Comparison of Blood Clot Culture with Conventional Blood Culture and Biphasic Blood Culture for the Diagnosis of Enteric Fever

Diagnosis of enteric fever based on clinical presentation is difficult as signs and symptoms are often non-specific. Isolation of enteric fever pathogens remains the gold standard in diagnosis. Removal of serum with antibacterial activity in clot culture, may enhance the growth of typhoid bacilli. We would like to evaluate clot blood culture system over conventional blood culture and Biphasic blood culture for diagnostic accuracy. Blood cultures by conventional blood culture, Biphasic blood culture and clot culture were performed for 100 consecutive patients for whom enteric fever is suspected. The sensitivity and specificity of whole blood culture and Biphasic medium was found to be 72% and 100%.Both system were of equal sensitivity. Clot culture showed 100% sensitivity. From our study, we strongly recommend clot bile culture be used for routine diagnostic purpose in areas where enteric fever is endemic. Major advantage of practicing clot culture is we utilize what is usually considered as leftover, avoiding the need for additional volume of blood and found to have increased potential for isolation.