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Abstract：
Background Enteric fever is a systemic infection in humans caused by the Gram-negative bacilliSalmonella enterica serovars Typhi and Paratyphi. Although the diagnosis typically involves the isolation of Salmonella enterica serovars, it is often determined based on laboratory findings and clinical observations. However, due to the wide variety and the non-specific character of clinical features, making a definitive diagnosis presents numerous challenges. Therefore, the aim of this study was to find the predictive hematological and biochemical parameters which would serve in the diagnosis, prognosis, and treatment of typhoid fever cases. Methodology A cross-sectional study was conducted from November 2020 to September 2021 on1076consented volunteerparticipants. Stool culture and identification tests enabled us to distinguish three groups including 423 Salmonella Typhi positive patients, 115 S. Paratyphi positive patients, and 538 Salmonella negative participants. Biochemical and hematological parameters were evaluated using standard methods from commercial kits and Sysmex KX-21N automated hematology analyzer, respectively. A multiple logistic regression analysis was performed to identify the validity of the hematological and biochemical characteristics for enteric fever diagnosis. Results Multiple logistic regression showed hyper creatininemia, hypoalbuminemia, hyper total proteinemia, hyper alkaline phosphatase (ALP), hyper alanine aminotransferase (ALT), hyper total bilirubinemia, hyper conjugated bilirubinemia, hyper triglyceridemia, hyper C-reactive protein (CRP), leukopenia, thrombocytopenia, lymphopenia, monocytopenia, low hemoglobin, low hematocrit, low mean corpuscular volume (MCV), low mean corpuscular hemoglobin (MCH), low platelet, low platelet crit level, high platelet distribution width (PDW) level, high erythrocyte sedimentation rate 1 (ESR1) level as significant biological abnormalities associated (odds ratio {OR} > 1; p < 0.05) with enteric fever infection. Similarly, hyper ESR2 was an independent predictor (OR > 1; p < 0.05) of S. Typhi infection. However, a negative and significant association (OR < 1; p < 0.05) was recorded between enteric fever infection and high mean platelet volume (MPV). Conclusion Overall the results of the biochemical and hematological profiles can serve as potential diagnostic markers for typhoid fever. These markers can also be useful in the appropriate management of those with enteric fever, preventing severity and limiting outcomes of mortality.
摘要：
背景肠道热是由革兰氏阴性杆菌肠道沙门氏菌伤寒和副伤寒引起的人类全身性感染。尽管诊断通常涉及肠沙门氏菌血清变型的分离，通常根据实验室检查结果和临床观察结果确定.然而,由于临床特征的多样性和非特异性，做出明确的诊断提出了许多挑战。因此,这项研究的目的是找到可用于诊断的预测性血液学和生化参数，预后,以及伤寒病例的治疗。方法2020年11月至2021年9月，对1076名自愿志愿者进行了横断面研究。粪便培养和鉴定测试使我们能够区分三组，包括423例伤寒沙门氏菌阳性患者，115例副伤寒阳性患者，和538名沙门氏菌阴性参与者。使用商业试剂盒和SysmexKX-21N自动血液学分析仪的标准方法评估生化和血液学参数。分别。进行了多元logistic回归分析，以确定血液学和生化特征对肠道热诊断的有效性。结果多因素logistic回归分析显示高肌酐血症,低蛋白血症,高总蛋白血症，高碱性磷酸酶(ALP),超丙氨酸转氨酶(ALT),高总胆红素血症,高结合胆红素血症,高甘油三酯血症,高C反应蛋白(CRP),白细胞减少症,血小板减少症,淋巴细胞减少,单核细胞减少症,低血红蛋白,低血细胞比容,低平均红细胞体积(MCV)，低平均红细胞血红蛋白（MCH），低血小板,低血小板crit水平，高血小板分布宽度（PDW）水平，高红细胞沉降率1(ESR1)水平与肠热感染显著相关(比值比{OR}>1;p<0.05)。同样，hyperESR2是伤寒沙门氏菌感染的独立预测因子(OR>1;p<0.05)。然而,肠热感染与高平均血小板体积(MPV)之间呈负相关(OR<1;p<0.05).结论总体上，生化和血液学特征的结果可以作为伤寒的潜在诊断标志物。这些标记物也可用于适当管理肠热患者，预防严重程度和限制死亡结果。
