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Serum antibody response to clostridium difficile toxins in patients with clostridium difficile diarrhoea

Serum-Antikörper-Antwort auf Clostridium difficile-Toxine bei Patienten mit Clostridium difficile-Diarrhoe

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Summary

Consecutive serum samples from 61 patients withClostridium difficile diarrhoea were investigated for antibody response toC. difficile toxins A and B in an indirect enzyme immunoassay (ELISA) and in a neutralization assay againstC. difficile cytotoxin. Sera from 64 blood donors, elderly healthy females and patients with other known intestinal enteropathogens served as controls. An immune response was detected by ELISA in approximately half of the patients withC. difficile diarrhoea. The specificity of the ELISA was 94% or 97%, depending on the control material used. Furthermore, a correlation was found between clinical recovery without relapse ofC. difficile diarrhoea and high IgG titers to toxin B in the ELISA, and/or appearance of neutralizing antibodies. It is concluded that the ELISA for detection of serum antibodies toC. difficile toxins may be of diagnostic value in combination with the conventional tissue culture assay for cytotoxin in stool. High ELISA IgG titres to toxin B and/or the appearance of neutralizing antibodies may also be a positive prognostic sign in patients withC. difficile diarrhoea.

Zusammenfassung

Von 61 Patienten mitClostridium difficile-Diarrhoe wurden konsekutive Serumproben mit einem indirekten Enzymimmunassay (ELISA) und einem Neutralisationstest fürC. difficile Cytotoxin auf die Antikörperantwort gegen die Toxine A und B vonC. difficile untersucht. Als Kontrollen wurden Seren von 64 Blutspendern, älteren gesunden Frauen und Patienten, die an Krankheiten durch andere bekannte enteropathogene Erreger litten, verwendet. Bei annähernd der Hälfte der Patienten mitC. difficile-Diarrhoe wurde mittels ELISA eine Immunantwort entdeckt. In Abhängigkeit vom Kontrollmaterial ergab sich für den ELISA-Test eine Spezifität von 94% oder 97%. Bei Patienten, die sich ohne Rezidiv von derC. difficile-Diarrhoe erholten, bestand eine Korrelation zu hohen IgG-Titern gegen Toxin B im ELISA-Test und/oder Auftreten von neutralisierenden Antikörpern. Daraus läßt sich schließen, daß die Bestimmung der Antikörper gegenC. difficile-Toxine im Serum mit ELISA in Kombination mit dem herkömmlichen Gewebekultur-Test auf Cytotoxin von diagnostischem Wert ist. Hohe ELISA IgG-Titer gegen Toxin B und/oder das Auftreten neutralisierender Antikörper im Serum können bei Patienten mitC. difficile-Diarrhoe als positives prognostisches Zeichen gewertet werden.

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Authors and Affiliations

  1. Department of Bacteriology, National Bacteriological Laboratory, S-105 21, Stockholm

    B. Aronsson M.D. Ph.D.,  M. Granström,  R. Möllby &  C. E. Nord

  2. Department of Infectious Diseases, Karolinska Institute, Roslagstull Hospital, Box 5651, S-114 89, Stockholm

    B. Aronsson M.D. Ph.D.

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  1. B. Aronsson M.D. Ph.D.
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  2. M. Granström
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  3. R. Möllby
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  4. C. E. Nord
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Aronsson, B., Granström, M., Möllby, R. et al. Serum antibody response to clostridium difficile toxins in patients with clostridium difficile diarrhoea. Infection 13, 97–101 (1985). https://doi.org/10.1007/BF01642866

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  • DOI: https://doi.org/10.1007/BF01642866

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