ANTIBODY-RESPONSE IN STAPHYLOCOCCUS-AUREUS SEPTICEMIA - A PROSPECTIVE-STUDY

Formation of serum antibodies against alpha-toxin, teichoic acid and l ipase was followed in 63 patients with Staphylococcus aureus septicaem ia in 240 consecutive serum samples. Control subjects comprised 23 pat ients with septicaemia due to other causes and 21 febrile patients wit hout septicaemia. An antibody response against alpha-toxin, measured b y ELISA, was most common (40%) in the initial serum, but antibody to t eichoic acid was present in the highest number of positive patients (6 0%) when samples were drawn between 0 and 30 days: 74% of the patients showed a positive antibody response to at least one of the three anti gens. When complicated versus uncomplicated septicaemia was compared ( samples taken 8-14 days), 14 (45%) of 31 patients had a positive respo nse against alpha-toxin versus 12 (75%) of 16, against teichoic acid 1 6 (51%) of 31 versus 12 versus (75%) of 16 and against lipase 15 (48%) of 31 versus 8 (50%) of 16. Patients with low initial antibody levels displayed a poorer antibody response than those with higher initial a ntibody levels. This phenomenon was observed with all three antigens, but was most pronounced with alpha-toxin. The initial antibody levels may predict the antibody response during the course of the disease. EL ISA titres against alpha-toxin correlated (r = 0.87) with biological n eutralising activity of the antisera. The results may indicate a biolo gical role of serum antibodies in staphylococcal septicaemia.