Toxin Involvement in Toxic Shock Syndrome

• Published in: The Journal of infectious diseases Vol. 153; no. 5; pp. 918 - 926
• Main Authors: Crass, Barbara A., Bergdoll, Merlin S.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.05.1986; University of Chicago Press
• Subjects: Adolescent; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antibodies; Antibodies, Bacterial - analysis; Bacterial Toxins; Biological and medical sciences; Convalescence; Diseases; Emergency and intensive care: infection, septic shock; Enterotoxins; Enterotoxins - biosynthesis; Enterotoxins - immunology; Female; Humans; Infections; Intensive care medicine; Male; Medical sciences; Middle Aged; Orginal Articles; Shock, Septic - immunology; Shock, Septic - microbiology; Staphylococcus; Staphylococcus - immunology; Staphylococcus - isolation & purification; Staphylococcus - metabolism; Staphylococcus aureus; Staphylococcus aureus - immunology; Staphylococcus aureus - isolation & purification; Staphylococcus aureus - metabolism; Staphylococcus epidermidis - immunology; Staphylococcus epidermidis - isolation & purification; Staphylococcus epidermidis - metabolism; Superantigens; T tests; Toxicity; Toxins; Staphylococcus aureus; Infection; Human; Toxin; Production; Bacteriosis; Staphylococcal infection; Toxic shock syndrome
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/153.5.918

Cultures for Staphylococcus and sera from 434 individuals with confirmed or probable toxic shock syndrome (TSS) were studied. Three hundred forty-eight (91.6%) of the staphylococcal isolates produced TSS toxin-1 (TSST-1) alone or in combination with one or more staphylococcal enterotoxins. Isolates producing both staphylococcal enterotoxin C and TSST-1 had a higher association with non menstrual and fatal cases than did any other toxin combination. The sera of 284 patients with TSS were tested for antibodies to TSST-1, and 234 (82.4%) had no detectable levelof antibody compared with 80 (77.7%) of 103 healthy controls having antibody levels of ⩾1:800. The sera from patients with TSS also had lower levels of antibody to staphylococcal enterotoxins A, B, and C than did the controls, a result indicating that these subjects may have an immunodeficiency that inhibits the production and/or maintenance of antibodies to the staphylococcal enterotoxins and TSST-1.