Rocha LB, Santos ARR, Munhoz DD, Cardoso LTA, Luz DE, Andrade FB, Horton DSPQ, Elias WP, Piazza RMF. Development of a rapid agglutination latex test for diagnosis of enteropathogenic and enterohemorrhagic Escherichia coli infection in developing world: defining the biomarker, antibody and method.
PLoS Negl Trop Dis 2014;
8:e3150. [PMID:
25254981 PMCID:
PMC4177769 DOI:
10.1371/journal.pntd.0003150]
[Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 07/29/2014] [Indexed: 12/16/2022] Open
Abstract
Background
Enteropathogenic and enterohemorrhagic Escherichia coli (EPEC/EHEC) are human intestinal pathogens responsible for diarrhea in both developing and industrialized countries. In research laboratories, EPEC and EHEC are defined on the basis of their pathogenic features; nevertheless, their identification in routine laboratories is expensive and laborious. Therefore, the aim of the present work was to develop a rapid and simple assay for EPEC/EHEC detection. Accordingly, the EPEC/EHEC-secreted proteins EspA and EspB were chosen as target antigens.
Methodology
First, we investigated the ideal conditions for EspA/EspB production/secretion by ELISA in a collection of EPEC/EHEC strains after cultivating bacterial isolates in Dulbecco’s modified Eagle’s medium (DMEM) or DMEM containing 1% tryptone or HEp-2 cells-preconditioned DMEM, employing either anti-EspA/anti-EspB polyclonal or monoclonal antibodies developed and characterized herein. Subsequently, a rapid agglutination latex test (RALT) was developed and tested with the same collection of bacterial isolates.
Principal findings
EspB was defined as a biomarker and its corresponding monoclonal antibody as the tool for EPEC/EHEC diagnosis; the production of EspB was better in DMEM medium. RALT assay has the sensitivity and specificity required for high-impact diagnosis of neglected diseases in the developing world.
Conclusion
RALT assay described herein can be considered an alternative assay for diarrhea diagnosis in low-income countries since it achieved 97% sensitivity, 98% specificity and 97% efficiency.
A rapid and low-cost diagnosis for EPEC/EHEC infections is extremely required considering their global prevalence, the severity of the diseases associated with them, and the fact that the use of antibiotics to treat EHEC infections can be harmful. For EHEC, the detection of Stx toxins has already been developed, but for EPEC, an internationally recognized standard diagnostic test is lacking. Thus, the approach for their rapid detection in this study was the use of the secreted proteins EspA and/or EspB, since they are the major secreted proteins in both pathogens. EspB was defined as a biomarker and its corresponding monoclonal antibody as the tool for EPEC/EHEC diagnosis using a latex agglutination assay, which can be employed in less equipped laboratories in developing countries.
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