Early diagnosis of clostridial gas gangrene using sialidase antibodies.

In order to improve the diagnosis of gas gangrene, especially at an early stage of infection, new ways for the detection of the responsible Clostridia were investigated. Sialidase, known to be excreted in large amounts by the most frequently occurring myonecrotizing clostridial species, Clostridium perfringens, Clostridium septicum, and Clostridium sordellii, was isolated. With polyclonal antibodies raised against these enzymes, two immunological assays were established, which are directed against the sialidase activity (sialidase inhibition test) and the enzyme protein ('sandwich'-ELISA), respectively. Using these assays, species-specific information about the presence of clostridial sialidase was obtained within 50 min or 6 h. Animal tests revealed that both assays are applicable 8-12 h after clostridial infection, using resected tissues or wound fluids for estimations. The assays allow specific, sensitive, and quantitative measurement of clostridial sialidases, and no significant interference by sialidases from other microbes or from host tissues occurred. The applicability of the new assays for an early diagnosis of gas gangrene in human patients is discussed.

Sialidase activity in the sera of patients and rabbits with clostridial myonecrosis.

The origin and nature of gas gangrene can be diagnosed exactly only by time-consuming bacteriological tests. In order to improve the diagnostic procedures, rabbits were infected with strains of Clostridium perfringens, Clostridium septicum or Clostridium sordellii. Sialidase activity was found to increase rapidly in serum; elevated creatine kinase activities were observed, too. High sialidase concentrations were found in sera (up to 1.6 mU/ml) and in tissues of wounded regions (up to 110 mU/g) of patients diagnosed to be infected with C. perfringens. By inhibition of enzyme activity with antibodies specific for the sialidase from this Clostridium species, it was possible to identify the clostridial origin of the sialidase activities. In the same material from other patients supposed to suffer from gas gangrene, but where no Clostridia could be detected, significant sialidase activity was not found. Thus, sialidase may be a useful tool for the diagnosis of myonecrosis due to clostridial infection.