We reported the analytical interference of anti-Escherichia coli protein (EP) antibodies in human sera and residual EP in a recombinant nucleocapsid protein-based enzyme-linked immunosorbent assay as a possible source of false positives in severe acute respiratory syndrome serodiagnosis. The rate of false positives was significantly reduced by adding mouse anti-EP antiserum in the blocking step.Severe acute respiratory syndrome (SARS) is an emerging infectious disease caused by a zoonotic coronavirus (CoV) named SARS-CoV (12). The viral nucleocapsid (N) protein is composed of 422 amino acids with an estimated molecular mass of 46 kDa (3, 10). Currently, several recombinant N protein (rNP)-based serodiagnostic systems that use either antigen-capturing (4, 8, 15) or indirect (6, 17, 19, 22) enzyme-linked immunosorbent assay (ELISA) systems have been developed. However, small portions of false positives have been reported (11,20,23), making this diagnostic tool less favorable for the early detection of possible resurfacing SARS infections. As the presence of anti-EP antibodies (Ab) in sera of healthy humans has been widely reported (5, 9, 14), herein we hypothesize that the interactions between the residual Escherichia coli proteins (REP) present in the coating antigen and the naturally occurring anti-E. coli protein (anti-EP) antibodies in healthy humans may serve as a potential interference (21).In this study, 14 overlapping fragments encoded by the complete open reading frame of the N gene of strain HK-39849 (24), designated rNP 1 to rNP 14 , were expressed using a pRSET protein expression system (Invitrogen) and purified by use of nickel-charged Sepharose FastFlow matrix (Amersham Biosciences) according to the manufacturer's instructions. As was found in other studies (2, 7, 13, 16), rNP 5 (amino acids 72 to 422) shows the highest antigenicity, which is comparable to that of the full-length rNP (data not shown). We have chosen rNP 5 as the antigen for the subsequent immunoassays due to its relatively high expression level (7.2 g/ml). The purified rNP 5 was analyzed by use of silver-staining-based sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blotting with serum of a convalescent SARS patient showing a single prominent band observed at about 42 kDa (Fig. 1). The purity of rNP 5 was 94.6% as determined by light densitometry (Bio-Rad).The rNP 5 -based ELISA was first assessed by screening serum samples from 300 healthy individuals and 8 convalescent SARS patients. Briefly, wells were immobilized with 50 ng of rNP 5 and washed before a standard blocking procedure with blocking buffer (3% milk powder in phosphate-buffered saline with 0.05% Tween 20). Human serum samples (1:100 [vol/vol]) were then applied, and incubation was performed at 37°C for 25 min, followed by incubation of horseradish peroxidase (HRP)-mouse anti-human immunoglobulin G (IgG) (1:1,000 [vol/vol]; Zymed) for 25 min. Absorbance was measured at 450 nm after the addition of TMB solution (Zymed) and 12% sulfuric acid. The rel...