title: The role of antibodies against alpha-toxin and teichoic acid in the diagnosis of staphylococcal infections.
abstract: An enzyme-linked immunosorbent assay (ELISA) was used with purified alpha-toxin and teichoic acid preparations to measure the IgG and IgM response in Staphylococcus aureus infections. After determining antibodies in a normal population, cut-off levels were set for all age groups. ELISA with alpha-toxin was more sensitive than the antistaphylolysin neutralization test (ASTA). Determining IgM antibodies with the two antigens was found to be of limited diagnostic value. Positive IgG titers against alpha-toxin were found in 21 of 27 patients (78%) with endocarditis, 11 of 14 (79%) with complicated septicemia, eight of 20 (40%) with uncomplicated septicemia and in 12 of 22 (54%) with chronic osteomyelitis. The IgG responses to teichoic acid and alpha-toxin were somewhat different when measured by ELISA, and the parallel performance of the two assays resulted in improved serological diagnostics. The number of positive patients increased to 89%, 86%, 65% and 64%, respectively, in the four groups with a diagnostic specificity of 93%. In septicemic staphylococcal infections, the diagnosis could be established in all patients (28 of 28) with adequately spaced paired samples.
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000907:Antibodies, Bacterial / Q000032:analysis*; D001427:Bacterial Toxins / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D004697:Endocarditis, Bacterial / Q000175:diagnosis; D004797:Enzyme-Linked Immunosorbent Assay; D005667:Furunculosis / Q000175:diagnosis; D006460:Hemolysin Proteins / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis*; D007075:Immunoglobulin M / Q000032:analysis*; D007136:Immunoglobulins; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis; D018805:Sepsis / Q000175:diagnosis; D013203:Staphylococcal Infections / Q000175:diagnosis*; D013211:Staphylococcus aureus / Q000276:immunology; D013682:Teichoic Acids / Q000276:immunology*
chemical_list: D000907:Antibodies, Bacterial; D001427:Bacterial Toxins; D006460:Hemolysin Proteins; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D007136:Immunoglobulins; D013682:Teichoic Acids; C006603:antistaphylolysin; C021091:staphylococcal alpha-toxin