Measurement of antibody responses to pneumolysin--a promising method for the presumptive aetiological diagnosis of pneumococcal pneumonia.

An enzymeimmunoassay (EIA) for measuring antibodies to pneumococcal pneumolysin has been developed. The method was used to study the possible pneumococcal aetiology of pneumonia in 159 mostly elderly patients admitted to hospital because of a positive chest X-ray. The results obtained with the assay were compared to those obtained by other diagnostic methods, namely blood culture, detection of pneumococcal antigen in urine and demonstration of an antibody response to pneumococcal C-polysaccharide and capsular polysaccharides. Antibody response to pneumolysin was found in 32 of 39 (82%) patients with pneumococcal pneumonia aetiologically diagnosed presumptively by other methods. In addition, the EIA for pneumolysin antibodies was positive in 31 patients without evidence of pneumococcal aetiology by other methods. The clinical and laboratory investigations of these patients supported the presumption of bacterial infection. We conclude that the EIA we have developed for measuring pneumolysin antibodies is a promising, sensitive method for the presumptive aetiological diagnosis of pneumococcal pneumonia. The assay is simple to perform because only one antigen is needed and measurement of IgG antibodies alone seems to be enough for aetiological diagnosis.