title: The use of a new assay for detecting antibody to Staphylococcus aureus in severely injured patients.
abstract: Investigation of the antibody response to Staphylococcus aureus infection has been hindered by lack of a simple and specific assay. We report an enzyme-linked immunosorbent assay (ELISA) using a strain of S. aureus devoid of Protein A, a frequent cause of false positive results in ELISAs, and have used this assay to study antibody responses of 23 severely injured patients. This IgM ELISA had a diagnostic sensitivity for major Staphylococcal infection of 70% (seven of ten patients with major infection) and a specificity of 92% (12 of 13 patients without major infection). Of three patients with major Staphylococcal infections who mounted no IgM response, two died and the other developed severe chronic Staphylococcal infection, and hence prompt initiation of appropriate therapy was necessary. Furthermore, the ability to mount IgM response to Staphylococcal infections appears to contribute to an orchestrated host defense response against this organism.
authors.affiliation: Price Institute of Surgical Research, University of Louisville School of Medicine, Kentucky.
authors.forename: M J
authors.initials: MJ
authors.lastname: Hershman
authors.forename: S H
authors.initials: SH
authors.lastname: Appel
authors.forename: C D
authors.initials: CD
authors.lastname: George
authors.forename: K M
authors.initials: KM
authors.lastname: Cost
authors.forename: H C
authors.initials: HC
authors.lastname: Polk
mesh_terms: D000907:Antibodies, Bacterial / Q000032:analysis*; D004797:Enzyme-Linked Immunosorbent Assay; D004926:Escherichia coli / Q000276:immunology; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis; D008722:Methods; D011549:Pseudomonas / Q000276:immunology; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000209:etiology; D013211:Staphylococcus aureus / Q000276:immunology*; D014947:Wounds and Injuries / Q000150:complications / Q000276:immunology / Q000382:microbiology*
chemical_list: D000907:Antibodies, Bacterial; D007075:Immunoglobulin M