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Rapid detection of enteric fever by coagglutination and countercurrent immunoelectrophoresis
M Mishra1, Y S Thakar, C Chande
1Department of Microbiology, Government Medical College, Nagpur.
Abstract:
A total of 463 patients clinically suspected of enteric fever and 100 healthy individuals were investigated by coagglutination (COAG) and countercurrent immunoelectrophoresis (CIEP) for rapid diagnosis of enteric fever. The S. typhi was grown in blood culture in 32 (6.91%) and Widal test was positive in 126 (27.21%) cases. The serum COAG with local antiserum was positive in 165 (35.64%), serum COAG with standard antiserum in 163 (35.21%), Blood culture supernatant (BCS) COAG in 153 (33.05%), serum CIEP for antigen (Ag) in 118 (25.09%), BCS CIEP in 99 (21.39%) while serum CIEP for antibody (Ab) was positive in 34 (7.34%) cases. Only two healthy controls revealed positive COAG result with local antiserum. The sensitivity of all antigen detection tests was 100% except BCS CIEP (98.25%) in the first week of fever and declined rapidly to 75.79% for serum COAG tests, 69.47% for BCS COAG and dramatically to 37.89% for serum CIEP for Ag and 22.11% for BCS CIEP tests during the second week whereas the sensitivity of serum CIEP for Ab detection rose from 17.54% to 23.16% from first to second week of illness. In view of the resulting data, it is suggested that both COAG and CIEP may be employed for the rapid diagnosis of enteric fever in the routine clinical setup.
Insights
Coagglutination (COAG) and countercurrent immunoelectrophoresis (CIEP) offer rapid diagnosis for enteric fever. These methods, particularly COAG, show promise for routine clinical use in identifying Salmonella Typhi infections.
Area of Science:
- Medical Microbiology
- Diagnostic Immunology
Background:
- Enteric fever, primarily caused by Salmonella Typhi, poses a significant global health challenge.
- Accurate and rapid diagnostic methods are crucial for timely treatment and control of outbreaks.
Purpose of the Study:
- To evaluate the efficacy of coagglutination (COAG) and countercurrent immunoelectrophoresis (CIEP) for the rapid diagnosis of enteric fever.
- To compare the sensitivity and specificity of COAG and CIEP with traditional methods like blood culture and the Widal test.
Main Methods:
- Investigated 463 patients with suspected enteric fever and 100 healthy controls.
- Employed coagglutination (COAG) and countercurrent immunoelectrophoresis (CIEP) using both serum and blood culture supernatant (BCS).
- Compared results with blood culture and Widal test.
Main Results:
- COAG tests showed higher positivity rates (33.05%-35.64%) compared to CIEP (21.39%-25.09%) and Widal test (27.21%).
- Antigen detection sensitivity for COAG was high in the first week (100%) but declined in the second week.
- Antibody detection via serum CIEP showed lower sensitivity, increasing slightly in the second week.
Conclusions:
- Both COAG and CIEP are valuable tools for the rapid diagnosis of enteric fever in clinical settings.
- COAG demonstrates particular utility for prompt identification of Salmonella Typhi infections.
- Further research may optimize these methods for improved sensitivity and specificity across different stages of illness.