Gallbladder Carriage of Salmonellaparatyphi A May Be an Important Factor in the Increasing Incidence of This Infection in South Asia
Authors: Nely Shrestha Khatri
Journal: Annals of Internal Medicine (2009)

Letters21 April 2009Gallbladder Carriage of Salmonella paratyphi A May Be an Important Factor in the Increasing Incidence of This Infection in South AsiaNely Shrestha Khatri, MD, Pukar Maskey, MD, Sanjay Poudel, MD, Vijay Kumar Jaiswal, MD, Abhilasha Karkey, MSc, Samir Koirala, MD, Nikki Shakya, MD, Krishna Agrawal, MD, Amit Arjyal, MD, Buddha Basnyat, MD, Jeremy Day, MD, Jeremy Farrar, MD, Christiane Dolecek, MD, and Stephen Baker, PhDNely Shrestha Khatri, MDFrom Patan Hospital, Lalitpur, Nepal, and Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Pukar Maskey, MDFrom Patan Hospital, Lalitpur, Nepal, and Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Sanjay Poudel, MDFrom Patan Hospital, Lalitpur, Nepal, and Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Vijay Kumar Jaiswal, MDFrom Patan Hospital, Lalitpur, Nepal, and Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Abhilasha Karkey, MScFrom Patan Hospital, Lalitpur, Nepal, and Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Samir Koirala, MDFrom Patan Hospital, Lalitpur, Nepal, and Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Nikki Shakya, MDFrom Patan Hospital, Lalitpur, Nepal, and Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Krishna Agrawal, MDFrom Patan Hospital, Lalitpur, Nepal, and Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Amit Arjyal, MDFrom Patan Hospital, Lalitpur, Nepal, and Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Buddha Basnyat, MDFrom Patan Hospital, Lalitpur, Nepal, and Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Jeremy Day, MDFrom Patan Hospital, Lalitpur, Nepal, and Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Jeremy Farrar, MDFrom Patan Hospital, Lalitpur, Nepal, and Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., Christiane Dolecek, MDFrom Patan Hospital, Lalitpur, Nepal, and Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam., and Stephen Baker, PhDFrom Patan Hospital, Lalitpur, Nepal, and Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-8-200904210-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Enteric fever is a burden in developing countries, in which poor sanitary conditions facilitate its persistence. Most cases are attributed to the bacterium Salmonella typhi. However, S.paratyphi A is an emerging agent of enteric fever. This trend is apparent in Kathmandu, Nepal, where the proportion of enteric fever cases at Patan Hospital caused by S.paratyphi A increased from 17.5% in 1993 to 34% in 2003 (1).Salmonellatyphi and S. paratyphi A are atypical with respect to the majority of the genus Salmonella because they can survive and replicate in deeper tissues. Systemic dissemination causes organisms to be found in ...References1. Maskey AP, Basnyat B, Thwaites GE, Campbell JI, Farrar JJ, Zimmerman MD. Emerging trends in enteric fever in Nepal: 9124 cases confirmed by blood culture 1993-2003. Trans R Soc Trop Med Hyg. 2008;102:91-5. [PMID: 18023462] CrossrefMedlineGoogle Scholar2. Levine MM, Black RE, Lanata C. Precise estimation of the numbers of chronic carriers of Salmonella typhi in Santiago, Chile, an endemic area. J Infect Dis. 1982;146:724-6. [PMID: 7142746] CrossrefMedlineGoogle Scholar3. Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ. Typhoid fever. N Engl J Med. 2002;347:1770-82. [PMID: 12456854] CrossrefMedlineGoogle Scholar4. Maskey AP, Day JN, Phung QT, Thwaites GE, Campbell JI, Zimmerman M, et al. Salmonella enterica serovar Paratyphi A and S. enterica serovar Typhi cause indistinguishable clinical syndromes in Kathmandu, Nepal. Clin Infect Dis. 2006;42:1247-53. [PMID: 16586383] CrossrefMedlineGoogle Scholar5. Ristori C, Rodríguez H, Vicent P, Lobos H, D'Ottone K, García J, et al. Investigation of the Salmonella typhi-paratyphi carrier state in cases of surgical intervention for gallbladder disease. Bull Pan Am Health Organ. 1982;16:161-71. [PMID: 6810980] MedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Nely Shrestha Khatri, MD; Pukar Maskey, MD; Sanjay Poudel, MD; Vijay Kumar Jaiswal, MD; Abhilasha Karkey, MSc; Samir Koirala, MD; Nikki Shakya, MD; Krishna Agrawal, MD; Amit Arjyal, MD; Buddha Basnyat, MD; Jeremy Day, MD; Jeremy Farrar, MD; Christiane Dolecek, MD; Stephen Baker, PhDAffiliations: From Patan Hospital, Lalitpur, Nepal, and Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.Acknowledgment: The authors thank the surgeons, operation theater staff, community medical workers, and microbiology and surgical staff for providing technical support.Grant Support: Wellcome Trust.Disclosures: None disclosed.Corresponding Author: Buddha Basnyat, MD, Oxford University Clinical Research Unit, Patan Hospital, Lalitpur, Nepal; e-mail, rishibas@wlink.com.np. 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