The detection of antibody to S aureus in human serum can aid in the management of staphylococcal diseases [1]. RIAs and ELISAs can detect low levels of antibody and demonstrate increased antibody production during serious
staphylococcal infections [2,3]. We compared four S aureus constituents--cell-wall
peptidoglycan and teichoic
acid, and extracellular alpha-toxin and nuclease--as
antigens in a sensitive ELISA. The value of testing more than a single serum sample was also determined. Elevated
IgG antibody to
peptidoglycan, present in one or more serum samples of 13 (50%) of 26 patients with complicated
bacteremia, was found to be the most sensitive test. All 26 patients had a significant
IgG antibody response to
peptidoglycan. Three (27%) of 11 patients with uncomplicated
bacteremia had elevated levels of antibody to
peptidoglycan in their serum, and seven (64%) showed a significant change in titer when serial serum samples were tested. Maximum detection rates for the other
antigens in complicated and uncomplicated
bacteremia were, respectively, 62% and 37% for teichoic
acid, 38% and 37% for nuclease, and 54% and 13% for alpha-toxin. In single serum samples, the detection rate for all four
antigens marginally improved the results, with detection rates of 62% and 36% for complicated and uncomplicated
bacteremia, respectively. Cross-reactive antibody to
peptidoglycan but not to the other three
antigens was present in six (75%) of eight patients with long-standing
subacute bacterial endocarditis due to either viridans streptococci or Staphylococcus epidermidis (data not shown).(ABSTRACT TRUNCATED AT 250 WORDS)