Coproantibody Excretion During Enteric Infections

Abstract

Observations are reported on the presence of antibody in fecal specimens from patients with a variety of enteric infections. The prepn. of fecal specimens was essentially that of Burrows. Agglutinin titration was done as usual. Studies were made at intervals during active infection and convalescence and, in some cases, over several months. Serum and fecal agglutinin titrations were done simultaneously with stool cultures. Grouping of patients was based on clinical diagnosis, isolation of enteric pathogen, and presence of fecal agglutinins for the particular infectious agents indicated. Although positive cultures were found in only 47.8% of the patients, fecal agglutinins were obtained in 96.7%. Fecal agglutinins were demonstrated in high titer in all of 5 cases of chronic ulcerated colitis during periods of exacerbation of the disease. In acute bacillary dysentery, fecal agglutinins were demonstrated on the 3d day, rose to high titer on the 9th day, and disappeared when the stool cultures became negative. Circulating antibody, however, did not rise to significant titer until recovery was begun, and then rose and remained at a high level during the observation period. In chronic bacillary dysentery, significant fecal agglutinin titers were found. Acute diarrhea of Salmonella origin followed the fecal antibody pattern of acute bacillary dysentery. High titer fecal agglutinins were obtained in chronic Salmonella infections. In chronic ulcerative colitis, relatively high-titer fecal agglutinins for at least one sp. of Shigella were present during exacerbation of symptoms. Where positive cultures were obtained, fecal agglutinins occurred in highest titer when the greatest numbers of the causative organism were excreted, but disappeared after recovery. The diagnostic utility of this observation is obvious. Coproantibody is not completely effective in initiating recovery; fecal agglutinins to high titer may be found in chronic forms of enteric infection. In these cases the demonstration of coproantibody parallels evidence of clinical activity of the disease, even though the infectious agent is not recovered.