SUMMARY. TO determine the usefulness of the teichoic acid antibody (TAA) test in conditions where unspecific viral and bacterial antibodies are often encountered, we measured TAA by the gel-diffusion method in 475 patients without known staphylococcal disease; they included 213 patients with arthritis, 108 with liver diseases, 100 with gastro-intestinal disorders and 54 with acute pharyngitis. Positive controls were 104 patients with bacteraemia and 203 healthy adults were negative controls. Thirteen (6%) of the healthy adults had positive TAA titres (≥4), and the highest titre was 8 in two people (1%). Positive titres were found in 38% of patients with bacteraemia and high titres (≥8) were seen in 24%. Among the patients with arthritis, positive TAA titres were found significantly more often than in healthy controls in patients with arthritis (p<0·01) and systemic lupus erythematosus (SLE; p < 0·02). In other patient groups, the percentage of positive TAA titres did not differ significantly from that in healthy adults. Eight (2%) of the 475 patients without known staphylococcal infection had TAA titres ≥8 but these high, titres were not associated with any particular disease group. Only two of these eight patients had slightly raised antibody to staphylococcal α-haemolysin. We conclude that the TAA test cannot be used as a reliable indicator of septic staphylococcal disease in patients with arthritis or SLE, but that in general, TAA titres ≥8 point strongly to infection even in patients with autoimmune or liver diseases.


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