Distribution Flagellin Gene Variants of Salmonella Typhi in Patients with Typhoid Fever in West Kutai, East Kalimantan, Indonesia

摘要

Background: Virulence of S. typhi possessed an important factor for occurrence of typhoid fever in humans. Penetration of S. typhi in the intestinal mucosa is an important step in the establishment of infection because it allows microorganisms to pass through the epithelial barrier. This penetration is mostly determined by the motility of bacteria. Flagella are composed of a protein called flagellin that associated with the first stage of invasion which allows the bacteria to make direct contact with host cells. Objectives: To explore distributions of Salmonella typhi flagellin gene in effort to explain pathogenesis of typhoid fever in patients with typhoid fever in West Kutai, East Kalimantan. Indonesia. Method: This study was an observational study with cross sectional design. Blood samples collected in January 2011 to December 2012 in Damai District and Barong Tongkok District, West Kutai. Blood cultures performed in patients with suspected typhoid fever, based on clinical features determined by the medical personnel. All positive culture isolate were examine for Hd, Hj, z66 and z66Ind of flagellin genes by Polymerase Chain Reaction (PCR). Results: A total of 62 S. typhi isolates obtained from 425 patients with clinically suspected typhoid fever. All 62 (100%) samples found fliC d, fljBz66 gene was found by 47 (75.81%) z66Ind 8 (12.9%) respectively and there was no samples had fliC j. This study shows that significant differences between flagellin gene variants in relation to the incidence of gastrointestinal bleeding (p = 0.034). Conclusion: We found three types of flagellin gene of S. typhi in West Kutai, they are FliC d, FljBz66 and z66Ind. S. typhi containing fliC d genes provides the possibility 9 times more likely to cause gastrointestinal bleeding in patients with typhoid fever when compared with S. typhi containing fljBz66 genes, and 17.5 times when compared with z66Ind gene.