Etiologic diagnosis of pneumonia by antigen detection: crossreactions between pneumococcal C-polysaccharide and oral microorganisms.
Crossreactions between bacteria occurring more or less frequently in the respiratory tract were investigated using an enzyme-linked immunosorbent assay (ELISA) developed for the detection of pneumococcal C-polysaccharide. A collection of 218 strains was investigated: 30 Streptococcus pneumoniae, 120 alpha-streptococci, and 68 strains representing other species. Strong crossreactions were observed with 36% of the alpha-streptococci and with two of 11 Staphylococcus aureus strains. The collection of alpha-streptococci consisted of 90 fresh clinical isolates and 30 stock strains. Almost all crossreactions of alpha-streptococci were found among the clinical isolates. Among the stock strains only one of four Streptococcus mitis strains was positive. Pneumococcal C-polysaccharide and phosphorylcholine inhibited the reactions in ELISA with monoclonal antibodies against pneumococcal C-polysaccharide, as well as with a polyclonal antiserum against pneumococcal C-polysaccharide. We suggest that the cross reactions between alpha-streptococci and pneumococci depend on the presence of phosphorylcholine as a common antigenic determinant. The crossreaction in the ELISA with some Staphylococcus aureus strains may be explained by the presence of protein A binding to the Fc portion of the antibodies. When the 10 alpha-streptococci that showed the strongest crossreactions and ten pneumococci representing different types were tested in different concentrations the absorbance values were lower for most alpha-streptococci compared with the pneumococci. This explains that false positive results with alpha-streptococci do not seem to constitute a practical problem in this ELISA developed for detection of pneumococcal C-polysaccharide in samples from patients with pneumonia.
D000942:Antigens, Bacterial / Q000032:analysis / Q000276:immunology*; D003429:Cross Reactions; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis*; D011135:Polysaccharides, Bacterial / Q000276:immunology*; D013211:Staphylococcus aureus / Q000276:immunology; D013291:Streptococcus / Q000276:immunology; D013296:Streptococcus pneumoniae / Q000276:immunology*
D000942:Antigens, Bacterial; D011135:Polysaccharides, Bacterial; C027158:polysaccharide C-substance (Streptococcus)