title: Antibodies to major outer membrane proteins of Escherichia coli in urinary infection in the elderly.
abstract: The serologic response to infection in elderly bacteriuric subjects and young women with acute pyelonephritis was measured with an enzyme-linked immunosorbent assay (ELISA) using the major outer membrane protein complex (MOMP) of one Escherichia coli strain as antigen. Elderly controls and subjects with asymptomatic bacteriuria had variable titers; control titers were significantly lower than those with asymptomatic bacteriuria. Titers were stable over 2-12 w in asymptomatic subjects. Elderly subjects with invasive infection and women with pyelonephritis demonstrated increases in titer between acute and convalescent serum for E. coli and other Enterobacteriaceae. With a convalescent specimen with an antibody titer greater than or equal to 3 standard deviations (SD) above the acute, the sensitivity of the MOMP ELISA for identifying invasive infection was 74%, the specificity 86%, the positive predictive value 82%, and the negative predictive value 79%. With the criteria of greater than or equal to 3 SD or an initial serum to control ratio of greater than or equal to 15 these parameters were 95%, 82%, 82%, and 95%, respectively. These initial investigations suggest the MOMP of E. coli may be an antigen with wide cross-reactivity, suitable for use as an objective test to identify invasive Enterobacteriaceae urinary infection.
authors.affiliation: Department of Medicine, University of Manitoba, Winnipeg, Canada.
authors.forename: L E
authors.initials: LE
authors.lastname: Nicolle
authors.forename: J
authors.initials: J
authors.lastname: Brunka
authors.forename: E
authors.initials: E
authors.lastname: Ujack
authors.forename: L
authors.initials: L
authors.lastname: Bryan
mesh_terms: D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000032:analysis / Q000096:biosynthesis*; D000942:Antigens, Bacterial / Q000276:immunology; D001425:Bacterial Outer Membrane Proteins / Q000276:immunology*; D001437:Bacteriuria / Q000175:diagnosis / Q000276:immunology*; D003429:Cross Reactions; D003556:Cystitis / Q000276:immunology; D004756:Enterobacteriaceae Infections / Q000175:diagnosis / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D004926:Escherichia coli / Q000276:immunology*; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000276:immunology; D011704:Pyelonephritis / Q000276:immunology
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins