Typhoid Fever in Young Children in Bangladesh: Clinical Findings, Antibiotic Susceptibility Pattern and Immune Responses
Farhana Khanam, Md Abu Sayeed, Feroza Kaneez Choudhury, Alaullah Sheikh, Dilruba Ahmed, Doli Goswami, Md Lokman Hossain, W Abdullah Brooks, Stephen B. Calderwood, Richelle C. Charles, Alejandro Cravioto, Edward T. Ryan, Firdausi Qadri
Children bear a large burden of typhoid fever caused by Salmonella enterica serotype Typhi (S. Typhi) in endemic areas. However, immune responses and clinical findings in children are not well defined. Here, we describe clinical and immunological characteristics of young children with S. Typhi bacteremia, and antimicrobial susceptibility patterns of isolated strains. As a marker of recent infection, we have previously characterized antibody-in-lymphocyte secretion (TPTest) during acute typhoid fever in adults. We similarly assessed membrane preparation (MP) IgA responses in young children at clinical presentation, and then 7-10 days and 21-28 days later. We also assessed plasma IgA, IgG and IgM responses and T cell proliferation responses to MP at these time points. We compared responses in young children (1-5 years) with those seen in older children (6-17 years), adults (18-59 years), and age-matched healthy controls. We found that, compared to age-matched controls patients in all age cohorts had significantly more MP-IgA responses in lymphocyte secretion at clinical presentation, and the values fell in all groups by late convalescence. Similarly, plasma IgA responses in patients were elevated at presentation compared to controls, with acute and convalescent IgA and IgG responses being highest in adults. T cell proliferative responses increased in all age cohorts by late convalescence. Clinical characteristics were similar in all age cohorts, although younger children were more likely to present with loss of appetite, less likely to complain of headache compared to older cohorts, and adults were more likely to have ingested antibiotics. Multi-drug resistant strains were present in approximately 15% of each age cohort, and 97% strains had resistance to nalidixic acid. This study demonstrates that S. Typhi bacteremia is associated with comparable clinical courses, immunologic responses in various age cohorts, including in young children, and that TPTest can be used as marker of recent typhoid fever, even in young children.
https://doi.org/10.1371/journal.pntd.0003619
Immunoglobulin A
Nalidixic Acid
Salmonella enterica
Immunoglobulin M
Pharmacology, Toxicology and Pharmaceutics(all)
Khanam, F., Sayeed, M. A., Choudhury, F. K., Sheikh, A., Ahmed, D., Goswami, D., ... Qadri, F. (2015). Typhoid Fever in Young Children in Bangladesh: Clinical Findings, Antibiotic Susceptibility Pattern and Immune Responses. PLoS Neglected Tropical Diseases, 9(4), [e0003619]. https://doi.org/10.1371/journal.pntd.0003619
Typhoid Fever in Young Children in Bangladesh : Clinical Findings, Antibiotic Susceptibility Pattern and Immune Responses. / Khanam, Farhana; Sayeed, Md Abu; Choudhury, Feroza Kaneez; Sheikh, Alaullah; Ahmed, Dilruba; Goswami, Doli; Hossain, Md Lokman; Brooks, W Abdullah; Calderwood, Stephen B.; Charles, Richelle C.; Cravioto, Alejandro; Ryan, Edward T.; Qadri, Firdausi.
In: PLoS Neglected Tropical Diseases, Vol. 9, No. 4, e0003619, 07.04.2015.
Khanam, F, Sayeed, MA, Choudhury, FK, Sheikh, A, Ahmed, D, Goswami, D, Hossain, ML, Brooks, WA, Calderwood, SB, Charles, RC, Cravioto, A, Ryan, ET & Qadri, F 2015, 'Typhoid Fever in Young Children in Bangladesh: Clinical Findings, Antibiotic Susceptibility Pattern and Immune Responses', PLoS Neglected Tropical Diseases, vol. 9, no. 4, e0003619. https://doi.org/10.1371/journal.pntd.0003619
Khanam F, Sayeed MA, Choudhury FK, Sheikh A, Ahmed D, Goswami D et al. Typhoid Fever in Young Children in Bangladesh: Clinical Findings, Antibiotic Susceptibility Pattern and Immune Responses. PLoS Neglected Tropical Diseases. 2015 Apr 7;9(4). e0003619. https://doi.org/10.1371/journal.pntd.0003619
Khanam, Farhana ; Sayeed, Md Abu ; Choudhury, Feroza Kaneez ; Sheikh, Alaullah ; Ahmed, Dilruba ; Goswami, Doli ; Hossain, Md Lokman ; Brooks, W Abdullah ; Calderwood, Stephen B. ; Charles, Richelle C. ; Cravioto, Alejandro ; Ryan, Edward T. ; Qadri, Firdausi. / Typhoid Fever in Young Children in Bangladesh : Clinical Findings, Antibiotic Susceptibility Pattern and Immune Responses. In: PLoS Neglected Tropical Diseases. 2015 ; Vol. 9, No. 4.
@article{9456a2df44564ea5b2bc95c528fc1695,
title = "Typhoid Fever in Young Children in Bangladesh: Clinical Findings, Antibiotic Susceptibility Pattern and Immune Responses",
abstract = "Children bear a large burden of typhoid fever caused by Salmonella enterica serotype Typhi (S. Typhi) in endemic areas. However, immune responses and clinical findings in children are not well defined. Here, we describe clinical and immunological characteristics of young children with S. Typhi bacteremia, and antimicrobial susceptibility patterns of isolated strains. As a marker of recent infection, we have previously characterized antibody-in-lymphocyte secretion (TPTest) during acute typhoid fever in adults. We similarly assessed membrane preparation (MP) IgA responses in young children at clinical presentation, and then 7-10 days and 21-28 days later. We also assessed plasma IgA, IgG and IgM responses and T cell proliferation responses to MP at these time points. We compared responses in young children (1-5 years) with those seen in older children (6-17 years), adults (18-59 years), and age-matched healthy controls. We found that, compared to age-matched controls patients in all age cohorts had significantly more MP-IgA responses in lymphocyte secretion at clinical presentation, and the values fell in all groups by late convalescence. Similarly, plasma IgA responses in patients were elevated at presentation compared to controls, with acute and convalescent IgA and IgG responses being highest in adults. T cell proliferative responses increased in all age cohorts by late convalescence. Clinical characteristics were similar in all age cohorts, although younger children were more likely to present with loss of appetite, less likely to complain of headache compared to older cohorts, and adults were more likely to have ingested antibiotics. Multi-drug resistant strains were present in approximately 15{\%} of each age cohort, and 97{\%} strains had resistance to nalidixic acid. This study demonstrates that S. Typhi bacteremia is associated with comparable clinical courses, immunologic responses in various age cohorts, including in young children, and that TPTest can be used as marker of recent typhoid fever, even in young children.",
author = "Farhana Khanam and Sayeed, {Md Abu} and Choudhury, {Feroza Kaneez} and Alaullah Sheikh and Dilruba Ahmed and Doli Goswami and Hossain, {Md Lokman} and Brooks, {W Abdullah} and Calderwood, {Stephen B.} and Charles, {Richelle C.} and Alejandro Cravioto and Ryan, {Edward T.} and Firdausi Qadri",
doi = "10.1371/journal.pntd.0003619",
journal = "PLoS Neglected Tropical Diseases",
T1 - Typhoid Fever in Young Children in Bangladesh
T2 - Clinical Findings, Antibiotic Susceptibility Pattern and Immune Responses
AU - Khanam, Farhana
AU - Sayeed, Md Abu
AU - Choudhury, Feroza Kaneez
AU - Sheikh, Alaullah
AU - Ahmed, Dilruba
AU - Goswami, Doli
AU - Hossain, Md Lokman
AU - Brooks, W Abdullah
AU - Calderwood, Stephen B.
AU - Charles, Richelle C.
AU - Cravioto, Alejandro
AU - Ryan, Edward T.
AU - Qadri, Firdausi
N2 - Children bear a large burden of typhoid fever caused by Salmonella enterica serotype Typhi (S. Typhi) in endemic areas. However, immune responses and clinical findings in children are not well defined. Here, we describe clinical and immunological characteristics of young children with S. Typhi bacteremia, and antimicrobial susceptibility patterns of isolated strains. As a marker of recent infection, we have previously characterized antibody-in-lymphocyte secretion (TPTest) during acute typhoid fever in adults. We similarly assessed membrane preparation (MP) IgA responses in young children at clinical presentation, and then 7-10 days and 21-28 days later. We also assessed plasma IgA, IgG and IgM responses and T cell proliferation responses to MP at these time points. We compared responses in young children (1-5 years) with those seen in older children (6-17 years), adults (18-59 years), and age-matched healthy controls. We found that, compared to age-matched controls patients in all age cohorts had significantly more MP-IgA responses in lymphocyte secretion at clinical presentation, and the values fell in all groups by late convalescence. Similarly, plasma IgA responses in patients were elevated at presentation compared to controls, with acute and convalescent IgA and IgG responses being highest in adults. T cell proliferative responses increased in all age cohorts by late convalescence. Clinical characteristics were similar in all age cohorts, although younger children were more likely to present with loss of appetite, less likely to complain of headache compared to older cohorts, and adults were more likely to have ingested antibiotics. Multi-drug resistant strains were present in approximately 15% of each age cohort, and 97% strains had resistance to nalidixic acid. This study demonstrates that S. Typhi bacteremia is associated with comparable clinical courses, immunologic responses in various age cohorts, including in young children, and that TPTest can be used as marker of recent typhoid fever, even in young children.
AB - Children bear a large burden of typhoid fever caused by Salmonella enterica serotype Typhi (S. Typhi) in endemic areas. However, immune responses and clinical findings in children are not well defined. Here, we describe clinical and immunological characteristics of young children with S. Typhi bacteremia, and antimicrobial susceptibility patterns of isolated strains. As a marker of recent infection, we have previously characterized antibody-in-lymphocyte secretion (TPTest) during acute typhoid fever in adults. We similarly assessed membrane preparation (MP) IgA responses in young children at clinical presentation, and then 7-10 days and 21-28 days later. We also assessed plasma IgA, IgG and IgM responses and T cell proliferation responses to MP at these time points. We compared responses in young children (1-5 years) with those seen in older children (6-17 years), adults (18-59 years), and age-matched healthy controls. We found that, compared to age-matched controls patients in all age cohorts had significantly more MP-IgA responses in lymphocyte secretion at clinical presentation, and the values fell in all groups by late convalescence. Similarly, plasma IgA responses in patients were elevated at presentation compared to controls, with acute and convalescent IgA and IgG responses being highest in adults. T cell proliferative responses increased in all age cohorts by late convalescence. Clinical characteristics were similar in all age cohorts, although younger children were more likely to present with loss of appetite, less likely to complain of headache compared to older cohorts, and adults were more likely to have ingested antibiotics. Multi-drug resistant strains were present in approximately 15% of each age cohort, and 97% strains had resistance to nalidixic acid. This study demonstrates that S. Typhi bacteremia is associated with comparable clinical courses, immunologic responses in various age cohorts, including in young children, and that TPTest can be used as marker of recent typhoid fever, even in young children.
U2 - 10.1371/journal.pntd.0003619
DO - 10.1371/journal.pntd.0003619
JO - PLoS Neglected Tropical Diseases
JF - PLoS Neglected Tropical Diseases
M1 - e0003619
10.1371/journal.pntd.0003619