Enzyme-linked immunosorbent assay (ELISA) for antibodies to Clostridium difficile toxins in patients with pseudomembranous colitis and antibiotic-associated diarrhoea

J Immunol Methods. 1983 Jun 10;60(3):341-50. doi: 10.1016/0022-1759(83)90291-0.


Enzyme-linked immunosorbent assay (ELISA) was established with purified toxins from Clostridium difficile as antigen to measure antibody response in patients with pseudomembranous colitis (PMC) and prolonged antibiotic-associated diarrhoea (AAD). Positive ELISA titres were defined in a control population. Antibodies of IgG class against toxin B were demonstrated in 6/88 (7%) control sera and in 31/61 (51%) sera from 11/19 (58%) patients. Antibodies of IgA class were found in one patient while antibodies of IgM class were not demonstrated. ELISA antibodies against toxin A were not demonstrated. For comparison a neutralization test was performed and neutralizing antibodies to toxin B but not to toxin A were demonstrated in 10/61 (16%) sera from 4/19 (21%) patients and in none of the controls. ELISA was found to be a more sensitive assay than neutralization. ELISA antibodies were detected from the third week of the disease while neutralizing antibodies appeared after 5 weeks. Lack of an antibody response in ELISA seemed to correlate to a more severe colitis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / adverse effects*
  • Antibodies, Bacterial / analysis*
  • Bacterial Proteins*
  • Bacterial Toxins / immunology*
  • Clostridium / immunology*
  • Diarrhea / chemically induced*
  • Diarrhea / immunology
  • Diarrhea / microbiology
  • Enterocolitis, Pseudomembranous / immunology
  • Enterocolitis, Pseudomembranous / microbiology*
  • Enzyme-Linked Immunosorbent Assay
  • Humans


  • Anti-Bacterial Agents
  • Antibodies, Bacterial
  • Bacterial Proteins
  • Bacterial Toxins
  • toxB protein, Clostridium difficile