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Clin. Vaccine Immunol. doi:10.1128/CVI.00215-07
Copyright (c) 2007, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.

Immunological investigations of a potential use of poly-N-acetyl--(1,6)-glucosamine as an antigen for the detection of staphylococcal orthopedic prosthesis-related infections

Laboratoire de Recherche sur les Biomatériaux et les Biotechnologies, Université du Littoral-Côte d'Opale, Bassin Napoléon, BP 120, 62327 Boulogne-sur-mer, France; Département d'Orthopédie de l'Université de Lille, Hôpital Salengro 59037 Lille

^* To whom correspondence should be addressed. Email: jabbouri{at}univ-littoral.fr.

	Abstract

Staphylococcus aureus and coagulase-negative staphylococci are microorganisms most frequently isolated from orthopedic implant-associated infections. Their capacity to maintain these infections is thought to be related to their ability to form adherent biofilms. Poly-N-acetyl--(1,6)-glucosamine (PNAG) is an important constituent of the extracellular biofilm matrix of staphylococci. In the present study, we explored the possibility of using the PNAG as an antigen for detecting antibodies in the blood sera of patients with staphylococcal orthopedic prosthesis-associated infections. First, we tested the presence of anti-PNAG antibodies in an animal model, in the blood sera of guinea pigs that developed an implant-associated infection caused by biofilm-forming, PNAG-producing strains of S. epidermidis. Animals infected with S. epidermidis RP62A showed significantly higher levels of anti-PNAG IgGs than the control group. The comparative study of healthy individuals and patients with staphylococcal prosthesis-related infections showed that (i) relatively high levels of anti-PNAG IgGs are present in the blood sera of the healthy control group, (ii) the corresponding levels in the infected patients were slightly, but not significantly higher and (iii) only one of ten of patients had a level of anti-PNAG IgMs significantly higher that this of the control group.

In conclusion, the encouraging results obtained in the animal study could not be readily applied for the diagnostic of staphylococcal orthopedic prosthesis-related infections in humans, and PNAG does not seem to be appropriate antigen for this purpose. Further studies are necessary to determine whether the developed ELISA method could serve as a complementary test in the individual follow-up treatment of such infections when they are caused by PNAG-producing staphylococci.