Evaluation of enzyme-linked immunosorbent assay for detection of Salmonella typhi antigen and antibodies.

Enteric fever is considered a major health problem in developing countries. The need for a rapid, accurate and conclusive method for diagnosis is important for adequate and proper treatment. The usefulness and reliability of the ELISA test in detection of S. typhi O antigen and specific IgG and IgM antibodies were assessed using sera obtained from 63 subjects clinically suspected to have enteric fever, 22 febrilenon-enteric subjects and 20 normal subjects. ELISA detection of S. typhi somatic antigen was positive in 75% of subjects with positive clot cultures. IgG and IgM antibodies to S. typhi lipopolysaccharide (LPS) were detected in sera from 83% and 88% of enteric fever subjects, respectively. While anti-LPS IgM was negative in all sera from febrile non-enteric subjects, 9% were positive for anti-LPS-IgG. The use of an ELISA for detection of anti-S. typhi LPS antibody in combination with the Widal test and/or the O antigen detection ELISA would provide a useful (95.8% sensitivity) adjunct to standard culture methods and allow for an earlier and more rapid diagnosis of enteric fever.