Prognostic value of teichoic acid antibodies in Staphylococcus aureus bacteremia: a reassessment

Teichoic acid antibodies were measured in serum using counter immunoelectrophoresis and immunodiffusion technics with a partially purified antigen. Immunodiffusion titers of greather than or equal to 1:4 were obtained in 15/16 patients with S aureus endocarditis but in only two of 122 noninfected individuals and in no patients with endocarditis caused by other gram-positive bacteria. These same elevated titers of antibody were noted in seven of 23 patients with nonendocarditis S aureus infections. These seven patients all had either prolonged, untreated staphylococcal bacteremia or a primary site of infection which was not promptly eradicated. Six of these seven patients responded to four weeks or less of antimicrobial therapy without developing any complications. The development of high titers of teichoic acid antibodies during the course of S aureus bacteremia could not be reliably used to determine the appropriate duration of antistaphylococcal treatment.