Serum antibody response to toxins A and B of Clostridium difficile

J Infect Dis. 1983 Jul;148(1):93-100. doi: 10.1093/infdis/148.1.93.


An enzyme-linked immunosorbent assay (ELISA) for the detection of antibodies to toxins A and B of Clostridium difficile was developed. Serum samples from 340 patients were tested for determination of the age-related prevalence of antitoxin. Antibody to toxin A was present in 64% of patients more than two years old and antibody to toxin B in 66% of patients more than six months old. A strongly positive ELISA value correlated with the presence of cytotoxicity-neutralizing antibody (P less than 0.001). Strongly positive ELISA values were obtained more commonly in convalescent sera from 16 patients with C difficile-induced colitis than in sera from the control population (antibody to toxin A, P less than 0.05; antibody to toxin B, P less than 0.001). Testing of paired sera revealed significant increases in the titer of IgG antibody to toxin A or B. Ten of the 16 patients with colitis had IgM titers of greater than or equal to 1:160 to one or both toxins. The data presented suggest that antibodies to toxins A and B are present in the majority of older children and adults and that patients with C difficile-induced disease develop serologic responses to one or both toxins.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibodies, Bacterial / biosynthesis*
  • Bacterial Proteins*
  • Bacterial Toxins / immunology*
  • Child
  • Child, Preschool
  • Clindamycin / administration & dosage
  • Clostridium Infections / complications*
  • Clostridium Infections / drug therapy
  • Clostridium Infections / immunology
  • Cytotoxins / pharmacology
  • Enterocolitis, Pseudomembranous / etiology
  • Enterocolitis, Pseudomembranous / immunology*
  • Enterotoxins / immunology*
  • Humans
  • Immunoglobulin G / analysis
  • Immunoglobulin M / analysis
  • Infant
  • Infant, Newborn
  • Middle Aged
  • Neutralization Tests


  • Antibodies, Bacterial
  • Bacterial Proteins
  • Bacterial Toxins
  • Cytotoxins
  • Enterotoxins
  • Immunoglobulin G
  • Immunoglobulin M
  • tcdA protein, Clostridium difficile
  • toxB protein, Clostridium difficile
  • Clindamycin