Isolation of a Highly Purified Capsular Polysaccharide from Salmonella enterica Serovar Typhi (Salmonella typhi) and Its Use in Serological Diagnostics of Typhoid Fever

For use in differential diagnostics of typhoid fever, samples of the capsular polysaccharide from Salmonella enterica serovar Typhi (usually named Vi-antigen) were isolated and characterized by physicochemical and serological methods. It was shown that only the sample of Vi-antigen with the minimal (0.57%) admixture of the corresponding lipopolysaccharide (LPS) from S. typhi retained a high serological activity in the tests with monoreceptor anti-Vi sera. However, it exhibited a substantially weaker reaction with sera from normal donors and patients with acute nontyphoid salmonelloses, than Vi-antigen preparations with a higher (0.8–1.2%) LPS content. The chromatographically pure Vi-antigen was further purified by triple reprecipitation with hexadecyltrimethylammonium bromide. The content of the LPS admixture in the resulting Vi-antigen samples was determined quantitatively by GC. A high purification level of the Vi-antigen from the LPS admixture allows us to hope that this preparation could serve as a basic component of the test system for the diagnostics of typhoid fever.     

Isolation of flagellin antigens of salmonellae by the method of ultracentrifugation and their use for preparation of erythrocytic H-diagnostic agents]

Flagellar preparations were obtained from 6 salmonellae strains by differential ultracentrifugation; they were characterized by morphological, immunochemical, and serological tests. The results of investigations showed that the preparations possessed high serological activity; somatic antigen admixture was insignificant. Flagellins extracted from the flagellae were used to prepare erythrocytic H-diagnostic agents. The results of their use in the examination of sera of healthy persons, and of those suffering from typhoid fever and salmonellosis indicated the expediency of using passive H-hemagglutination for diagnostic purposes.     

An immunoblotting as a method for the diagnosis of typhoid fever

The patients' sera had been referred to the National Salmonella Centre for routine Widal serology. Sera were predominately from patients suspected of having been infected with Salmonella Typhi, but also included one serum from patient with typhoid fever who was culture positive for Salmonella Typhi. The immunoblotting procedure using Salmonella Typhi somatic (O=9,12 LPS) and flagellar (H=d) antigens was used for preliminary testing of selected patients sera previously evaluated by Widal agglutination assay as containing different levels of antibodies against O and/or H antigens of Salmonella Typhi. Following Chart et al., immunoblotting reactions were graded between 0 and 3, with 0 indicating an absence of antibody binding, and 3 where antibody binding was readily observed. Sera giving reaction of 2 or 3 were considered to be antibody positive for this study. Positive immunoblotting reaction to O=9,12 LPS antigen was obtained only with the serum of patient with typhoid fever. Presence of specific anti-LPS antibodies was also observed in two other patients' sera diluted 1:50, and in case of one of them also in dilution 1:200, but intensity of antigen-antibody reaction was under positive result criterion. The most other sera positive to O=9,12 antigen in law dilutions (1:50, 1:100) by Widal assay, showed the traces of non-specific reaction by immunoblotting. Presence of positive antigen-antibody reaction was indicated for five sera in dilution 1:50 when tested with the >55 kDa H=d flagellar protein subunit, including the serum of patient with typhoid fever. Only in this serum the high level of specific antibodies was detected also in dilution 1:200, what was not observed in case of the other four, which appeared negative. All the other sera were shown not to contain antibodies to flagella antigen. Although the presented results are preliminary and additional study of more sera of people infected with Salmonella Typhi is needed, it can be concluded after Chart et al., that an immunoblotting procedure incorporating O=9,12 LPS and flagellar H=d antigens is a useful method for providing serological evidence of infection with Salmonella Typhi. In our opinion it can serve as a rapid test for the diagnosis of typhoid fever.     

Determination of the Vi-antigen content of acetone-dried typhoid vaccines

Summary A number of typhoid strains and coli strain 5396/38 are compared for their Vi-antigen content with the aid of complement fixation and erythrocyte sensibilization tests. Acetone-killed and dried germs were used as source material. Parallel batches derived from the same strain showed good agreement. Moreover, results with erythrocyte sensibilization and complement fixation reaction were closely correlated. The conclusion is drawn that serological determination of the Vi-antigen of acetone-dried typhoid vaccine is possible. Further investigations, however, must be carried out to compare the functional capacity to produce antibodies of strains with the same serologically determined content of Vi-antigen. We thank Dr.M. Landy for the revision of this paper.     

Salmonella antigens inBacterium coli and paragglutination

Summary The phenomenon of paragglutination with typhoid serum ofB. coli from the intestines of healthy persons and of patients suffering from typhoid or paratyphoid fever was observed and studied. Evidence could be obtained that the paragglutination was to be attributed to the presence of a commonSalmonella antigen (XXVIII), so that it is wrong to make a distinction between paragglutination and co-agglutination. Salmonella antigens were found in various combinations withB. coli and different combinations could also be ascertained with the same person.The attention is drawn to the presence of the Vi-antigen withB. coli, also from healthy persons, and the possibility of its connection with the Vi-agglutinin in the blood of healthy persons is pointed at.     

Lipopolysaccharide Specific Immunochromatography Based Lateral Flow Assay for Serogroup Specific Diagnosis of Leptospirosis in India

Background

Leptospirosis is a re-emerging infectious disease that is under-recognized due to low-sensitivity and cumbersome serological tests. MAT is the gold standard test and it is the only serogroup specific test used till date. Rapid reliable alternative serogroup specific tests are needed for surveillance studies to identify locally circulating serogroups in the study area.

Methods/Principal Findings

In the present investigation the serological specificity of leptospiral lipopolysaccharides (LPS) was evaluated by enzyme linked immunosorbent assay (ELISA), dot blot assay and rapid immunochromatography based lateral flow assay (ICG-LFA). Sera samples from 120 MAT positive cases, 174 cases with febrile illness other than leptospirosis, and 121 seronegative healthy controls were evaluated for the diagnostic sensitivity and specificity of the developed assays. LPS was extracted from five locally predominant circulating serogroups including: Australis (27.5%), Autumnalis (11.7%), Ballum (25.8%), Grippotyphosa (12.5%), Pomona (10%) and were used as antigens in the diagnostics to detect IgM antibodies in patients’ sera. The sensitivity observed by IgM ELISA and dot blot assay using various leptospiral LPS was >90% for homologous sera. Except for Ballum LPS, no other LPS showed cross-reactivity to heterologous sera. An attempt was made to develop LPS based ICG-LFA for rapid and sensitive serogroup specific diagnostics of leptospirosis. The developed ICG-LFA showed sensitivity in the range between 93 and 100% for homologous sera. The Wilcoxon analysis showed LPS based ICG-LFA did not differ significantly from the gold standard MAT (P>0.05).

Conclusion

The application of single array of LPS for serogroup specific diagnosis is first of its kind. The developed assay could potentially be evaluated and employed for as MAT alternative.     

vi—PHA试剂的研制及其在检测伤寒带者中的应用

Purified S. typhi Vi antigen is sensitized with equal volume of tannic acid treated formalational sheep erythrocytes (SRBC) at a final concentration of 1 microgram/ml. The Vi-passive hemagglutination assay (Vi-PHA) diagnostic reagent is developed to detect Vi antibodies to S. typhi for the detection of chronic carriers after typhoid fever and the screening S. typhi healthy carriers from food-handlers, which is characterized with high sensitivity, strong specificity and good stability. This Vi-PHA reagent is able to detect 1.16 micrograms/ml of Vi antibodies and doesn't make any cross reaction with healthy sera. For the sera of other diseases, the cross rate is only 0.84%. Using this reagent, 19 positive sera (6.93%) are detected from 274 convalescent sera from typhoid fever, 14 convalescents of which are stool-culture S. typhi positive, that persists a positive rate of 73.68%; 3 positive sera are detected from 106 foodhandlers, one of which is stool-culture S. typhi positive. Therefore, the reagent is simple, convenient, rapid and easy to be applicated in basic unit.     

Combined rapid (TUBEX) test for typhoid-paratyphoid A fever based on strong anti-O12 response: design and critical assessment of sensitivity

Rapid diagnostics can be accurate but, often, those based on antibody detection for infectious diseases are unwittingly underrated for various reasons. Herein, we described the development of a combined rapid test for two clinically-indistinguishable bacterial diseases, typhoid and paratyphoid A fever, the latter fast emerging as a global threat. By using monoclonal antibodies (mAbs) to bacterial antigens of known chemical structures as probes, we were able to dissect the antibody response in patients at the level of monosaccharides. Thus, a mAb specific for a common lipopolysaccharide antigen (O12) found in both the causative organisms was employed to semi-quantify the amounts of anti-O12 antibodies present in both types of patients in an epitope-inhibition particle-based (TUBEX) immunoassay. This colorimetric assay detected not only anti-O12 antibodies that were abundantly produced, but also, by steric hindrance, antibodies to an adjoining epitope (O9 or O2 in the typhoid or paratyphoid bacillus, respectively). Sensitivity and, particularly, reaction intensities, were significantly better than those obtained using an anti-O9 or anti-O2 mAb-probe in the examination of paired sera from 22 culture-confirmed typhoid patients (sensitivity, 81.8% vs 75.0%) or single sera from 36 culture-confirmed paratyphoid patients (52.8% vs 28.6), respectively. Importantly, sensitivity was better (97.1% for typhoid, 75.0% for paratyphoid) if allowance was made for the absence of relevant antibodies in certain specimens as determined by an independent, objective assay (ELISA)--such specimens might have been storage-denatured (especially the older paratyphoid samples) or procured from non-responders. Benchmarking against ELISA, which revealed high concordance between the two tests, was useful and more appropriate than comparing with culture methods as traditionally done, since antibody tests and culture target slightly different stages of these diseases. Paired sera analysis was insightful, revealing 64% of typhoid patients who had no change in antibody titer over 4-16 days, and 14% with no IgM-IgG class-switching.     

Comparative evaluation of the immunological activity of new typhoid vaccines with established prophylactic effectiveness (data from a controlled experiment)]

The authors present the results of studying the immunological efficacy of a dry alcoholic typhoid vaccine enriched with S. typhi Vi-antigen in the assessment of this vaccine in controlled epidemiological trial during the immunization of children aged 7--8 years. O- and Vi-antibodies were tested in the reaction of hemagglutination, H-antibodies--in the agglutination reaction with the microbial diagnostic agent, the properties of antibodies--in a test with cystein, and bactericidal properties of the sera--against the virulent S. typhi strain. Examination of 355 coupled sera obtained before and 3 weeks after the immunization demonstrated a high level of Vi-(1:47) and of the O-(1:580) antibodies and high bactericidal properties of the sera in persons vaccinated with the alcoholic vaccine enriched with the S. typhi Vi-antigen. The results obtained and the data on the formation of prolonged immunity following a simgle immunization suggested that a high protective effect was caused by a combined action of the O- and Vi-antigens contained in the vaccine in optimal doses.     

Demonstration of an antigenic protein specific for Salmonella typhi

Current studies were undertaken to determine the presence of a specific antigenic protein on the outer membrane of Salmonella typhi. Immunoblot analysis using sera from patients with fevers revealed that the 50 kD band was specifically recognized only by typhoid sera. The 50 kD band located on the outer membrane is protein by nature and is not a Vi (capsular), dH (flagellar), or O9 (somatic) antigen of S. typhi. These results indicate the usefulness of the specific antigen in the development of a serodiagnostic test for typhoid fever since antibodies of both the IgM and IgG class responses were obtained.     

A comparison of the yield of Vi and O antigens during the adaptation of Salmonella typhi strains to cultivation under starvation conditions

S. typhi strains Ty(2)4446 and Vi-1S underwent multiple passages in f synthetic liquid starvation culture medium consisting of water with salts and glucose added. In the process of the adaptation of the cultures to these stress conditions (starvation stress) the increasing yield of biomass from passage to passage was observed. Differences in the accumulation of Vi- and O-antigens were noted in two strains under study. In the cultures of strain Ty(2)4446 an insignificant increase in the antigen content from passage to passage was observed, while in the cultures of strain Vi-1S an increase in the content of Vi- and O-antigens was 4- to 5-fold. With the adaptation of the culture the Vi-antigen to O-antigen ratio changed from 1:57 to 1:20 for strain Ty(2)4446 and from 1:2.7 tp 1:2.2 for strain Vi-1S. Strain Ty(2)4446 had an advantage over strain Vi-1S with respect to the synthesis of Vi-antigen. These data are indicative of the expediency of using not only strain Ty(2)4446, but also strain Vi-1S for the preparation of typhoid vaccine, especially the one based on Vi-antigen.     

Determination of O and Vi antigens in typhoid fever in the slide coagglutination reaction

Investigations with a view to the development and trial of a slide coagglutination test system for the detection of specific Salmonella typhi antigens have been made. As a result, diagnostic agents with sensitivity to group D Salmonella lipopolysaccharides and Vi-antigen, equal to 1 X 10(-5) to 1 X 10(-6) g/l, have been obtained. Specimens of saliva, urine and fecal filtrates from 61 adult patients with bacteriologically confirmed typhoid fever and 54 practically healthy persons have been studied. The coagglutination test has been positive with specimens from 90 +/- 4% of typhoid fever patients and, within the first 5 days of the disease, with those from 85 +/- 7% of such patients. The slide coagglutination test with saliva specimens has been found to be more informative than that with urine specimens. The data obtained in these investigations indicate that the slide coagglutination test is highly sensitive and specific, which offers good prospects for its use as a simple, economic and demonstrative method for the early tentative diagnosis of typhoid fever.     

Use of hybrid strains of S, typhi and S. typhimurium for characterizing the biological activity of individual Salmonella antigens by the alternative recording of the experimental results]

Intraperitoneal infection of mice, subcutaneously immunized with acetone vaccines of various antigenic composition, with the microbes of hybrid salmonellae strains of murine and typhoid fever caused development of infectious process approaching natural infection. A significant elevation of the intensity of immunity was provided by preparations containing serologically identical O-antigen in infection with O-strains, or Vi-antigen in infection with Vi-strains. For the formation of animal resistance to infection it was necessary to immunize the mice with vaccines containing homologous H- and O-antigens (in infection with O-strains) and H-, O- and Vi-antigens (in infection with Vi-strains). Immunization with killed vaccines with a full-value antigenic structure provided effective protection of mice from doses approaching LD50.     

Comparison of usefulness of lipopolysaccharides extracted by phenol and trichloroacetic acid from Salmonella Typhimurium and Enteritidis for serodiagnosis of salmonelosis

Salmonella Typhimurium and Salmonella Enteritidis are the two predominant serogroups, responsible for about 80% of all human cases of salmonelosis in Poland. Therefore we compared the usefulness of lipopolysaccharides antigens extracted by phenol (Westphal method) and trichloroacetic acid (Boivine method) from Salmonella Typhimurium and Enteritidis in ELISA method for the determination of antibodies. We used one home - made LPS antigen and two others commercially available antigens from SIGMA - Aldrich. Our study showed that the presence of antibodies was found in 35 (74.5%) sera from 47 samples from patients with suspected salmonelosis. There was no significant statistical differences of frequency of appearance of antibodies to all three Salmonella antigens in sera from patients with salmonelosis and in sera from control group. This study showed that all three antigens are useful for determination of IgA, IgG, IgM antibodies for Salmonella serogroup B and D in routine serological diagnosis of salmonelosis. However, it should be considered possibility of cross-reaction between LPS antigen of Salmonella and antibodies to Yersinia enterocolitica which could be correlated with similarity between somatic antigens of these two pathogens.     

Detection of porin antigen in serum for early diagnosis of mouse infections with Salmonella typhimurium

Abstract The monoclonal antibodies to porin, an outer membrane protein isolated from Salmonella typhimurium and sandwich enzyme linked immunosorbent assay (ELISA) has made possible the detection of porin from sera of S. typhimurium -infected mice. The specificity of the monoclonal antibodies was ascertained based on their cross-reactivity with porins isolated from S. typhi, Shigella flexneri and Escherichia coli and lipopolysaccharide (LPS) of S. typhimurium and E. coli . Serum samples were found to be positive for porin as early as 3 days after intravenous and 5 days after oral infection. In addition, a positive correlation was observed between the bacterial load and the concentration of porin detected in the sera. On the other hand, analysis of sera for anti-porin antibody showed diametrically opposite time kinetics with antigenaemia. These results indicate that porin accumulates in the serum of infected mice much earlier than the appearance of antibodies to porin. Thus detection of porin holds promise for early diagnosis of typhoid.     

The Ecological Dynamics of Fecal Contamination and Salmonella Typhi and Salmonella Paratyphi A in Municipal Kathmandu Drinking Water

One of the UN sustainable development goals is to achieve universal access to safe and affordable drinking water by 2030. It is locations like Kathmandu, Nepal, a densely populated city in South Asia with endemic typhoid fever, where this goal is most pertinent. Aiming to understand the public health implications of water quality in Kathmandu we subjected weekly water samples from 10 sources for one year to a range of chemical and bacteriological analyses. We additionally aimed to detect the etiological agents of typhoid fever and longitudinally assess microbial diversity by 16S rRNA gene surveying. We found that the majority of water sources exhibited chemical and bacterial contamination exceeding WHO guidelines. Further analysis of the chemical and bacterial data indicated site-specific pollution, symptomatic of highly localized fecal contamination. Rainfall was found to be a key driver of this fecal contamination, correlating with nitrates and evidence of S. Typhi and S. Paratyphi A, for which DNA was detectable in 333 (77%) and 303 (70%) of 432 water samples, respectively. 16S rRNA gene surveying outlined a spectrum of fecal bacteria in the contaminated water, forming complex communities again displaying location-specific temporal signatures. Our data signify that the municipal water in Kathmandu is a predominant vehicle for the transmission of S. Typhi and S. Paratyphi A. This study represents the first extensive spatiotemporal investigation of water pollution in an endemic typhoid fever setting and implicates highly localized human waste as the major contributor to poor water quality in the Kathmandu Valley.     

The effect of immunostimulants on the resistance of white mice to the causative agent of typhoid fever

The influence of prodigiosan, salmosan, polyribonate and levamisole on the body nonspecific and specific resistance to S. typhi strain 4446 has been studied. Prodigiosan and salmosan have proved to be the most effective. The injection of these compounds simultaneously with typhoid vaccine (both chemical adsorbed vaccine and alcohol-treated vaccine, enriched with Vi-antigen) significantly increases the survival rate of immunized animals (by 35-45%), elevates the resistance index (1.5- to 2.3-fold) and the effectiveness index of the vaccine (17- to 32-fold) in comparison with the controls. Besides, prodigiosan and salmosan alone are capable of increasing nonspecific resistance to S. typhi strain 4446, which is manifested by an increase of the survival rate of stimulated animals by 61.87%. Proceeding from the results thus obtained, the possibility of good prospects for prodigiosan and salmosan in the prophylaxis of typhoid fever in humans may be inferred.     

An age-stratified serosurvey against purified Salmonella enterica serovar Typhi antigens in the Lao People´s Democratic Republic

The epidemiology of typhoid fever in Lao People`s Democratic Republic is poorly defined. Estimating the burden of typhoid fever in endemic countries is complex due to the cost and limitations of population-based surveillance; serological approaches may be a more cost-effective alternative. ELISAs were performed on 937 serum samples (317 children and 620 adults) from across Lao PDR to measure IgG antibody titers against Vi polysaccharide and the experimental protein antigens, CdtB and HlyE. We measured the significance of the differences between antibody titers in adults and children and fitted models to assess the relationship between age and antibody titers. The median IgG titres of both anti-HylE and CdtB were significantly higher in children compared to adults (anti-HylE; 351.7 ELISA Units (EU) vs 198.1 EU, respectively; p<0.0001 and anti-CdtB; 52.6 vs 12.9 EU; p<0.0001). Conversely, the median anti-Vi IgG titer was significantly higher in adults than children (11.3 vs 3.0 U/ml; p<0.0001). A non-linear trend line fitted to the anti-CdtB and anti-HlyE IgG data identified a peak in antibody concentration in children <5 years of age. We identified elevated titers of anti-HlyE and anti-CdtB IgG in the serum of children residing in Lao PDR in comparison to adults. These antigens are associated with seroconversion after typhoid fever and may be a superior measure of disease burden than anti-Vi IgG. This approach is scalable and may be developed to assess the burden of typhoid fever in countries where the disease may be endemic, and evidence is required for the introduction of typhoid vaccines.     

Integration of molecular dynamics simulation and hotspot residues grafting for de novo scFv design against Salmonella Typhi TolC protein

With the development of de novo binders for protein targets from non‐related scaffolds, many possibilities for therapeutics and diagnostics have been created. In this study, we described the use of de novo design approach to create single‐chain fragment variable (scFv) for Salmonella enterica subspecies enterica serovar Typhi TolC protein. Typhoid fever is a global health concern in developing and underdeveloped countries. Rapid typhoid diagnostics will improve disease management and therapy. In this work, molecular dynamics simulation was first performed on a homology model of TolC protein in POPE membrane bilayer to obtain the central structure that was subsequently used as the target for scFv design. Potential hotspot residues capable of anchoring the binders to the target were identified by docking “disembodied” amino acid residues against TolC surface. Next, scFv scaffolds were selected from Protein Data Bank to harbor the computed hotspot residues. The hotspot residues were then incorporated into the scFv scaffold complementarity determining regions. The designs recapitulated binding energy, shape complementarity, and interface surface area of natural protein‐antibody interfaces. This approach has yielded 5 designs with high binding affinity against TolC that may be beneficial for the future development of antigen‐based detection agents for typhoid diagnostics.     

Latent persistence of specific antigens of the causative agent in the composition of circulating immune complexes in typhoid fever

This study revealed the presence of O-antigen of group D salmonellae and Vi-antigen in circulating immune complexes in patients with typhoid fever, bacteriologically confirmed (56 +/- 5.6% and 65 +/- 5.4% of cases, respectively) and not confirmed (15.5 +/- 5% and 39 +/- 7% of cases, respectively), in patients with diarrhea of nontyphoid etiology in the presence of negative results of the coagglutination test and in healthy persons. The level and dynamics of circulating immune complexes were established with respect to the antigens contained in these complexes. Altogether O- and Vi-antigens were detected in circulating immune complexes, respectively, in 92%, 96% and 94% of cases on weeks 1, 2 and 3 from the beginning of the disease, and in all cases on weeks 4 and 5, the antigens being determined together and separately. Thus, the latent persistence of S. typhi antigens as part of circulating immune complexes in the blood serum was established. The determination of such persistence is of great pathogenetic and diagnostic importance, which also applies to the early period of the disease. The use of such specific and sensitive method as the coagglutination test for this purpose accelerates and facilitates the diagnosis of typhoid fever.