty —Notile 7st K/A with Hydrogen sulphide ceed i er > ScTvphi- K/A, Gas (+, Speck of H2S (+) > S.Paratyphi A KIA, Gas (+), H25(-) J» 5S, Paratyohi B- K/A, Gas (+), abundant H2S (+)TSI Resu Itsidal test Serological test for diagnosis of enteric fever Principle - Tube agglutination test Measurement of H & O agglutinin in patient sera H agglutination appears at the end of second week and persists till one year O agglutination appears at the end of first week and remains till six months antigens > Solmenelta Tp - H and O antigens > Simonetta Paratypht-H antigen Agglutination pattern > 0 compact granular chalky lumps {carpet / matt] nos [ wacy / fyTyphidot °® rapid assayethod - widal > 3 sets of tubes are prepared - 0 & H.Ag of S.Typt ee and H antigen of peratypht Cut off titre varies from place te place - depends on the endemicity Preferred - 4 fold raise in ‘Ab titre in paired sera (2 oe en weeks apart ) Single report > or equal to 1160 considered significantLimitations of widal test > cross reactivity with other Salmoneta spp > Fase positives > Previous infection wth. yi ‘Autoimmune diseases False negatives > Early antini Antibody levels vary in different areas - difficult to establish cut off levels oe ee