Antibody response to teichoic acid and peptidoglycan in Staphylococcus aureus osteomyelitis.

An enzyme-linked immunosorbent assay was used to evaluate the immunoglobulin G (IgG) response to Staphylococcus aureus crude teichoic acid (TA) and peptidoglycan (PG) in both rabbits and patients with osteomyelitis. In rabbits with experimental S. aureus osteomyelitis, elevated levels of IgG to TA were present in 13/18 (72%) of the serum samples obtained at 4 and 10 weeks postinfection. In contrast, only 5/18 (28%) of these sera were found to be positive for antibodies to PG. Of a total of 39 patients with confirmed S. aureus osteomyelitis (11 acute, 28 chronic), IgG to TA was elevated in 17 (44%), whereas antibodies to PG were found to be increased in only 1 (3%). Cross-reacting antibodies to S. aureus TA were detected in only 1/18 (6%) of the patients with osteomyelitis caused by organisms other than S. aureus. These studies indicate that IgG to TA is more prevalent than IgG to PG in patients with staphylococcal osteomyelitis. Although these results are encouraging, a larger number of patients is required for an adequate evaluation of the TA enzyme-linked immunosorbent assay for the diagnosis and management of suspected S. aureus osteomyelitis.