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Journal of Clinical Microbiology, February 2001, p. 544-550, Vol. 39, No. 2
Immunology Research and Development Section,
Oxoid Ltd., Basingstoke, United Kingdom
Received 13 July 2000/Returned for modification 21 September
2000/Accepted 30 October 2000
Many of the commercial slide agglutination tests for
Staphylococcus aureus incorporate antibodies against cell
surface antigens associated with methicillin resistance, including
capsular polysaccharides and an uncharacterized antigen, serotype 18. These tests are more sensitive than the first-generation agglutination
procedures that detected only bound coagulase and protein A, but they
suffer from false-positive reactions with some coagulase-negative
staphylococci. The aim of this study was to elucidate the mechanism for
false-positive agglutination by S. epidermidis in these
tests. A group of methicillin-resistant S. aureus (MRSA)
isolates, including a serotype 18 strain, that were not detectable in
the first-generation tests were found to be of capsular polysaccharide
type 8. All of these isolates were deficient in bound coagulase and/or
protein A, and they possessed a heat-stable, proteinaceous antigen that
was absent from a prototype capsule type 8 strain. Enzyme-linked
immunosorbent assay and agarose gel immunodiffusion experiments
demonstrated that this proteinaceous antigen was also present on both
methicillin-sensitive and methicillin-resistant S. epidermidis clinical isolates. S. epidermidis strains
that gave false-positive agglutination test results had a considerably higher level of this antigen than strains that gave the correct negative result. These findings reveal the importance of the careful selection of MRSA strains for raising anti-capsular type 8 antibodies for use in agglutination tests. Strains devoid of the antigen shared
with S. epidermidis should be used to eliminate potential cross-reactions with this coagulase-negative coccus.
0095-1137/01/$04.00+0 DOI: 10.1128/JCM.39.2.544-550.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
A Shared Noncapsular Antigen Is Responsible
for False-Positive Reactions by Staphylococcus epidermidis
in Commercial Agglutination Tests for Staphylococcus
aureus
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Corresponding author. Mailing address: Immunology
Research and Development Section, Oxoid Ltd., Wade Rd., Basingstoke
RG24 8PW, United Kingdom. Phone: 44 (0) 01256 694366. Fax: 44 (0) 01256 463388. E-mail: janet.blake{at}oxoid.com.
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