Enzyme-linked immunosorbent assay for antibodies against teichoic acid in patients with staphylococcal infections

Abstract

A highly purified teichoic acid preparation was used in an enzyme-linked immunosorbent assay [ELISA] to measure the specific IgG and IgM response in staphylococcal disease. Antibody determination in a normal population, showing a difference of up to 20-fold in the mean IgG titers between the youngest children and adults, was used to establish age-correlated upper normal values. IgM antibodies were of little diagnostic value since their response was often low or absent. Increased IgG titers were found in 24 of 27 (89%) patients with endocarditis, in 11 of 14 (79%) with complicated septicemia and in 10 of 20 (50%) with uncomplicated septicemia with serum samples drawn between days 7 and 30 of disease. With paired samples, the numbers of patients with increased IgG titers were 17 of 17, 3 of 4 and 6 of 7, respectively, in the same patient groups. Increased IgG titers were less often demonstrated in patients with chronic osteomyelitis (7 of 22). The ELISA for teichoic acid antibodies was a sensitive and specific method for diagnosing staphylococcal endocarditis and septicemia. For optimal results, the substantial age-correlated variation in normal titers and the importance of adequately spaced samples should be considered.