Guidelines for the Use of the Teichoic Acid Antibody Assay

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Abstract
In this issue of the Archives, Wheat et al1 describe the efficacy of a commercially available teichoic acid antibody assay kit (ENDO-STAPH, Meridian Diagnostics Inc, Cincinnati) to identify the presence of serum antibodies to the cell-wall, teichoic acid moiety of Staphylococcus aureus. The test kit will permit every hospital laboratory to perform this simple but clinically important test, which should be done sequentially in every case of S aureus bacteremia. See also p 261. Crowder and White2 originally observed that patients with endocarditis due to S aureus usually have a high titer of teichoic acid antibodies. Subsequently, Tuazon et al3 first noted the strong association between the presence of such antibodies and the evolution of metastatic complications following an episode of bacteremia. The metastatic complications include endocarditis and clinical evidence of seeding to bones, joints, meninges, brain, or other viscera (including a positive urine culture in an

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