Evaluation of seven different enzyme-linked immunosorbent assays for serodiagnosis of Staphylococcus aureus bacteremia

Objective: Serologic assays for Staphylococcus aureus antibodies were evaluated regarding their ability to differentiate between uncomplicated and complicated S. aureus bacteremia, between S. aureus and non-S. aureus bacteremia, and between S. aureus and non-S. aureus endocarditis. Methods: Enzyme-linked immunosorbent assays (ELISAs) were performed to measure Ig G antibodies against seven S. altreus antigens (peptidoglycan, teichoic acid, S. aureus ultrasonicate, whole S. aureus cells, a-toxin, lipase and capsular polysaccharide) in 129 patients with S. aureus bacteremia (including 51 with endocarditis), 78 patients with non-S. aureus bacteremia (including 27 with endocarditis) and 100 febrile non-bacteremic controls. Results: Whole-cell ELISA was the most sensitive assay. The specificity of all assays was low. Two different combinations of ELISAs for whole cells, teichoic acid, a-toxin, lipase and capsular polysaccharide did distinguish between S. aureus and non-S. aureus endocarditis, but not between uncomplicated and complicated S. aureus bacteremia. (C) 2002 Elsevier Science Inc. All rights reserved