The serological diagnosis of staphylococcal infective endocarditis

R.W. Watkin, S. Lang, Peter A. Lambert, W.A. Littler, Tom S.J. Elliott

Research output: Contribution to journalArticle

Abstract

Objectives: Establishing the diagnosis of infective endocarditis (IE) can be difficult when blood cultures remain sterile or echocardiography is inconclusive. Staphylococcus aureus is a common aetiological microorganism in IE and is associated with severe valvular destruction and increased mortality. Early diagnosis using culture and antibiotic independent tests would be preferable to allow prompt antibiotic administration. We have developed and evaluated 2 serological assays for the rapid identification of a staphylococcal aetiology in infective endocarditis. The assays measure IgG against whole cells of S. aureus and IgG against lipid S, a novel extracellular antigen released by Gram-positive microorganisms. Methods: Serum was collected from 130 patients with IE and 94 control patients. IgG against whole cells of S. aureus and against lipid S was measured by enzyme linked immunosorbent assay (ELISA). Results: Anti-lipid S IgG titres were higher in IE caused by Gram-positive microorganisms than in controls (p < 0.0001) and higher in staphylococcal IE than in both controls and IE caused by other microorganisms (p = 0.0003). Anti-whole cell staphylococcal IgG was significantly higher in serum from patients with staphylococcal IE than in IE caused by other microorganisms and control samples (p < 0.0001). Conclusion: High anti-whole cell IgG titres are predictive of a staphylococcal aetiology in IE. Elevated serum anti-lipid S IgG titres are predictive of Gram-positive infection compared to controls, very high titres being associated with staphylococcal IE. © 2005 The British Infection Society.

Original languageEnglish
Pages (from-to)301-307
Number of pages7
JournalJournal of Infection
Volume53
Issue number5
DOIs
Publication statusPublished - Nov 2006

Fingerprint

Endocarditis
Immunoglobulin G
Lipids
Staphylococcus aureus
Serum
Anti-Bacterial Agents
Infection
Echocardiography
Early Diagnosis
Enzyme-Linked Immunosorbent Assay
Antigens
Mortality

Keywords

  • endocarditis
  • serology
  • staphyloccocal

Cite this

Watkin, R.W. ; Lang, S. ; Lambert, Peter A. ; Littler, W.A. ; Elliott, Tom S.J. / The serological diagnosis of staphylococcal infective endocarditis. In: Journal of Infection. 2006 ; Vol. 53, No. 5. pp. 301-307.
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The serological diagnosis of staphylococcal infective endocarditis. / Watkin, R.W.; Lang, S.; Lambert, Peter A.; Littler, W.A.; Elliott, Tom S.J.

In: Journal of Infection, Vol. 53, No. 5, 11.2006, p. 301-307.

Research output: Contribution to journalArticle

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T1 - The serological diagnosis of staphylococcal infective endocarditis

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AU - Lang, S.

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