Rapid serodiagnosis of Staphylococcus aureus surgical site infection following median sternotomy.
OBJECTIVE
To determine the sensitivity and specificity of a novel ELISA for the serodiagnosis of surgical site infection (SSI) due to staphylococci following median sternotomy.


METHODS
Twelve patients with a superficial sternal SSI and 19 with a deep sternal SSI due to Staphylococcus aureus were compared with 37 control patients who also underwent median sternotomy for cardiac surgery but exhibited no microbiological or clinical symptoms of infection. A further five patients with sternal SSI due to coagulase-negative (CoNS) staphylococci were studied. An ELISA incorporating a recently recognised exocellular short chain form of lipoteichoic acid (lipid S) recovered from CoNS, was used to determine serum levels of anti-lipid S IgG in all patient groups.


RESULTS
Serum anti-lipid S IgG titres of patients with sternal SSI due to S. aureus were significantly higher than the control patients (P<0.0001). In addition, patients with deep sternal SSI had significantly higher serum anti-lipid S IgG titres than patients with superficial sternal SSI (P = 0.03). Serum anti-lipid S IgG titres of patients with sternal SSI due to CoNS were significantly higher than the control patients (P = 0.001).


CONCLUSIONS
The lipid S ELISA may facilitate the diagnosis of sternal SSI due to S. aureus and could also be of value with infection due to CoNS.
Casey
A L
AL
Department of Clinical Microbiology and Infection Control, The Queen Elizabeth Hospital, University Hospital Birmingham NHS Foundation Trust, Edgbaston, Birmingham B15 2TH, UK. anna.casey@uhb.nhs.uk
Worthington
T
T
Bonser
R S
RS
Lambert
P A
PA
Elliott
T S J
TS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods* / Q000592:standards*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008070:Lipopolysaccharides / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013203:Staphylococcal Infections / Q000175:diagnosis*; D013211:Staphylococcus aureus / Q000276:immunology / Q000302:isolation & purification*; D013249:Sternum / Q000382:microbiology / Q000601:surgery; D013530:Surgical Wound Infection / Q000175:diagnosis* / Q000382:microbiology; D013682:Teichoic Acids / Q000276:immunology
D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D008070:Lipopolysaccharides; D013682:Teichoic Acids; C009900:lipoteichoic acid