151. Investigation of the role of typhoid toxin in acute typhoid fever in a human challenge model
- Author
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Gibani, Malick M, Jones, Elizabeth, Barton, Amber, Jin, Celina, Meek, Juliette, Camara, Susana, Galal, Ushma, Heinz, Eva, Rosenberg-Hasson, Yael, Obermoser, Gerlinde, Jones, Claire, Campbell, Danielle, Black, Charlotte, Thomaides-Brears, Helena, Darlow, Christopher, Dold, Christina, Silva-Reyes, Laura, Blackwell, Luke, Lara-Tejero, Maria, Jiao, Xuyao, Stack, Gabrielle, Blohmke, Christoph J, Hill, Jennifer, Angus, Brian, Dougan, Gordon, Galán, Jorge, and Pollard, Andrew J
- Subjects
Adult ,Adolescent ,Bacterial Toxins ,Middle Aged ,Salmonella typhi ,bacterial infections and mycoses ,complex mixtures ,3. Good health ,Mice, Inbred C57BL ,Mice ,Young Adult ,Double-Blind Method ,13. Climate action ,Acute Disease ,Animals ,Humans ,Typhoid Fever - Abstract
Salmonella Typhi is a human host-restricted pathogen that is responsible for typhoid fever in approximately 10.9 million people annually1. The typhoid toxin is postulated to have a central role in disease pathogenesis, the establishment of chronic infection and human host restriction2-6. However, its precise role in typhoid disease in humans is not fully defined. We studied the role of typhoid toxin in acute infection using a randomized, double-blind S. Typhi human challenge model7. Forty healthy volunteers were randomized (1:1) to oral challenge with 104 colony-forming units of wild-type or an isogenic typhoid toxin deletion mutant (TN) of S. Typhi. We observed no significant difference in the rate of typhoid infection (fever ≥38 °C for ≥12 h and/or S. Typhi bacteremia) between participants challenged with wild-type or TN S. Typhi (15 out of 21 (71%) versus 15 out of 19 (79%); P = 0.58). The duration of bacteremia was significantly longer in participants challenged with the TN strain compared with wild-type (47.6 hours (28.9-97.0) versus 30.3(3.6-49.4); P ≤ 0.001). The clinical syndrome was otherwise indistinguishable between wild-type and TN groups. These data suggest that the typhoid toxin is not required for infection and the development of early typhoid fever symptoms within the context of a human challenge model. Further clinical data are required to assess the role of typhoid toxin in severe disease or the establishment of bacterial carriage.