Background Persistent carriers have a higher risk of Staphylococcus aureus infections than noncarriers but a lower risk of bacteremia-related death. Here, the role played by anti-staphylococcal antibodies was studied

Methods Serum samples from 15 persistent carriers and 19 noncarriers were analyzed for immunoglobulin (Ig) G, IgA, and IgM binding to 19 S. aureus antigens, by means of Luminex technology. Nasal secretions and serum samples obtained after 6 months were also analyzed

Results Median serum IgG levels were significantly higher in persistent carriers than in noncarriers for toxic shock syndrome toxin (TSST)–1 (median fluorescence intensity [MFI] value, 11,554 vs. 4291; P<.001) and staphylococcal enterotoxin (SE) A (742 vs. 218; P<.05); median IgA levels were higher for TSST-1 (P<.01), SEA, and clumping factor (Clf) A and B (P<.05). The in vitro neutralizing capacity of anti–TSST-1 antibodies was correlated with the MFI value (R ² =0.93) and was higher in persistent carriers (90.6% vs. 70.6%; P<.05). Antibody levels were stable over time and correlated with levels in nasal secretions (for IgG, R ² =0.87; for IgA, R ² =0.77)

Conclusions Antibodies to TSST-1 have a neutralizing capacity, and median levels of antibodies to TSST-1, SEA, ClfA, and ClfB are higher in persistent carriers than in noncarriers. These antibodies might be associated with the differences in the risk and outcome of S. aureus infections between nasal carriers and noncarriers