Immunomagnetic separation and PCR detection show Shigellae to be common faecal agents in children from urban marginal communities of Costa Rica

Culture and immunomagnetic separation-polymerase chain reaction assays (IMS-PCR) were used to isolate and identify Shigella flexneri, S. dysenteriae type I and S. sonnei in faeces from 250 children up to 5 years and from their mothers (n = 143) selected at random from a large urban marginal community of Costa Rica. Children hospitalized because of severe diarrhoea (n = 110) were also studied. Only S. flexneri, mainly serotype 2a, and S. sonnei were found by culture. All specimens in which Shigella was cultured were also positive by the corresponding IMS-PCR. S. flexneri was isolated by culture from 1 (0.7%) mother and 4 (1.6%) community children. S. sonnei was found in 2 (0.8%) children. An additional 12 S. flexneri and four S. sonnei in the community children were found by IMS-PCR. In total, Shigella was cultured from 0.7% of mothers and 2.4% of children. By the IMS-PCR 2% of mothers and 8% of children were positive. S. flexneri was isolated by culture from 14 (12.7%) hospitalized children and S. sonnei from 1 (0.9%). An additional 11 S. flexneri and three S. sonnei were found by IMS-PCR. In total, Shigella was cultured from 13.6% of hospitalized children. By the IMS-PCR 26% of them were Shigella positive. Thus IMS-PCR was more than twice as effective in diagnosing shigellae as culture. Twelve (60%) Shigella positive community children were above 3-years-old and 25% of them were under one year. Seven (35%) of the Shigella positive children had dysenteric and 9 (45%) normal stools. Half of the Shigella infected community children had been weaned before the 3 months of age. By the age of 5 months, 90% of them were already weaned. Seventeen (59%) of the hospitalized Shigella positive children were under 1 year of age. The stools were watery or semiliquid in 13 (45%) and dysenteric in 12 (41%) of them. We conclude that shigellosis is common in Costa Rica and represents an important cause of severe infant diarrhoea requiring hospitalization.

Serum antibody titres to Shigella lipopolysaccharides and invasion plasmid antigens in healthy Costa Rican and Swedish women

Specific serum antibody titres to defined lipopolysaccharides (LPS) of Shigella spp. and Salmonella serogroup B (BO) and Shigella invasion plasmid antigens (Ipa) were determined by enzyme immunoassays in healthy Costa Rican women from low (n = 34), middle (n = 36) and high (n = 19) socioeconomic conditions and from 64 Swedish women. Specific IgG antibody titres were the highest, in particular to the S. flexneri Y LPS, with mean titres of 750 (SD = 360), 690 (380), and 820 (300) for the Low, Middle and High Costa Rican groups respectively. Lower titres were recorded against S. sonnei and S. dysenteriae type 1. Titres against Salmonella LPS were very low (< 250). In Swedish women, significantly lower serum anti-LPS titres were found (p < 0.05). No statistically significant differences regarding socioeconomic conditions or serum anti-LPS titres were seen in the Costa Rican groups (p > 0.05). Mean IgG-titres to the Ipa of 330 (150), 220 (170) and 140 (110) were found for the 3 Costa Rican groups, respectively. The IgG and IgM titres to Ipa in serum from the Low group were significantly higher than those of the High group (p < 0.05). The mean serum IgG titre of 70 (90) for the Swedish women was significantly lower than that of the Low and Middle groups (p < 0.05), but similar to that of the High group (p > 0.05). High IgG anti-Ipa titres were found in 38% from the Low, 19% from the Middle but none in the High group (mean value of the High group +2 SD).(ABSTRACT TRUNCATED AT 250 WORDS)

Titres of class-specific antibodies against Shigella and Salmonella lipopolysaccharide antigens in colostrum and breast milk of Costa Rican, Swedish and Vietnamese mothers

Enzyme immunoassays (EIA) were used to estimate titres of class-specific antibodies against purified and chemically defined phenol-water-extracted lipopolysaccharide (LPS) antigens of Salmonella serogroup B (BO), Shigella dysenteriae type I, Plesiomonas shigelloides (the same O-antigen as Shigella sonnei) and Shigella flexneri Y. Titres in colostrum and breast milk of Swedish, Vietnamese and Costa Rican mothers from various socioeconomic conditions were compared. The antibodies were mainly of the IgA isotype. IgM antibodies were also present, but only very low concentrations of IgG were found. In Costa Rican mothers, the IgA antibody titres were significantly higher (P less than 0.05) in women of low and middle socioeconomical conditions than were those in mothers of high socioeconomical level. The low titres in the last group were comparable to those found in Swedish mothers. The IgA antibody titres found in Vietnamese mothers were similar to those of Costa Rican mothers from the low and middle socioeconomic conditions, being highest against S. flexneri Y LPS. The IgM antibody titres were also highest in Vietnamese mothers, immediately followed by the Costa Rican mothers of low socioeconomic conditions. The low IgM titres in the Costa Rican women of high socioeconomic level were comparable to those seen in Swedish mothers. The results suggest that, in Costa Rica and Vietnam, S. flexneri is the most prevalent Shigella sp. causing infection and that Salmonella serogroup B infections are rare in all three countries. The results also show that the antibody repertoire in colostrum and breast milk varies. Furthermore, in addition to the prevalence of a specific micro-organism in a determined geographical area, such differences may be associated mainly with exposure to certain pathogens in particular socioeconomic conditions.