Evaluating a pathogen-specific IgG binding assay for rapid detection of healthcare-associated infections

Abstract

Rapid and accurate diagnosis of healthcare-associated infections (HAIs) is an unmet need for improving outcomes in intensive care units (ICUs). Traditional culture-based methods, while the gold standard, are time-consuming and can delay therapeutic interventions. In this study, we evaluated the diagnostic utility of pathogen-specific immunoglobulin G (IgG) binding levels using an enzyme-linked immunosorbent assay (ELISA). We measured IgG binding against pathogens including Acinetobacter baumannii, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Enterococcus faecalis, Enterococcus faecium, and Staphylococcus aureus. Diagnostic performance was evaluated through receiver operating characteristic (ROC) curve analysis, with culture results as the reference. The assay demonstrated an overall diagnostic accuracy of 83.2%, with a sensitivity of 85.4%, a specificity of 81.4%, and an area under the curve (AUC) of 0.910. Pathogen-specific cutoff values ranged from 0.918 to 1.534. Especially, A. baumannii showed the highest performance metrics, achieving a sensitivity of 94.7%, a specificity of 93.6%, and an AUC of 0.975. The pathogen-specific IgG binding levels can offer a novel and effective diagnostic tool for the initial assessment of HAIs, enhancing early detection and improving patient management across healthcare settings.