Summary
Chronic colonization withStaphylococcus aureus is found in 40–50% of the sputum producing patients with cystic fibrosis treated at Stockholm's Cystic Fibrosis Center, Huddinge University Hospital. 30–40% of these patients had increased ELISA IgG antibody titres against teichoic acid and against alpha-toxin. About half of the number of patients showed increased antibody titres to either antigen during infection. Increased antibody titres against staphylococcal antigenes were only found in ≤10% of patients not chronically colonized with S. aureus (no different from the normal population). The serum titres of antistaphylococcal antibodies were significantly higher in the chronically colonized patients (p<0.001). Patients who were also chronically harbouringPseudomonas aeruginosa had the highest titres of both antibodies. The titres increased with clinical signs of infection and were normalized by antimicrobial chemotherapy. To conclude, the use of ELISA IgG antibodies may prove suitable for routine evaluation of the need for, and control of the efficacy of antistaphylococcal chemotherapy in cystic fibrosis.
Zusammenfassung
Bei 40 bis 50% der Sputum produzierenden Patienten mit zystischer Fibrose, die am Stockholmer Zystische Fibrose Zentrum der Universitätsklinik Huddinge behandelt werden, findet sich eine chronische Kolonisation mitStaphylococcus aureus. 30 bis 40% dieser Patienten zeigten einen Anstieg der mit ELISA bestimmten IgG-Antikörper gegen Teichonsäure und alpha-Toxin. Im Laufe der Infektion traten bei etwa der Hälfte der Patienten Antikörpertiteranstiege gegen eines der Antigene auf. Bei nicht chronisch mitS. aureus kolonisierten Patienten fanden sich in ≤10% der Fälle erhöhte Antikörpertiter gegen Staphylokokkenantigene (kein Unterschied zur Normalbevölkerung). Bei chronisch kolonisierten Patienten waren die Titer an Serumantikörpern gegen Staphylokokkenantigene außerdem signifikant höher (p<0,001). Patienten, die zusätzlich chronisch mitPseudomonas aeruginosa besiedelt waren, wiesen die höchsten Antikörpertiter gegen die beiden Antigene auf. Wenn klinische Infektionszeichen auftraten, stiegen die Titer an, sie normalisierten sich mit der Antibiotikatherapie. Die Bestimmung der IgG-Antikörper mittels ELISA eignet sich möglicherweise für die Routinebestimmung der Notwendigkeit einer anti-Staphylokokken-Therapie bei zystischer Fibrose und für die Bewertung ihrer Wirksamkeit.
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Strandvik, B., Hollsing, A., Möllby, R. et al. Antistaphylococcal antibodies in cystic fibrosis. Infection 18, 170–172 (1990). https://doi.org/10.1007/BF01642107
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DOI: https://doi.org/10.1007/BF01642107