title: Antibody responses in patients with invasive Staphylococcus aureus infections.
abstract: Correlation between antibody response and clinical outcome in Staphylococcus aureus bacteremia has yielded conflicting results. Immunization schedules have failed in clinical trials. Is the humoral response toward S. aureus of protective nature? A prospective study was performed in patients with invasive S. aureus (ISA) infections during the period 2003-2005. The antibody levels were determined at the beginning and at the end of treatment and one month later (n = 96, n = 71, and n = 51, respectively). As controls, 115 healthy individuals were used. A quantitative enzyme-linked immunosorbent assay (ELISA) against eight purified antigens was performed. Bacterial isolates were grouped as to the production of alpha-toxin, agr type, and pulsed-field gel electrophoresis (PFGE) type. Large variations were seen in the antibody levels. The levels in the second sample were the highest. A correlation between agr group, PFGE group, alpha-toxin production, and initial antibody levels was observed. Patients with fatal outcome displayed lower initial antibody levels to all antigens and significantly so in regard to teichoic acid, lipase, enterotoxin A, and scalded skin syndrome toxin. In episodes with complicated bacteremia, initial significantly low levels to teichoic acid and lipase were registered. Low initial antibody levels against several antigens were associated with increased mortality and complicated bacteremia in invasive S. aureus infections. Bacterial properties, strain, and toxin production affected the antibody response.
authors.affiliation: Department of Infectious Diseases, Skaraborg Hospital, 541 85, Skövde, Sweden. gunnar.jacobsson@vgregion.se
authors.forename: G
authors.initials: G
authors.lastname: Jacobsson
authors.forename: P
authors.initials: P
authors.lastname: Colque-Navarro
authors.forename: E
authors.initials: E
authors.lastname: Gustafsson
authors.forename: R
authors.initials: R
authors.lastname: Andersson
authors.forename: R
authors.initials: R
authors.lastname: Möllby
mesh_terms: D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood*; D000917:Antibody Formation; D000942:Antigens, Bacterial; D001426:Bacterial Proteins / Q000096:biosynthesis / Q000276:immunology; D001427:Bacterial Toxins / Q000096:biosynthesis / Q000276:immunology; D015373:Bacterial Typing Techniques; D016172:DNA Fingerprinting; D016521:Electrophoresis, Gel, Pulsed-Field; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D006460:Hemolysin Proteins / Q000096:biosynthesis / Q000276:immunology; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000276:immunology* / Q000401:mortality / Q000473:pathology; D013211:Staphylococcus aureus / Q000145:classification / Q000276:immunology* / Q000302:isolation & purification / Q000472:pathogenicity; D015534:Trans-Activators / Q000096:biosynthesis / Q000276:immunology; D037521:Virulence Factors / Q000096:biosynthesis / Q000276:immunology
chemical_list: C095698:Agr protein, Staphylococcus aureus; D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D001427:Bacterial Toxins; D006460:Hemolysin Proteins; D015534:Trans-Activators; D037521:Virulence Factors; C021091:staphylococcal alpha-toxin
references.citation: J Infect Dis. 2003 Sep 1;188(5):743-52
references.pmid: 12934191
references.citation: Clin Vaccine Immunol. 2009 Jan;16(1):139-41
references.pmid: 19005019
references.citation: J Pediatr. 2007 Sep;151(3):260-5, 265.e1
references.pmid: 17719934
references.citation: Infect Immun. 2003 Dec;71(12):6864-70
references.pmid: 14638774
references.citation: Int Immunopharmacol. 2009 Jan;9(1):127-33
references.pmid: 19013542
references.citation: J Clin Invest. 1978 Mar;61(3):597-609
references.pmid: 641141
references.citation: Infect Immun. 2000 May;68(5):2431-4
references.pmid: 10768927
references.citation: J Immunol Methods. 1995 Jun 28;183(2):279-90
references.pmid: 7602150
references.citation: Immunobiology. 2008;213(3-4):285-96
references.pmid: 18406374
references.citation: J Exp Med. 2008 Feb 18;205(2):287-94
references.pmid: 18268041
references.citation: Nat Med. 2004 Mar;10(3):243-5
references.pmid: 14758355
references.citation: J Infect Dis. 1983 Oct;148(4):692-8
references.pmid: 6631061
references.citation: N Engl J Med. 2003 Apr 3;348(14):1342-7
references.pmid: 12672861
references.citation: Eur J Clin Microbiol Infect Dis. 2008 Sep;27(9):839-48
references.pmid: 18449584
references.citation: Clin Diagn Lab Immunol. 2005 Mar;12(3):387-98
references.pmid: 15753252
references.citation: Infect Immun. 1996 May;64(5):1659-65
references.pmid: 8613375
references.citation: Clin Diagn Lab Immunol. 2000 Jan;7(1):14-20
references.pmid: 10618270
references.citation: Vaccine. 2000 Feb 25;18(16):1624-8
references.pmid: 10689139
references.citation: J Clin Microbiol. 1994 Feb;32(2):407-15
references.pmid: 7908673
references.citation: J Immunol. 1980 Jul;125(1):155-62
references.pmid: 6966649
references.citation: Scand J Infect Dis. 2007;39(1):6-13
references.pmid: 17366006
references.citation: Lancet. 1978 Nov 25;2(8100):1116-8
references.pmid: 82681
references.citation: J Med Microbiol. 1998 Mar;47(3):217-25
references.pmid: 9511827
references.citation: J Infect Dis. 1986 Jan;153(1):109-15
references.pmid: 3941274
references.citation: J Infect Dis. 2001 Dec 15;184(12):1572-80
references.pmid: 11740733
references.citation: Infect Immun. 1992 Jul;60(7):2976-85
references.pmid: 1612762
references.citation: Mol Med Today. 1999 Dec;5(12):532-7
references.pmid: 10562719
references.citation: Clin Infect Dis. 2001 May 15;32(10):1470-9
references.pmid: 11317249
references.citation: J Infect. 2008 Apr;56(4):249-56
references.pmid: 18314197
references.citation: Vaccine. 2001 May 14;19(25-26):3376-83
references.pmid: 11348701
references.citation: Microbiology (Reading). 2003 Oct;149(Pt 10):2701-2707
references.pmid: 14523103
references.citation: N Engl J Med. 2002 Feb 14;346(7):491-6
references.pmid: 11844850
references.citation: Infect Immun. 2002 May;70(5):2278-81
references.pmid: 11953360
references.citation: Curr Opin Microbiol. 2007 Oct;10(5):428-35
references.pmid: 17921044
references.citation: J Infect Dis. 1999 Oct;180(4):1370-3
references.pmid: 10479175
references.citation: Emerg Infect Dis. 2007 Mar;13(3):491-3
references.pmid: 17552110
references.citation: Nat Rev Microbiol. 2005 Dec;3(12):948-58
references.pmid: 16322743
references.citation: Infect Dis Clin North Am. 2009 Mar;23(1):153-71
references.pmid: 19135920
references.citation: Lancet. 2004 Aug 21-27;364(9435):703-5
references.pmid: 15325835
references.citation: J Infect Dis. 2006 May 1;193(9):1275-8
references.pmid: 16586365