Interplay between the gut microbiome and typhoid fever: insights from endemic countries and a controlled human infection model

Abstract Background Typhoid fever is a systemic infection caused by Salmonella enterica serovar Typhi (S. Typhi) invasion from the gut lumen. Transmission between people occurs through ingestion of contaminated food and water, particularly in settings with poor water and sanitation infrastructure, r...

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Main Authors: Philip M. Ashton, Leonardos Mageiros, James E. Meiring, Angeziwa Chunga-Chirambo, Farhana Khanam, Sabina Dongol, Happy Banda, Abhilasha Karkey, Lorena Preciado-Llanes, Helena Thomaides-Brears, Malick Gibani, Nazmul Hasan Rajib, Nazia Rahman, Prasanta Kumar Biswas, Md Amirul Islam Bhuiyan, Sally Kay, Kate Auger, Olivier Seret, Nicholas R. Thomson, Andrew J. Pollard, Stephen Baker, Buddha Basnyat, John D. Clemens, Christiane Dolecek, Sarah J. Dunstan, Gordon Dougan, Robert S. Heyderman, Virginia E. Pitzer, Firdausi Qadri, Melita A. Gordon, Kathryn E. Holt, Thomas C. Darton, STRATAA Study Group
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Microbiome
Online Access:https://doi.org/10.1186/s40168-025-02125-7
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author Philip M. Ashton
Leonardos Mageiros
James E. Meiring
Angeziwa Chunga-Chirambo
Farhana Khanam
Sabina Dongol
Happy Banda
Abhilasha Karkey
Lorena Preciado-Llanes
Helena Thomaides-Brears
Malick Gibani
Nazmul Hasan Rajib
Nazia Rahman
Prasanta Kumar Biswas
Md Amirul Islam Bhuiyan
Sally Kay
Kate Auger
Olivier Seret
Nicholas R. Thomson
Andrew J. Pollard
Stephen Baker
Buddha Basnyat
John D. Clemens
Christiane Dolecek
Sarah J. Dunstan
Gordon Dougan
Robert S. Heyderman
Virginia E. Pitzer
Firdausi Qadri
Melita A. Gordon
Kathryn E. Holt
Thomas C. Darton
STRATAA Study Group
author_facet Philip M. Ashton
Leonardos Mageiros
James E. Meiring
Angeziwa Chunga-Chirambo
Farhana Khanam
Sabina Dongol
Happy Banda
Abhilasha Karkey
Lorena Preciado-Llanes
Helena Thomaides-Brears
Malick Gibani
Nazmul Hasan Rajib
Nazia Rahman
Prasanta Kumar Biswas
Md Amirul Islam Bhuiyan
Sally Kay
Kate Auger
Olivier Seret
Nicholas R. Thomson
Andrew J. Pollard
Stephen Baker
Buddha Basnyat
John D. Clemens
Christiane Dolecek
Sarah J. Dunstan
Gordon Dougan
Robert S. Heyderman
Virginia E. Pitzer
Firdausi Qadri
Melita A. Gordon
Kathryn E. Holt
Thomas C. Darton
STRATAA Study Group
author_sort Philip M. Ashton
collection DOAJ
description Abstract Background Typhoid fever is a systemic infection caused by Salmonella enterica serovar Typhi (S. Typhi) invasion from the gut lumen. Transmission between people occurs through ingestion of contaminated food and water, particularly in settings with poor water and sanitation infrastructure, resulting in over 10 million illnesses annually. As the pathogen invades via the gastrointestinal tract, it is plausible that the gut microbiome may influence the outcome of S. Typhi exposure. There is some evidence that bacteria producing short-chain fatty acids (SCFAs) may create an environment unfavourable to invasive Salmonella, but data from humans is limited. Methods To investigate the association between the gut microbiome and typhoid fever, we analysed samples collected from three all-age cohorts enrolled in a prospective surveillance study conducted across three settings where typhoid fever is endemic (Dhaka, Bangladesh; Blantyre, Malawi; and Kathmandu, Nepal). Cohorts consisted of acute typhoid fever patients (n = 92), asymptomatic household contacts of typhoid fever patients (representing individuals who were likely exposed to S. Typhi but did not develop the disease, n = 97) and asymptomatic serosurvey participants with high Vi antibody titres (representing individuals who were exposed to S. Typhi and may be carriers, n = 69). The stool microbiomes of each cohort were characterised using shotgun metagenomics, and bacterial diversity, composition and function were compared. Results We identified 4 bacterial species that were significantly lower in abundance in typhoid fever patients compared with household contacts (i.e. probably exposed), in two of the three participant populations (Bangladesh and Malawi). These bacteria may represent taxa that provide protection against the development of clinical infection upon exposure to S. Typhi and include the inflammation-associated species Prevotella copri clade A and Haemophilus parainfluenzae. Our functional analysis identified 28 specific metabolic gene clusters (MGCs) negatively associated with typhoid fever in Bangladesh and Malawi, including seven MGCs involved in SCFA metabolism. The putative protection provided by microbiome SCFA metabolism was supported by data from a controlled human infection model conducted in a UK population, in which participants who did not develop typhoid fever following ingestion of S. Typhi had a higher abundance of a putative SCFA-metabolising MGC (q-value = 0.22). Conclusions This study identified the same protective associations between taxonomic and functional microbiota characteristics and non-susceptibility to typhoid fever across multiple human populations. Future research should explore the potential functional role of SCFAs and inflammation-associated bacteria in resistance to S. Typhi and other enteric infections. Video Abstract
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spelling doaj-art-63cbbf32c28f4374bafe7cb1b43d74f42025-08-20T03:46:15ZengBMCMicrobiome2049-26182025-07-0113111610.1186/s40168-025-02125-7Interplay between the gut microbiome and typhoid fever: insights from endemic countries and a controlled human infection modelPhilip M. Ashton0Leonardos Mageiros1James E. Meiring2Angeziwa Chunga-Chirambo3Farhana Khanam4Sabina Dongol5Happy Banda6Abhilasha Karkey7Lorena Preciado-Llanes8Helena Thomaides-Brears9Malick Gibani10Nazmul Hasan Rajib11Nazia Rahman12Prasanta Kumar Biswas13Md Amirul Islam Bhuiyan14Sally Kay15Kate Auger16Olivier Seret17Nicholas R. Thomson18Andrew J. Pollard19Stephen Baker20Buddha Basnyat21John D. Clemens22Christiane Dolecek23Sarah J. Dunstan24Gordon Dougan25Robert S. Heyderman26Virginia E. Pitzer27Firdausi Qadri28Melita A. Gordon29Kathryn E. Holt30Thomas C. Darton31STRATAA Study Group32Malawi-Liverpool-Wellcome ProgrammeDepartment of Infectious Diseases, School of Translational Medicine, Monash UniversityMalawi-Liverpool-Wellcome ProgrammeMalawi-Liverpool-Wellcome ProgrammeInternational Centre for Diarrhoeal Diseases ResearchOxford University Clinical Research Unit, Patan Academy of Health SciencesMalawi-Liverpool-Wellcome ProgrammeOxford University Clinical Research Unit, Patan Academy of Health SciencesOxford Vaccine Group, Department of Paediatrics, University of OxfordOxford Vaccine Group, Department of Paediatrics, University of OxfordOxford Vaccine Group, Department of Paediatrics, University of OxfordInternational Centre for Diarrhoeal Diseases ResearchInternational Centre for Diarrhoeal Diseases ResearchInternational Centre for Diarrhoeal Diseases ResearchInternational Centre for Diarrhoeal Diseases ResearchWellcome Sanger InstituteWellcome Sanger InstituteWellcome Sanger InstituteWellcome Sanger InstituteOxford Vaccine Group, Department of Paediatrics, University of OxfordDepartment of Medicine, University of CambridgeOxford University Clinical Research Unit, Patan Academy of Health SciencesInternational Centre for Diarrhoeal Diseases ResearchNuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of OxfordDepartment of Infectious Diseases, The University of Melbourne at The Peter Doherty Institute for Infection and ImmunityDepartment of Medicine, University of CambridgeResearch Department of Infection, Division of Infection and Immunity, University College LondonDepartment of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale UniversityInternational Centre for Diarrhoeal Diseases ResearchMalawi-Liverpool-Wellcome ProgrammeDepartment of Infectious Diseases, School of Translational Medicine, Monash UniversityClinical Infection Research Group, Division of Clinical Medicine, School of Medicine & Population Health, and The Florey Institute for Infection, University of SheffieldStrategic Typhoid Alliance Across Asia and Africa ConsortiumAbstract Background Typhoid fever is a systemic infection caused by Salmonella enterica serovar Typhi (S. Typhi) invasion from the gut lumen. Transmission between people occurs through ingestion of contaminated food and water, particularly in settings with poor water and sanitation infrastructure, resulting in over 10 million illnesses annually. As the pathogen invades via the gastrointestinal tract, it is plausible that the gut microbiome may influence the outcome of S. Typhi exposure. There is some evidence that bacteria producing short-chain fatty acids (SCFAs) may create an environment unfavourable to invasive Salmonella, but data from humans is limited. Methods To investigate the association between the gut microbiome and typhoid fever, we analysed samples collected from three all-age cohorts enrolled in a prospective surveillance study conducted across three settings where typhoid fever is endemic (Dhaka, Bangladesh; Blantyre, Malawi; and Kathmandu, Nepal). Cohorts consisted of acute typhoid fever patients (n = 92), asymptomatic household contacts of typhoid fever patients (representing individuals who were likely exposed to S. Typhi but did not develop the disease, n = 97) and asymptomatic serosurvey participants with high Vi antibody titres (representing individuals who were exposed to S. Typhi and may be carriers, n = 69). The stool microbiomes of each cohort were characterised using shotgun metagenomics, and bacterial diversity, composition and function were compared. Results We identified 4 bacterial species that were significantly lower in abundance in typhoid fever patients compared with household contacts (i.e. probably exposed), in two of the three participant populations (Bangladesh and Malawi). These bacteria may represent taxa that provide protection against the development of clinical infection upon exposure to S. Typhi and include the inflammation-associated species Prevotella copri clade A and Haemophilus parainfluenzae. Our functional analysis identified 28 specific metabolic gene clusters (MGCs) negatively associated with typhoid fever in Bangladesh and Malawi, including seven MGCs involved in SCFA metabolism. The putative protection provided by microbiome SCFA metabolism was supported by data from a controlled human infection model conducted in a UK population, in which participants who did not develop typhoid fever following ingestion of S. Typhi had a higher abundance of a putative SCFA-metabolising MGC (q-value = 0.22). Conclusions This study identified the same protective associations between taxonomic and functional microbiota characteristics and non-susceptibility to typhoid fever across multiple human populations. Future research should explore the potential functional role of SCFAs and inflammation-associated bacteria in resistance to S. Typhi and other enteric infections. Video Abstracthttps://doi.org/10.1186/s40168-025-02125-7
spellingShingle Philip M. Ashton
Leonardos Mageiros
James E. Meiring
Angeziwa Chunga-Chirambo
Farhana Khanam
Sabina Dongol
Happy Banda
Abhilasha Karkey
Lorena Preciado-Llanes
Helena Thomaides-Brears
Malick Gibani
Nazmul Hasan Rajib
Nazia Rahman
Prasanta Kumar Biswas
Md Amirul Islam Bhuiyan
Sally Kay
Kate Auger
Olivier Seret
Nicholas R. Thomson
Andrew J. Pollard
Stephen Baker
Buddha Basnyat
John D. Clemens
Christiane Dolecek
Sarah J. Dunstan
Gordon Dougan
Robert S. Heyderman
Virginia E. Pitzer
Firdausi Qadri
Melita A. Gordon
Kathryn E. Holt
Thomas C. Darton
STRATAA Study Group
Interplay between the gut microbiome and typhoid fever: insights from endemic countries and a controlled human infection model
Microbiome
title Interplay between the gut microbiome and typhoid fever: insights from endemic countries and a controlled human infection model
title_full Interplay between the gut microbiome and typhoid fever: insights from endemic countries and a controlled human infection model
title_fullStr Interplay between the gut microbiome and typhoid fever: insights from endemic countries and a controlled human infection model
title_full_unstemmed Interplay between the gut microbiome and typhoid fever: insights from endemic countries and a controlled human infection model
title_short Interplay between the gut microbiome and typhoid fever: insights from endemic countries and a controlled human infection model
title_sort interplay between the gut microbiome and typhoid fever insights from endemic countries and a controlled human infection model
url https://doi.org/10.1186/s40168-025-02125-7
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