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Identification of Novel Serodiagnostic Signatures of Typhoid Fever Using a Salmonella Proteome Array.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Darton, Thomas C 
Randall, Arlo 
Dongol, Sabina 
Karkey, Abhilasha 

Abstract

Current diagnostic tests for typhoid fever, the disease caused by Salmonella Typhi, are poor. We aimed to identify serodiagnostic signatures of typhoid fever by assessing microarray signals to 4,445 S. Typhi antigens in sera from 41 participants challenged with oral S. Typhi. We found broad, heterogeneous antibody responses with increasing IgM/IgA signals at diagnosis. In down-selected 250-antigen arrays we validated responses in a second challenge cohort (n = 30), and selected diagnostic signatures using machine learning and multivariable modeling. In four models containing responses to antigens including flagellin, OmpA, HlyE, sipC, and LPS, multi-antigen signatures discriminated typhoid (n = 100) from other febrile bacteremia (n = 52) in Nepal. These models contained combinatorial IgM, IgA, and IgG responses to 5 antigens (ROC AUC, 0.67 and 0.71) or 3 antigens (0.87), although IgA responses to LPS also performed well (0.88). Using a novel systematic approach we have identified and validated optimal serological diagnostic signatures of typhoid fever.

Description

Keywords

Salmonella Typhi, antibody response, controlled human infection model, enteric fever, fever diagnostics, machine learning, rapid diagnostic tests, serodiagnostics

Journal Title

Front Microbiol

Conference Name

Journal ISSN

1664-302X
1664-302X

Volume Title

8

Publisher

Frontiers Media SA
Sponsorship
Wellcome Trust (092661/Z/10/Z)