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

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Abstract
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.