Enzyme-linked immunosorbent assay for antibodies against teichoic acid in patients with staphylococcal infections.

A highly purified teichoic acid preparation was used in an enzyme-linked immunosorbent assay to measure the specific immunoglobulin G (IgG) and IgM response in staphylococcal disease. Antibody determination in a normal population, showing a difference of up to 20-fold in the mean IgG titers between the youngest children and adults, was used to establish age-correlated upper normal values. IgM antibodies were found to be of little diagnostic value since their response was often low or absent. Increased IgG titers were found in 24 of 27 (89%) patients with endocarditis, in 11 of 14 (79%) with complicated septicemia, and in 10 of 20 (50%) with uncomplicated septicemia with serum samples drawn between days 7 and 30 of disease. With paired samples, the numbers of patients with increased IgG titers were 17 of 17, 3 of 4, and 6 of 7, respectively, in the same patient groups. Increased IgG titers were less often demonstrated in patients with chronic osteomyelitis (7 of 22). The enzyme-linked immunosorbent assay for teichoic acid antibodies was found to be a sensitive and specific method for diagnosing staphylococcal endocarditis and septicemia. For optimal results, both the substantial age-correlated variation in normal titers and the importance of adequately spaced samples should be considered.