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Serological detection of Gram-positive bacterial infection around prostheses

M. Rafiq, FRCS, Research Fellow1; T. Worthington, Research Student2; S. E. Tebbs, PhD, Research Fellow2; R. B. C. Treacy, FRCS, Consultant Orthopaedic Surgeon1; R. Dias, MRCS, Orthopaedic Registrar1; P. A. Lambert, DSc, Reader3; and T. S. J. Elliott, FRC Path, Consultant Microbiologist2

1 Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham B31 2AP, UK.
2 Department of Clinical Microbiology, University Hospital, Edgbaston, Birmingham B15 2TM, UK.
3 Microbiology Research Group, Pharmaceutical Sciences Institute, Aston University, Birmingham B4 7ET, UK.

Correspondence should be sent to Professor T. S. J. Elliott.

Coagulase-negative staphylococci produce an exocellular glycolipid antigen which has potential as a serological marker of infection in bone. The value of this newly detected antigen was investigated by enzyme-linked immunosorbent assay (ELISA) in 15 patients with culture-proven infection of prostheses caused by Gram-positive bacteria. The antigen was purified by gel-permeation chromatography from the culture supernatants of coagulase-negative staphylococci grown in a chemically defined medium.

There were significant differences (p < 0.0001) between the serum IgG and IgM levels in patients with infection due to Gram-positive staphylococci and those of a control group of 32 patients with no infection. The ELISA test, which has potential for the diagnosis of infection, may be valuable in distinguishing between staphylococcal infection around prostheses and aseptic loosening.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General