Microbiology · Gram-Negative Bacteria (E. coli, Salmonella, Shigella, Vibrio, Klebsiella)

Widal test is used in the serological diagnosis of enteric fever. Which antibody titers are considered diagnostically significant in a patient from a non-endemic area without prior typhoid vaccination?

  • A O agglutinin titer ≥1:160 and H agglutinin titer ≥1:160
  • B O agglutinin titer ≥1:80 and H agglutinin titer ≥1:80
  • C Vi agglutinin titer ≥1:40 — single titre diagnostic
  • D H agglutinin titer alone ≥1:320 is sufficient for diagnosis
Correct answer: A. O agglutinin titer ≥1:160 and H agglutinin titer ≥1:160

Explanation

In non-endemic areas and unvaccinated individuals, Widal O agglutinin ≥1:160 and H agglutinin ≥1:160 are conventionally considered significant. A fourfold rise in titer in paired sera (acute and convalescent 2 weeks apart) is more meaningful than a single titre. O antibodies (somatic LPS antigen) appear earlier (1st week), indicate active infection, and fall faster; H antibodies (flagellar) appear later, persist longer, and may reflect past infection or vaccination. In endemic India, baseline titers may be higher, making interpretation difficult — blood culture remains the gold standard.

Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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