Detection of teichoic acid antibodies in children with staphylococcal infections

The presence of serum antibodies to teichoic acid was evaluated by gel diffusion and enzyme-linked immunosorbent assay in 14 patients with deep-seated staphylococcal infection, in 5 patients with superficial staphylococcal infections, in 10 patients with Gram-positive infections other than staphylococcal and in 12 age-matched, uninfected patients. Serum samples were obtained on admission and serially each week during hospitalization. Teichoic acid antibodies were detected by gel diffusion in only 5 of 14 patients with deep-seated staphylococcal infections, in 1 of 10 patients with other Gram-positive infections and in none of the other patients. With the enzyme-linked immunosorbent assay method all patients with deep-seated staphylococcal infections had concentrations of teichoic acid antibodies of 1:1600 or greater, and these titers were significantly larger than those in the other groups of patients. Using a titer of 1:3200 or greater as a diagnostic level in children with deep-seated Staphylococcus aureus infections, the sensitivity was 93% and the specificity was 89%. For all staphylococcal infections the sensitivity was 79% and the specificity was 96%.