ABSTRACT

Fifty (50) stool samples and corresponding venous blood specimens were collected from patients who presented for widal test diagnosis of typhoid fever in five Hospitals or Clinics in Umuahia. The stool samples were cultured on Salmonella  Shigella agar  (SSA) and the sera from the blood  specimens were used to screen for antibodies to febrile antigens of Salmonella typhi and Salmonella paratyphi A, B, and C. Out  of the 50  stool samples cultured, 33(73.33%) produced  significant growth on SSA. The isolates were characterized by colonial morphology, Gram staining reaction and Biochemical tests and were provisionally identified as Salmonella specie. The antibiotics sensitivity profile of the 33 isolates was done using the Kirby-Bauer disc agar diffusion technique. All the 33(100%) isolates were sensitive to Nitrofurontoin, 27(81.8%) were sensitive to Gentamicin, 22(66.7%) to Ciprofloxacin and 19(57.5%) to Ofloxacin, while one (3.30%) isolates was sensitive to Cefuroxime, all the isolates were resistant to Augmentin, Ceftazidime and Ceftriaxone. Comparison of culture widal test results revealed that only 7(21.2%) of the culture positive cases had significant antibody titres (> 1:80) to Salmonella febrile antigens. The result of this study show that there is a high level of antibiotic resistance among Salmonella  isolates and that widal test detected less than 50% of cultured positive cases. The results of this work suggest there is a need for culture and sensitivity as the basis for diagnosis and treatment of typhoid disease in the study area. 

TABLE OF CONTENTS 

Title page i

Certification ii

Dedication iii

Acknowledgements iv

Table of Contents                                                                                                          v

 .List of Table         viii

 List of Figure ix

Abstract x

CHAPTER ONE

1.1 INTRODUCTION 1

1.2 Aims and objectives  4

CHAPTER TWO 

2.0 LITERATURE REVIEW 5

2.1 Prevalence / incidence 5

2.2 Isolation and identification of Salmonella 7

2.3 Culture 8

2.4 Anti-microbial resistance 8

2.5 Widal agglutination test 11

CHAPTER THREE

3.0 MATERIALS AND METHODS 13

3.1 Study area 13

3.2 Sample collection 13

3.3 Media preparation 14

3.4 Isolation and identification of salmonella species 14

3.5 Culture 14

3.6 Widal tests 14

3.7 Gram Staning 15

3.8 Anti microbial Susceptiblity testing 15

3.9 Biochemical tests 16

CHAPTER FOUR

4.0 RESULTS 18

CHAPTER FIVE

5.0 DISCUSSION, CONCLUSION AND RECOMMENDATION 27

5.1 Conclusion 29

5.2 Recommendation 30

References 31

Appendix 37