Background: Salmonella Typhi and Salmonella Paratyphi A are the agents of enteric (typhoid) fever; both can establish chronic carriage in the gallbladder. Chronic Salmonella carriers are typically asymptomatic, intermittently shedding bacteria in the feces, and contributing to disease transmission. Detecting chronic carriers is of public health relevance in areas where enteric fever is endemic, but there are no routinely used methods for prospectively identifying those carrying Salmonella in their gallbladder. Methodology/Principal Findings: Here we aimed to identify biomarkers of Salmonella carriage using metabolite profiling. We performed metabolite profiling on plasma from Nepali patients undergoing cholecystectomy with confirmed S. Typhi or S. Paratyphi A gallbladder carriage (and non-carriage controls) using two-dimensional gas chromatography coupled with time-of-flight mass spectrometry (GCxGC-TOFMS) and supervised pattern recognition modeling. We were able to significantly discriminate Salmonella carriage samples from non-carriage control samples. We were also able to detect differential signatures between S. Typhi and S. Paratyphi A carriers. We additionally compared carriage metabolite profiles with profiles generated during acute infection; these data revealed substantial heterogeneity between metabolites associated with acute enteric fever and chronic carriage. Lastly, we found that Salmonella carriers could be significantly distinguished from non-carriage controls using only five metabolites, indicating the potential of these metabolites as diagnostic markers for detecting chronic Salmonella carriers. Conclusions/Significance: Our novel approach has highlighted the potential of using metabolomics to search for diagnostic markers of chronic Salmonella carriage. We suggest further epidemiological investigations of these potential biomarkers in alternative endemic enteric fever settings.
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Public release:
2018-01-17
License:
EMBL-EBI Terms of Use
Platform(s):
Pegasus 4D GCxGC-TOFMS
Factors:
Carriage status, Gender, Analytical run order, Fever, Right upper quadrant pain, Right upper quadrand tenderness, Fever 5 days on entry, Previous history of typhoid, Antibiotics 15 days, Jaundice at admission, Previous jaundice, Previous acute cholecystitis, Previous hospital due to cholecystitis, Pancreatitis, Diabetes, Gallbladder tissue thickness, Gall stones, Treatment with inj. Cefazoline, Total cell count, Neutrophils, Lymphocytes, Monocytes, Eosiniphils, Total bilirubin, Conjugated bilirubin, Aspartate transaminase, Alanine transaminase, Alkaline phosphatase, Amylase