Serum antibody concentrations of cytotoxin, exotoxin, A, lipopolysaccharide, protease, and elastase and survival of patients with Pseudomonas aeruginosa bacteremia.

The relationship between survival and serum concentrations of antibody to cytotoxin, exotoxin A, lipopolysaccharide (LPS; IgM and IgG), protease, and elastase (determined by enzyme-linked immunosorbent assay) was studied in a group of 41 patients with Pseudomonas aeruginosa bacteremia. The lowest mean concentrations of antibody to cytotoxin (P < .05) and of IgG to LPS (P < .01) were noted in the patients who died within 48 hours of onset. The mean level of antibody to cytotoxin in patients who died 9-45 days or 5-22 months following onset was similar to that in controls, while in patients who survived > or = 24 months the level was higher than in controls (P < .01). The mean level of IgG to LPS was highest in patients who survived > or = 24 months. The mean concentrations of antibody to the other antigens (except IgM to LPS) were higher in patients than in controls (P < .01). No significant change occurred in any mean antibody concentrations over time. Administration of antipseudomonal antibodies, especially to cytotoxin and LPS, should be considered in the early stages of therapy for patients with P. aeruginosa bacteremia.