Serological tests for staphylococcal infection.

The need for a reliable serological test for occult staphylococcal infection has long been evident, especially for the diagnosis of lesions of the spine and hip. Earlier reports on the use of the anti-a-haemolysin (Lack and Shelswell, 1955; Lack, 1957), and anti-leucocidin tests (Towers and Gladstone, 1958; Towers, 1961) have placed us in a position to compare the value of these two tests; antibodies to staphylocoagulase and staphylokinase have also been measured in the sera of patients with osteomyelitis, and the antibody response to these four antigens is contrasted. In the known cases of staphylococcal disease serial determinations were made at regular intervals for at least six months, but only the highest titre of each antibody is included in the Tables. The majority of the patients whose sera we have tested were in the Royal National Orthopaedic Hospital; the remainder were in other hospitals in Britain. The sera were inactivated at 56' C. for 30 minutes and stored at -20' C. until tested. Bacteriological confirmation of the staphylococcal infection was always sought but not always obtained. Antibody levels which rose after the onset of the disease usually fell as the disease subsided. The methods used in the four serological tests are described in the Appendix to this paper.