Christensson B, Espersen F, Hedström S A, Kronvall G
Scand J Infect Dis. 1985;17(1):47-53. doi: 10.3109/00365548509070419.
Immunoglobulin G antibody levels against Staphylococcus aureus peptidoglycan (PG) and crude staphylococcal antigen (SA) using enzyme-linked immunosorbent assay (ELISA) and antistaphylolysin (ASTA) antibody levels by gel diffusion were determined in 53 patients with S. aureus and 54 patients with non-S. aureus endocarditis and septicemia as compared with 63 febrile control patients. The two ELISAs were the most sensitive assays indicating S. aureus endocarditis in 83% and 88% in the PG- and SA-assays, respectively. 39% of non-S. aureus endocarditis patients were positive in the PG-assay due to antibodies cross-reacting with streptococci. A 100% specificity for S. aureus infections was obtained with the ASTA test, but this assay was less sensitive. A significant rise in anti-PG or anti-SA antibody levels was not only seen among S. aureus infections but also in some streptococcal and S. epidermidis infections as well as in 3 febrile control patients. When at least 2 of the 3 assays showed positive peak antibody levels 1-4 weeks after onset of infection together with a significant rise of both anti-PG and anti-SA antibody levels the S. aureus endocarditis diagnosis was highly suggestive. Thus, we recommend the combined use of these 3 assays using paired serum samples in diagnosing serious S. aureus infections.
采用酶联免疫吸附测定（ELISA）法测定了53例金黄色葡萄球菌感染患者、54例非金黄色葡萄球菌感染性心内膜炎和败血症患者以及63例发热对照患者血清中抗金黄色葡萄球菌肽聚糖（PG）和金黄色葡萄球菌粗抗原（SA）的免疫球蛋白G抗体水平，并通过凝胶扩散法测定了抗葡萄球菌溶血素（ASTA）抗体水平。两种ELISA法是最敏感的检测方法，PG检测法和SA检测法分别在83%和88%的金黄色葡萄球菌感染性心内膜炎患者中呈阳性。39%的非金黄色葡萄球菌感染性心内膜炎患者在PG检测中呈阳性，原因是抗体与链球菌发生交叉反应。ASTA检测对金黄色葡萄球菌感染具有100%的特异性，但该检测方法敏感性较低。抗PG或抗SA抗体水平不仅在金黄色葡萄球菌感染患者中显著升高，在一些链球菌和表皮葡萄球菌感染患者以及3例发热对照患者中也有升高。当感染发作后1 - 4周，这三种检测方法中至少有两种显示抗体水平呈阳性峰值，且抗PG和抗SA抗体水平均显著升高时，高度提示为金黄色葡萄球菌感染性心内膜炎。因此，我们建议在诊断严重金黄色葡萄球菌感染时，使用这三种检测方法并结合配对血清样本。
