Comparison of a new, rapid enzyme-linked immunosorbent assay with latex particle agglutination for the detection of Haemophilus influenzae type b infections.

A new, rapid enzyme-linked immunosorbent assay (ELISA) for the detection of polyribosylribitol phosphate of Haemophilus influenzae type b was compared with a commercially available latex particle agglutination (LPA) system (Bactigen; Wampole Laboratories, Cranbury, N.J.). By adding specimens and the anti-polyribosylribitol phosphate immunoglobulin-enzyme conjugate to the solid phase in a single step, it was possible to complete the ELISA procedure in 30 min. The ELISA was capable of detecting 0.3 ng of polyribosylribitol phosphate per ml in cerebrospinal fluid, 0.6 ng/ml in urine, and 1.2 ng/ml in serum; the in vitro sensitivity of LPA in these body fluids was 0.6, 0.3, and 0.3 ng/ml, respectively. Both procedures detected polyribosylribitol phosphate in specimens from 25 patients with bacteriologically confirmed H. influenzae type b infections. The specificity of ELISA appeared to be superior to that of LPA. ELISA was positive in only one of seven patients who had a positive LPA test and a clinical illness that was not compatible with haemophilus infection. Moreover, five patients with bacteriologically confirmed infections due to other pathogens (Streptococcus pneumoniae type 14 [two patients], Neisseria meningitidis group C, Escherichia coli K100, and Staphylococcus aureus) had false-positive LPA tests; only two (E. coli and S. aureus) were positive by ELISA. A total of 108 samples from 61 patients who had no evidence of haemophilus infections were negative by both procedures. The ELISA is a rapid, sensitive, and specific alternative to LPA for the detection of haemophilus polyribosylribitol phosphate.