ENZYME-LINKED IMMUNOSORBENT ASSAYS FOR DETECTING ANTIBODIES TO SHIGA-LIKE TOXIN-I, SHIGA-LIKE TOXIN-II, AND ESCHERICHIA-COLI O157-H7 LIPOPOLYSACCHARIDE IN HUMAN SERUM

Shiga-like toxin-producing Escherichia coli O157:H7 are important causes of bloody diarrhea and hemolytic uremic syndrome. To facilitate the epidemiologic study of these organisms, we developed enzyme-linked immunosorbent assays (ELISAs) for antibodies to Shiga-like toxin I (SLT I), Shiga-like toxin II (SLT II), and E. coli O157 lipopolysaccharide (LPS). We tested serum samples from 83 patients in two outbreaks of E. coli O157:H7 diarrhea and from 66 well persons. Forty-three patients (52%) had at least one serum sample positive for anti-O157 LPS antibodies; among 26 culture-confirmed patients, 24 (92%) had at least one positive serum sample. Two (3%) of 66 control sera had positive anti-O157 LPS titers. ELISA results for SLT I and II were compared with those of HeLa cell cytotoxicity neutralization assays on both patient and control sera. Neutralization assays detected anti-SLT I antibodies in at least one serum sample from each of 17 (20%) patients and 7 (10.6%) controls, while 16 (19%) patients and 7 controls had positive titers by anti-SLT I ELISA. Although all serum samples, including control sera, showed nonspecific neutralization of SLT II, no antibody titers to SLT II were detected by either neutralization or ELISA. These results indicate that ELISAs for SLT I and SLT II antibodies are comparable to HeLa cell cytotoxicity neutralization assays. Both the ELISAs and neutralization assays are insensitive in detecting infected patients. However, the ELISA for antibodies to E. coli O157 LPS is both sensitive and specific, and may be more useful than assays for antitoxic antibodies in detecting persons with E. coli O157:H7 infection.