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Microbiological culture simplified using anti-O12 monoclonal antibody in TUBEX test to detect Salmonella bacteria from blood culture broths of enteric fever patients.

ABSTRACT: Definitive diagnosis of infectious diseases, including food poisoning, requires culture and identification of the infectious agent. We described how antibodies could be used to shorten this cumbersome process. Specifically, we employed an anti-Salmonella lipopolysaccharide O12 monoclonal antibody in an epitope-inhibition 10-min test (TUBEX TP) to detect O12?Salmonella organisms directly from routine blood culture broths. The aim is to obviate the need to subculture the broth and subsequently identify the colonies. Thus, blood from 78 young outpatients suspected of having enteric fever was incubated in an enrichment broth, and after 2 or 4 days, broth samplings were examined by TUBEX TP as well as by conventional agar culture and identification. TUBEX TP was performed before the culture results. Eighteen isolates of S. Typhi (15 after 2 days) and 10 isolates of S. Paratyphi A (4 after 2 days) were obtained by conventional culture. Both these Salmonella serotypes, the main causes of enteric fever, share the O12 antigen. In all instances where either of these organisms was present (cultured), TUBEX TP was positive (score 4 [light blue]--to--score 10 [dark blue]; negative is 0 [pink-colored]) i.e. 100% sensitive. Identification of the specific Salmonella serotype in TUBEX-positive cases was achieved subsequently by conventional slide agglutination using appropriate polyclonal antisera against the various serotypes. Twelve Escherichia coli, 1 Alcaligenes spp. and 1 Enterobacter spp. were isolated. All of these cases, including all the 36 culture-negative broths, were TUBEX-negative i.e. TUBEX TP was 100% specific. In a separate study using known laboratory strains, TUBEX TF, which detects S. Typhi but not S. Paratyphi A via the O9 antigen, was found to efficiently complement TUBEX TP as a differential test. Thus, TUBEX TP and TUBEX TF are useful adjuncts to conventional culture because they can save considerable time (>2 days), costs and manpower.

SUBMITTER: Nugraha J

PROVIDER: S-EPMC3500315 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Microbiological culture simplified using anti-O12 monoclonal antibody in TUBEX test to detect Salmonella bacteria from blood culture broths of enteric fever patients.

Nugraha Jusak J Marpaung Ferdy R FR Tam Frankie C H FC Lim Pak Leong PL

PloS one 20121116 11

Definitive diagnosis of infectious diseases, including food poisoning, requires culture and identification of the infectious agent. We described how antibodies could be used to shorten this cumbersome process. Specifically, we employed an anti-Salmonella lipopolysaccharide O12 monoclonal antibody in an epitope-inhibition 10-min test (TUBEX TP) to detect O12⁺Salmonella organisms directly from routine blood culture broths. The aim is to obviate the need to subculture the broth and subsequently ide ...[more]

PMID: 23166719

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Project description:BackgroundEnteric fever remains a major public health problem in low resource settings and antibiotic resistance is increasing. In Asia, an increasing proportion of infections is caused by Salmonella enterica serovar Paratyphi A, which for a long time was assumed to cause a milder clinical syndrome compared to Salmonella enterica serovar Typhi.MethodologyA retrospective chart review study was conducted of 254 unique cases of blood culture confirmed enteric fever who presented at a referral adult hospital in Phnom Penh, Cambodia between 2008 and 2015. Demographic, clinical and laboratory data were collected from clinical charts and antibiotic susceptibility testing was performed. Whole genome sequence analysis was performed on a subset of 121 isolates.ResultsOne-hundred-and-ninety unique patients were diagnosed with Salmonella Paratyphi A and 64 with Salmonella Typhi. In the period 2008-2012, Salmonella Paratyphi A comprised 25.5% of 47 enteric fever cases compared to 86.0% of 207 cases during 2013-2015. Presenting symptoms were identical for both serovars but higher median leukocyte counts (6.8 x 109/L vs. 6.3 x 109/L; p = 0.035) and C-reactive protein (CRP) values (47.0 mg/L vs. 36 mg/L; p = 0.034) were observed for Salmonella Typhi infections. All but one of the Salmonella Typhi isolates belonged to haplotype H58 associated with multidrug resistance (MDR) (i.e. resistance to ampicillin, chloramphenicol and co-trimoxazole).;42.9% actually displayed MDR compared to none of the Salmonella Paratyphi A isolates. Decreased ciprofloxacin susceptibility (DCS) was observed in 96.9% (62/64) of Salmonella Typhi isolates versus 11.5% (21/183) of Salmonella Paratyphi A isolates (all but one from 2015). All isolates were susceptible to azithromycin and ceftriaxone.ConclusionsIn Phnom Penh, Cambodia, Salmonella Paratyphi A now causes the majority of enteric fever cases and decreased susceptibility against ciprofloxacin is increasing. Overall, Salmonella Typhi was significantly more associated with MDR and DCS compared to Salmonella Paratyphi A.

Project description:BackgroundIn many rural areas at risk for enteric fever, there are few data on Salmonella enterica serotypes Typhi (S. Typhi) and Paratyphi (S. Paratyphi) incidence, due to limited laboratory capacity for microbiologic culture. Here, we describe an approach that permits recovery of the causative agents of enteric fever in such settings. This approach involves the use of an electricity-free incubator based upon use of phase-change materials. We compared this against conventional blood culture for detection of typhoidal Salmonella.Methodology/principal findingsThree hundred and four patients with undifferentiated fever attending the outpatient and emergency departments of a public hospital in the Kathmandu Valley of Nepal were recruited. Conventional blood culture was compared against an electricity-free culture approach. Blood from 66 (21.7%) patients tested positive for a Gram-negative bacterium by at least one of the two methods. Sixty-five (21.4%) patients tested blood culture positive for S. Typhi (30; 9.9%) or S. Paratyphi A (35; 11.5%). From the 65 individuals with culture-confirmed enteric fever, 55 (84.6%) were identified by the conventional blood culture and 60 (92.3%) were identified by the experimental method. Median time-to-positivity was 2 days for both procedures. The experimental approach was falsely positive due to probable skin contaminants in 2 of 239 individuals (0.8%). The percentages of positive and negative agreement for diagnosis of enteric fever were 90.9% (95% CI: 80.0%-97.0%) and 96.0% (92.7%-98.1%), respectively. After initial incubation, Salmonella isolates could be readily recovered from blood culture bottles maintained at room temperature for six months.Conclusions/significanceA simple culture approach based upon a phase-change incubator can be used to isolate agents of enteric fever. This approach could be used as a surveillance tool to assess incidence and drug resistance of the etiologic agents of enteric fever in settings without reliable local access to electricity or local diagnostic microbiology laboratories.

Project description:The ability to detect a specific organism from a complex environment is vitally important to many fields of public health, including food safety. For example, tomatoes have been implicated numerous times as vehicles of foodborne outbreaks due to strains of Salmonella but few studies have ever recovered Salmonella from a tomato phyllosphere environment. Precision of culturing techniques that target agents associated with outbreaks depend on numerous factors. One important factor to better understand is which species co-enrich during enrichment procedures and how microbial dynamics may impede or enhance detection of target pathogens. We used a shotgun sequence approach to describe taxa associated with samples pre-enrichment and throughout the enrichment steps of the Bacteriological Analytical Manual's (BAM) protocol for detection of Salmonella from environmental tomato samples. Recent work has shown that during efforts to enrich Salmonella (Proteobacteria) from tomato field samples, Firmicute genera are also co-enriched and at least one co-enriching Firmicute genus (Paenibacillus sp.) can inhibit and even kills strains of Salmonella. Here we provide a baseline description of microflora that co-culture during detection efforts and the utility of a bioinformatic approach to detect specific taxa from metagenomic sequence data. We observed that uncultured samples clustered together with distinct taxonomic profiles relative to the three cultured treatments (Universal Pre-enrichment broth (UPB), Tetrathionate (TT), and Rappaport-Vassiliadis (RV)). There was little consistency among samples exposed to the same culturing medias, suggesting significant microbial differences in starting matrices or stochasticity associated with enrichment processes. Interestingly, Paenibacillus sp. (Salmonella inhibitor) was significantly enriched from uncultured to cultured (UPB) samples. Also of interest was the sequence based identification of a number of sequences as Salmonella despite indication by all media, that samples were culture negative for Salmonella. Our results substantiate the nascent utility of metagenomic methods to improve both biological and bioinformatic pathogen detection methods.

Dataset Information

Microbiological culture simplified using anti-O12 monoclonal antibody in TUBEX test to detect Salmonella bacteria from blood culture broths of enteric fever patients.

Publications

Microbiological culture simplified using anti-O12 monoclonal antibody in TUBEX test to detect Salmonella bacteria from blood culture broths of enteric fever patients.

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