The teichoic acid antibody is measured to diagnose infections caused by Staphylococcus aureus. Teichoic acid attaches to the organism's cell wall. High titers are associated with invasive infections such as bacterial endocarditis and osteomyelitis.

• Teichoic acid antibody titer <1:2

• Improper technique in testing

• Suspected infection caused by S. aureus
• Diagnosis of osteomyelitis or endocarditis caused by a bacterial infection
• Monitoring of ongoing therapy administered for gram-positive bacterial infections

Nursing Care Before the Procedure

Client preparation is the same as for any study involving the collection of a peripheral blood sample (see Appendix I).

• Inform the client that repeat or serial blood sampling and testing can be performed.

A venipuncture is performed and the sample collected in a red-topped tube. The tube should be labeled as an acute or convalescent sample, whichever applies.

Nursing Care After the Procedure

Care and assessment after the procedure are the same as for any study involving the collection of a peripheral blood sample.

• Inform the client of the time to return for a repeat test, usually in 2 weeks, to determine the change in titers between the acute and convalescent stages.
• Abnormal values: Note and report increases in titers. Assess for signs and symptoms associated with staphylococcal infections such as temperature elevation, bone pain in osteomyelitis, and changes in heart sounds in endocarditis. Administer ordered analgesic and antibiotic therapy and instruct in preventive antibiotic therapy in those at risk.