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Serum antibody responses to Clostridium difficile toxin A: predictive and protective?
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Clostridium difficile is a significant human pathogen causing a spectrum of diseases ranging from mild diarrhoea to fulminant pseudomembranous colitis and antibiotic associated diarrhoea, particularly in hospitalised patients. Morbidity and mortality rates are high, especially in the elderly. The main virulence factors of this non-invasive organism are toxin A (enterotoxin) and toxin B (cytotoxin).
This study examined serum antibody responses to toxin A, toxin B, and
non-toxin antigen in 44 hospitalised patients diagnosed with
C difficile associated diarrhoea (CDAD).
Serial serum samples were obtained for antibody measurement at entry to
the study and every three days subsequent until discharge. Serum
samples for each time point were not available for each individual.
This, as Kyne et al report, weakens the
study at the later time points. Serum levels of IgA, IgG, and IgM
against toxin A, toxin B, and non-toxin antigens were measured by
ELISA, although the report concentrates on the
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